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在慢性乙型肝炎和补偿性肝硬化中异常并发的HBsAg和抗HBs阳性

Bui Thai Huy Nguyen¹, Hoang Phuong Tran¹, Nguyen Tra Uyen Ho¹

¹Department of Infectious Diseases, Can Tho University of Medicine and Pharmacy, Can Tho City, Vietnam.

European journal of case reports in internal medicine

|January 15, 2026

概括

这项研究强调了一种罕见的慢性乙型肝炎病例,其中乙型肝炎表面抗原 (HBsAg) 和其抗体 (抗HBs) 都呈阳性. 这一不寻常的发现与晚期肝病有关,强调需要仔细监测和治疗.

科学领域:

肝病学肝病学是一种肝病学.
病毒学病毒学
免疫学免疫学免疫学

背景情况:

乙型肝炎表面抗原 (HBsAg) 和抗体 (抗HBs) 的同时存在是慢性乙型肝炎的罕见和矛盾的血清学发现.
这种现象可能源于乙型肝炎病毒 (HBV) S基因突变,导致免疫逃脱或复杂的宿主免疫反应.
识别这种模式至关重要,因为它可能意味着晚期肝病.

研究的目的:

报告一种慢性乙型肝炎病例,同时具有HBsAg和抗HBs阳性.
为了说明这种罕见的血清学发现的临床意义和潜在关联.
在这种情况下强调监控和管理的重要性.

主要方法:

一个54岁的男性患者的病例报告显示,他患有消化不良.
实验室检测包括HBsAg,抗HBs,HBeAg和HBVDNA水平.
肝脏弹性图,以评估肝脏硬度和纤维化阶段.

主要成果:

该患者同时表现出HBsAg和抗HBs阳性,以及HBeAg阳性和高HBVDNA病毒载量.
肝弹性图显示肝硬化 (F4),转氨酶水平轻微升高,血小板数量减少.
用诺福维尔的抗病毒治疗导致临床改善,肝酶减少,并在4个月内减少HBV DNA病毒载量.

结论:

在慢性乙型肝炎中同时出现HBsAg和抗HBs阳性是与高病毒载量和肝硬化相关的罕见发现.
这种血清学模式可能表明免疫逃脱和活跃的病毒复制,需要密切的临床关注.
对患有这种疾病的患者来说,定期监测肝功能,HBV DNA和治疗反应至关重要.

关键词:

慢性乙型肝炎慢性乙型肝炎 HBsAg 和抗HBs 的共存.肝硬化是肝硬化的一种疾病.免疫逃生变体的免疫逃生变体血清学的悖论

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