| Hyperlipidemia(HLP)affects millions of people each year.Hepatitis B is a worldwide disease,too.OBI(occult HBV infection)is defined as the presence of detectable HBV DNA in serum or liver tissue but undetectable HBV surface antigen in serum.It is pointed out the correlations among hyperlipidemia and hepatitis B infection,liver fibrosis.However,correlations among OBI and hyperlipidemia,liver fibrosis have not been reported yet.Objective:To study the prevalence of OBI in patients with hyperlipidemia or liver fibrosis.To clarify the histopathological changes in OBI patients and molecular characteristics of OBI patients.Methods:In the Chaper one,1036 HLP patients and 1134 replacement blood donor controls were recruited.Among them,252 HLP patients and 255 blood donors with antibody to HBV core were selected and analyzed.HBV-DNA was confirmed by nucleic acid testing assays,and nucleotide mutations were analyzed.In chapter two,1814 patients with abnormal liver fibrosis indexes were selected.The population was tested for serum biochemical activity of hepatic enzymes(AST,ALT)as well as immune markers(HBsAg,HBsAg,anti HBc,anti HBs,anti HCV and anti HIV).NAT and QPCR tests were designed to detect the load of HBV-DNA in the samples.Liver biopsy,Fibroscan and immunohistochemistry and fluorescence in situ hybridization were conducted in 36 liver biopsy cases(OBIs)and 8 liver biopsy(non-OBIs).Results:Chapter one:1.OBI was detected in 9.5%(24/252)of HLP patients and 2.4%(6/255)of blood donors,respectively(p<0.001).2.Viral load of OBI in HLP patients was higher than that of OBI in blood donors(p<0.05),which was a positive correlation between total cholesterol and HBV viral load levels(r = 0.474 p = 0.019),HBV vaccination rate was found significantly lower in OBI HLP patients than that in non-OBI HLP patients(p<0.01).3.The of BCP/PC fragment amplification in 19 patients were positive(79.17%).9 of which were B(47.37%)and 10 were C(52.63%).Chapter two:1.148 OBI patients(8.15%)in 1814 patients with liver fibrosis were observed.2.36 samples of liver biopsy were all OBI,BCP/PC and Pre S/S fragments were amplified in 36 liver biopsy.The variation of amino acid location in PreS/S region is closely linked to the mechanism of OBI.3.The Mean ± SD value(ng/ml)of liver fibrosis indexes were:HA 100.3±33.5,LN 38.5± 14.8,PCIII 22.5± 13.5,CIV 35.7± 10.7.The Mean ± SD value of LSM in patients with liver biopsy was 12.3±3.6 Kpa,and the Mean ± SD value of FISH IOD score was 16.3±3.6.4 IHC HBsAg,HBcAg positive rates(in 36 liver biopsy)were 2.8%,52.78%,respectively.5.The correlations between hyaluronic acid(HA),the liver histopathological scor-e and HBV DNA load;HBcAg IHC score and HA value;liver hardness(LSM)value and HBV-DNA load were positive.Conclusions:1 The prevalence of OBI was found high in patients among hyperlipidemia and liver fibrosis.2.The control of serum lipid levels may be effective in inhibiting HBV replication.3.We concluded that in liver fibrosis-OBI patients,histopathological HAI score and liver imaging scores were positively correlated with HBV DNA levels,which means the detection of OBI,and control of OBI were important for the liver fibrosis process.4.BCP/PC and PreS/S fragments could be amplified in a subset of OBI-patients with liver fibrosis.It is expected to further to clarify the pathogenesis of OBI in specific populations. |
PDF Full Text Request