The clinical analysis of serum HBsAg and HBsAb double positive in hepatitis B patients / 实用医学杂志

ABSTRACT

Objective Study of the rare hepatitis B virus patients model cases which both the hepatitis B surface antigen (HBsAg) and hepatitis B surface antibody (HBsAb) were positive, and discussion of its cause and the clinical value. Methods serum markers of hepatitis B virus (HBV-M) was detected by microparticle enzyme immunoassay chemiluminescence (MEIA); HBV-DNA was detected by fluores--cence quantitative PCR method, alanine aminotransferase and aspartate aminotransferase were detected by colorimetric, and all the data were combined with the clinical features of patients for comprehensive analysis. Results 1) HBsAg and HBsAb double positive detection rate was 2.3％ in 15600 cases of hepatitis B patients, there was no significant difference in the positive rate of different sex groups and different age groups (P> 0.05); 2) HBsAg, HBsAb, HBeAb, HBcAb positive mode accounted for the highest proportion in all HBsAg and HBsAb double positive cases, the percentage was 57.9％; 3) the positive rate of HBV DNA in hepatitis B patients with HBeAg positive rate were higher than HBeAg negative group in all HBsAg and HBsAb double positive cases; and the incident rate of double variation nt 1762 A-T/nt 1764 G-A in HBeAg negative group was higher than that in HBeAg positive group. There were significant differences between two groups (P < 0.05); 4) the detection rate of HBsAg and HBsAb double positive in patients with chronic hepatitis B were higher than those of asymptomatic carriers, liver cirrhosis, hepatitis B and hepatitis B hepatocellular carcinoma (P < 0.05). Conclusion The phenomenon of both positive HBsAg and HBsAb does not indicate the elimination of the hepatitis B virus infection, but it is likely suggested the mutation of the virus. It is necessary to prompt clinical detection of serum HBV DNA, so as to determine whether the virus in patients is in the replication status, and it also provide some help for clinical individualized treatment of HBsAg and HBsAb double positive patients.