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慢性乙肝基础上重叠急性甲肝(HAV)感染可以抑制乙肝病毒的复制。在鹿特丹男性同性恋者中爆发急性甲肝时,研究者详细观察了1例慢性乙肝患者在HAV感染早期的情况。 1例33岁男性同性恋者自1995年起HBeAg阳性。1996年经IFN治疗4个月无效。1997年8月起予拉咪夫定150mg每天口服,8周后HBV DNA滴度下降,但仍阳性。24周后ALT、AST及黄疸突然升至高峰。病毒血清学检测提示重叠急性甲肝感染。血清转氨酶升高前测到自体产生的IFN-γ,IL-10水平高峰,同时IFN-α、IL-12、TNF-α低于可检测水平,并测到HBV DNA滴度下降。拉咪夫定治疗后急性
Chronic hepatitis B based on overlapping acute hepatitis A (HAV) infection can inhibit the replication of hepatitis B virus. In an outbreak of acute hepatitis A among homosexual men in Rotterdam, the investigators examined in detail the early stage of HAV infection in one patient with chronic hepatitis B. A 33-year-old male homosexual was HBeAg-positive since 1995. In 1996 by the IFN treatment for 4 months is invalid. From January 1997 to December 2010, 100 mg of levamivir was administered orally daily, and HBV DNA titer decreased after 8 weeks but remained positive. After 24 weeks ALT, AST and jaundice suddenly peaked. Viral serology tests suggest overlapping acute hepatitis A infection. The levels of IFN-γand IL-10 were measured before the serum aminotransferase was elevated. The levels of IFN-α, IL-12 and TNF-α were lower than the detectable levels and the titer of HBV DNA was decreased. Acute after treatment with lamivudine