高敏PCR在HBV极低病毒载量的慢性乙型肝炎患者中检测的临床意义.docx

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1、病毒性肝炎DOI:10.12449/JCH240308高敏PCR在HBV极低病毒载量的慢性乙型肝炎患者中检测的临床意义丘助钦/，谢丹瞰任小，欧阳Qa.b广州医科大学附属第五医院a.感染性疾病科，b.广东高校生物靶向诊治与康复重点实验室，广州510000阖言储：邸昭,ouyangshi(ORQD:0000-0003-0173-3276)摘要：目的探讨使用高敏PCR在HBV极例声毒载量(HBVDNAlO99IUmL)人群检测中的意义。方法选取2019年9月2022年2月三州医科大哪解五医献受螃(酸)狗以物(NAs)治疗N48周敏HBVDNA*佥则(顾!1佛100IUmL)结果为低于检测下限的慢性乙

2、型肝炎(CHB)患者，进一步行高敏HBVDNA检测(检测下限10IUmL),根据结果分为极低病毒载量(VLVL,HBVDNA1099ImL)组和完溺毒学应答(CVR,HBVDNA10IUmL)的ROC曲线下面积为0.717(P=Q.002),最佳CUtQff值为1214.5IUmL,酸三度为95.5%,特异劭53.9%HBeAg阳性(OR=3.654,95%C:1.16211.489,P=O.027)和qHBsAg(0R=2.985,95%C:1.0588.422,P=O.039)嫌频CVR雌立影响因素.结论CHB患者经普敏检测HBVDNA低于48weeksinTheFifthAffiIiat

3、edHospitalofGuangzhouMedicalUniversityfromSeptember2019toFebruary2022andhadanHBVDNAloadbelowthelowerlimitofordinary-sensitivitydetection(100IUmL).Thenhigh-sensitivityHBVDNAdetectionwasperformedforallpatients,andaccordingtotheseresults,thepatientsWeredividedintoVefylowviralloadgxp(VLVLgroupwithanHBVD

4、NAloadf1099IUmL)andcompletevirdogicresponsegroup(CVRgroupwithanHBVDNAloadof10IUmL),withanoptimalcut-offvalueof1214.5IUmL,asensitivityof95.5%,andaSPeCifidtyof53.9%.PositiveHBeAg(oddsratioOR=3.654,95%confidenceintervalCl:1.16211489,P=0.027)andqHBsAg(OR=2.985,95%C:10588.422,P=O.039)wereindependentinflu

5、encingfactorsforfailuretoachieveCVR.ConclusionSomeCHBpatientshaveanHBVDNAloadof100IUmLbyordinary-sensitivitydetection,butwiththepresenceofVLVLdeterminedbyhigh-sensitivityPCR.TheVLVLgrouphadsignificantlyhigherlevelofinflammatorydamageandpositiveratesofpgRNAandHBeAg.PositiveHBeAgandhighqHBsAglevelarei

6、ndependentinfluencingfectorsforfailuretoachieveCVR.GinidansshouldnotignorethepresenceofVLVLinCHBpatients,andhigh-sensitivityHBVDNAdetectionshouldbeperformedinatimelymanner.Keywords:HepatitisB,Chronic;PolymeraseChainReaction;VeryLowViralLoadResearchfunding:NationalNaturalScienceFoUndationofChina(81803884);TheKeyLaboratoryofGuangdongHigherEducationInstitutes(2021KSYS009);TbeKeyMedicalDisciplinesofGuangzhouProject(20212023);UndergraduateInnovationAbilityEnhancementProgramProject(2