The Relationships Among HBV-M,HBV-DNA Level And Liver Damage In Peoples Above 40 Years With Chronic HBV Infection

【Objective】1. To observe the features of HBV-M and HBV DNA's quantitation in peoples above 40 years with chronic HBV infection.2. To study the relationship between HBV-M and HBV DNA's quantitation in peoples above 40 years with chronic HBV infection.3. To analyze the correlations among serum HBV-M,HBV DNA level and liver damage in peoples above 40 years with chronic HBV infection4. To explore the evidence of the early diagnosis,the choice of therapy,efficacy as well as prognosis and prevention【Methods】1.HBV-M were tested by time-resolved fluorescence immunoassay2.The level of HBV-DNA was detected by real-time quantitative PCR3. The markers of Liver fibrosis were monitored by the radioimmunoassay【Results】1.Male cases account for a majority of all the 500 chronic HBV infected cases, and the sex ratio of males to females is 2.25 ; In all the cases, HBeAg-negative accounts for 67.2% (336/500), the percentage of HBV DNA level lower than 103copise/ml is 35.2%(176/500); When classifying hepatitis by clinic, LC,HBeAg- negative CHB,inactive HBsAg carrier,HBeAg-positive CHB,chronic HBV carrier account for 43.4%,19.6%,15.6%,14%,7.4% respectively; classifying hepatitis by natural history of CHB, show : immune escape phase,immune control phase,immune clearance phase,immune tolerant phase account for 34.8%,34.0%,25.0%,6.2% respectively.2. The quantity test of HBV-M in 500 samples aged over 40 years with chronic HBV infection display that the serum HBsAg level is a normal distribution, serum HBeAg level is a abnormal distribution, The logarithm of serum HBV DNA level is a approximately normal distribution.3. When we Classify hepatitis by clinic,the mean of HBsAg of chronic HBV carrier and HBeAg-positive CHB is higher than other three teams(P﹤0.01); The mean of HBsAg is lower and lower along with the development of CHB natural history when classifying hepatitis by natural history; Similarly, the mean of HBsAg in HBeAg- positive CHB team is higher than HBV-DNA positive team.4. The serum HBeAg level is the highest in HBeAg- positive CHB group according to the clinical classification, and its second highest is in chronic HBV carrier group;when classifying by natural history, the serum HBeAg level is the highest in immune tolerant phase group, and its second highest is in immune clearance phase group; While study the serum HBV DNA level,there is the highest in HBeAg-positive CHB team, and its second highest is in LC team in clinical classification,.5. HBeAg,HBeAb have significant correlation with HBV DNA level, r=0.54**(p<0.01),r=-0.487**(p<0.01) respectively. And the correlation coefficient between HBsAg and HBV DNA is 0.292(p<0.01). In HBV DNA positive group, the correlation coefficient is 0.131(p<0.05) between HBsAg and HBeAg.6. There have asignifican correlation in HBeAg level,HBeAb level and HBV DNA leve with liver damage . HBsAg level and HBsAb level have a correlation with liver damage, too. In liver function tests, the ALB is the lowest in LC team, and also lower than other teams(P<0.01); Similarly, we found ALB is lower in HBeAg positive team and HBV-DNA positive team than in HBeAg-team and HBV-DNA negative team(P<0.01).7. In fours serum markers of liver fibrosis, all HA level is higher than normal in 500 samples, and the highest is in LC team, and then is in HBeAg-positive CHB team;There is a difference that PCⅢlevel,LN level,ⅣC level are highest in HBeAg- positive CHB team, and then are in LC team; Also classifying by natural history, these four markers are highest in immune clearance phase, and secondly in immune tolerant phase.8. To do comparative analysis on difference between HBeAg-positive CHB and HBeAg- negative CHB, show: male cases is more than female cases in HBeAg- negative CHB team, and the average age of HBeAg- negative CHB team is older than HBeAg-positive CHB team(P>0.05); The mean of HBsAg is higher in HBeAg-positive CHB team than in HBeAg- negative CHB team(P<0.01); In the differences of all liver function tests, the bilirubin's difference is significant (P>0.05), The means of fours serum markers of liver fibrosis are all higher in HBeAg-positive CHB team than in HBeAg- negative CHB team, but only HA have statistically significance .【Conclusion】1. There is very important significance for the early diagnosis ,effective observation and refectious judgement of chronic hepatitis B by HBV-M and HBV-DNA`s quantitative detection through the TRFIA and the Real-time quantitative PCR.2. There is normal distribution about HBsAg in peoples over 40 years with chronic HBV infection, and HBsAg has certain differences and statistical significance in different clinical types and stages in the natural history of CHB , which all indicate : HBsAg closely with activity of HBV and condition changes of the CHB patient.3. HBeAg and HBV-DNA , followed by HBsAg in patients of 40 years above with chronic HBV infection has a better positive correlation , so the combination of HBeAg,HBsAg with HBV-DNA would be more instructive for the judgments of replication of HBV.4. When we study the correlation between HBV-M level and HBV-DNA level, we found there has better correlation in HBeAg,HBV-DNA and liver damage , and we found the ALB, AST, HA andⅣC are the main aspects.5. When we further study HBeAg -positive CHB and HBeAg (-) CHB in patients over 40 years with chronic HBV infection, showed: Although there is difference among them, but not statistically significant. The reason of the results may be the differ of study samples and methods .