13 039例乙型肝炎患者血清HBV DNA水平流行病学分析

目的 了解本地区近四年乙型肝炎患者HBV DNA阳性率与病毒载量分布特点。方法 采用荧光定量聚合酶链反应（PCR）检测2012年至2015年间13 039例HBsAg阳性患者HBV DNA载量，并进一步分析24例HBeAg阳性、31例HBeAg阴性初诊乙肝患者四年间接受正规治疗后HBV DNA变化趋势。结果 本地区近4年间血清HBV DNA阳性率依次为48.6%、46.18%、38.69%、37.66%，呈逐年下降趋势，差异具有统计学意义（P<0.01）；各年度病毒载量均值的对数值分别为（5.48±1.56），（5.27±1.72），（5.29±1.68），（5.35±1.85）拷贝/mL。2013年、2014年、2015年分别与2012年相比，差异均有统计学意义（P<0.01、P<0.01、P<0.05），而低病毒载量（即病毒拷贝数的对数值小于5拷贝/mL）患者比例2012年明显大于其它年份，2012年分别与2013年、2014年、2015年相比，差异具有统计学意义（P<0.01，P<0.01，P<0.05）；HBeAg阳性/阴性乙肝患者接受正规治疗后，其HBV DNA载量均呈逐年下降趋势，其中第一年下降显著（P<0.01）。结论 近4年本地区血清HBV DNA阳性率呈逐年下降趋势，且低病毒载量比例明显增加。

Epidemiological analysis of serum HBV DNA level among 13 039 patients with Hepatitis B

Objective To investigate the positive rate of HBV DNA and viral load distribution among local patients with hepatitis B in the past 4 years．Methods The HBV DNA loads of 13 039 HBsAg positive patients between 2012 and 2015 were detected with fluorescence quantitative PCR．The changes of HBV DNA of 24 HBeAg positive and 31 HBeAg negative hepatitis B patients who were newly diagnosed and given regular treatment during the four years were further analyzed．Results The positive rates of serum HBV DNA in the past four years were 48.6%，46.18%，38.69% and 37.66%，decreasing year by year with significantly statistical difference（P<0.01）．The logarithms of the mean annual viral load were（5.48±1.56），（5.27±1.72），（5.29±1.68）and（5.35±1.85）copies/mL for each year，among which significant differences existed between the value in 2012 and those in 2013，2014 and 2015（P<0.01，P<0.01，P<0.05）．Meanwhile，the proportion of patients with low viral load（logarithm of viral loads<5 copies/mL）was significantly higher in 2012 than that in 2013，2014 and 2015 respectively（P<0.01，P<0.01，P<0.05）．The HBV DNA loads of HBeAg positive/negative hepatitis B patients after receiving regular treatment showed a declining trend year by year and declined most significantly in the first year（P<0.01）．Conclusion The positive rate of serum HBV DNA decreased gradually and the proportion of low viral load increased significantly in the past 4 years in the local region．