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目的探讨ＨＣＶ与ＨＢＶ重叠感染对慢性肝病过程、预后及对乙型肝炎病毒复制的影响。方法应用第二代抗＿ＨＣＶＥＬＩＳＡ及ＲＴ＿ＰＣＲ法测定１８７例ＨＢｓＡｇ阳性慢性肝病患者抗＿ＨＣＶ及ＨＣＶ＿ＲＮＡ，并对ＨＣＶ与ＨＢＶ重叠感染者的肝损害，ＨＣＶ，ＨＢＶ间的相互作用及预后进行分析。结果抗＿ＨＣＶ，ＨＣＶ＿ＲＮＡ的阳性率在慢性肝炎（轻度）１３．３％，慢性肝炎（中～重度）１６．１％，肝硬变２２．７％，慢性重型肝炎６３．６％，肝细胞癌１３．３％。平均阳性率１８．２％，慢性重型肝炎抗＿ＨＣＶ，ＨＣＶ＿ＲＮＡ的检出率最高，明显高于肝脏损害的其他肝病（Ｐ＜０．０５），近半数以上ＨＣＶ慢性感染已与ＨＢＶ重叠感染。结论ＨＣＶ与ＨＢＶ重叠感染的慢性肝病患者预后较差。但并未发现ＨＣＶ对ＨＢＶ复制具有阻遏作用。
Objective To investigate the influence of HCV and HBV over-infection on the course of chronic liver disease, prognosis and hepatitis B virus replication. Methods The anti-HCV and HCV RNA of 187 HBsAg-positive patients with chronic liver disease were detected by the second-generation anti-HCV ELISA and RT-PCR. The liver damage, the interaction between HCV and HBV and the prognosis were analyzed. Results The anti-HCV and HCV RNA positive rates were 13.3% in chronic hepatitis (mild), 16.1% in chronic hepatitis (moderate to severe), 22.7% in cirrhosis, 63.6% in chronic severe hepatitis, Cancer 13.3%. The average positive rate was 18.2%. The detection rate of anti-HCV and HCV_RNA of chronic severe hepatitis was the highest, significantly higher than that of other liver diseases with liver damage (P <0.05). Over half of HCV chronic infections had been infected with HBV. Conclusion The prognosis of patients with chronic liver disease with overlapping HCV and HBV infection is poor. However, no HCV was found to have a suppressive effect on HBV replication.