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HBsAg 음성인 간질환 환자에서 간조직내 HBV DNA의 검출

Detection of Intrahepatic HBV DNA in HBsAg-negative Liver Diseases

김영석|김부성|문종호|장재영|조영덕|진소영|천영국|심찬섭|은수훈|김연수
대한간학회 (The korean Association for the Study of the Liver)|2006.06|Clinical and Molecular Hepatology|제12권 제2호|pp. 201-208

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참고문헌

키워드

HBV 잠재감염간내 HBV DNA

초록

목적: HBV 잠재감염이란 혈청 HBsAg 음성자에서 HBV DNA가 저농도로 존재하는 상태이다. 특히 anti-HBc 양성자에서는 잠재감염이 빈번하다고 보고되고 있으며 잠재감염 상태는 간질환의 진행에 영향을 미칠 수 있다고 보고되고 있다. 저자들은 혈청 HBsAg 음성자에서 간내 HBV DNA 농도 측정으로 HBV 잠재감염의 빈도를 확인하고자 하였다. 대상과 방법: HBsAg이 음성인 56예를 대상으로 하였다. 이 중 16예는 anti-HBc 양성이며 anti-HBs 음성(A군)이었으며 또 다른 26예는 anti-HBc와 anti-HBs가 모두 양성(B군)이었다. 나머지 14예는 anti-HBc가 음성(C군)이었다. 17예는 anti-HCV 양성이었다. 간조직검사 시 취한 간조직을 영하 70도에 보관 후 간내 DNA를 추출하여 Real-time PCR법으로 HBV DNA 농도를 정량하였다. 결과: 1) 간내 HBV DNA는 총 19예(34%)에서 검출되었는데 A군에서 16예(56%)로 검출 빈도가 가장 높았으며 B군 8예(31%) 그리고 C군 2예(14%)였다(P=0.01 between A and C). 2) 간내 HBV DNA 농도는 A군은 2,010±6,660 copies/mg, B군은 6,180±29,530 copies/mg 그리고 C군은 350±1,220 copies/mg으로 anti-HBc 양성군에서 음성군에 비해 높은 경향을 보였으나 유의한 차이는 관찰되지 않았다. 3) 간내 HBV DNA는 anti-HCV 양성군 중 5예(29.4%), 음성군 중 14예(35.9%)에서 검출되었다. 결론: 혈청 HBsAg 음성자에서도 간조직내 HBV 잠재감염이 드물지 않았으며 특히 혈청 anti-HBc 양성인 경우 잠재감염률이 높았다.

Abstract

Backgrounds/Aims: Occult HBV infection is characterized by the presence of HBV infection with undetectable HBsAg. This study was carried out to find out the frequency of HBV infection in HBsAg- negative patients. Methods: Fifty-six HBsAg-negative patients including 17 anti-HCV positive patients were evaluated. Patients were grouped according to their serological status; group A (anti-HBc+, anti-HBs-, n=16), B (anti-HBc+, anti-HBs+, n=26), and C (anti-HBc-, anti-HBs+/-, n=14). DNA was extracted from frozen liver biopsy specimen, and HBV DNA level was measured with real-time PCR. Results: Overall frequency of detectable intrahepatic HBV DNA was 34% (19/56). The frequency was 56% (9/16) in group A, 31% (8/26) in group B and 14% (2/14) in group C (P=0.01). Intrahepatic HBV DNA levels were as follows; 2,010±6,660 copies/mg in group A, 6,180±29,530 copies/mg in group B and 350±1,220 copies/mg in group C. The frequency of occult HBV infection was not increased in anti-HCV positive patients. Conclusions: Intrahepatic HBV DNA is frequently detected in anti-HBc positive, HBsAg-negative patients, although the concentration is low.

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