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目的了解ＨＢＶ前Ｃ区Ａ８３变异的临床意义。方法用错配ＰＣＲ－ＲＦＬＰ检测ＨＢＶ感染者血清ＨＢＶ前Ｃ区Ａ８３变异株。结果该变异株在急性肝炎未检出；在慢性肝炎、肝硬化和重型肝炎检出率分别为６６．７％、４８．９％和４５．５％；慢性无症状ＨＢＶ携带者为３．３％；各型肝炎均以血清抗ＨＢｅ（＋）组的变异检出率最高；肝硬化血清变异株阳性者的腹水发生率和肝功能异常率较阴性者无显著差别。结论机体对ＨＢｅＡｇ长期的或强烈的特异性体液免疫可能参与Ａ８３变异的发生机制；Ａ８３变异株对肝硬化的成因及病症的严重性无特殊影响。
Objective To investigate the clinical significance of A83 mutation in pre-HBV C region. Methods Mismatched PCR-RFLP was used to detect the HBV pre-HBV A83 mutation in HBV infected individuals. Results The mutant strains were not detected in acute hepatitis. The prevalence rates of chronic hepatitis, cirrhosis and severe hepatitis were 66.7%, 48.9% and 45.5% respectively. The incidence of chronic asymptomatic HBV carriers was 3.3 %. The highest detection rate was found in each type of hepatitis with anti-HBe (+) serum. The incidence of ascites and abnormal liver function in cirrhotic patients with positive serum cirrhosis was not significantly different from that of negative ones. Conclusion Long-term or intense humoral immunity to HBeAg may be involved in the pathogenesis of A83 mutation. The A83 variant has no specific effect on the causes of cirrhosis and the severity of the disease.