丁型肝炎病毒抗体IgM与乙肝表面抗原相关性探讨
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摘要
目的:探讨酶联免疫吸附法(ELISA)检测丁型肝炎病毒抗体Ig M(抗-HD Ig M)与乙肝表面抗原(HBs Ag)之间的相关性。方法:检测某三甲医院4 428例门诊和住院患者抗-HD Ig M;经阻断试验和巯基乙醇破坏试验后确认抗-HD Ig M真假阳性;真阳性样品同时用ELISA和电化学发光法(ELC)检测HBs Ag;假阳性样品进行类风湿因子(RF)的检测。结果:经ELISA检测有155例抗-HD Ig M阳性样品,确认有118例是真阳性、37例假阳性。118例抗-HD Ig M真阳性样品用ELISA和ELC法检测HBs Ag都有超过50%是阴性;37例抗-HD Ig M假阳性样品有28例RF阳性。结论:抗-HD Ig M阳性同时HBs Ag阴性主要可能是HBV隐匿性感染;HDV急性感染时HBs Ag大量消耗、浓度太低、难以检测等原因。
Objective: To investigate the correlation between anti-hepatitis D IgM( anti-HD IgM)determined by enzyme-linked immunosorbent assay( ELISA) and HBs Ag. Methods: The anti-HD IgM in 4428 outpatients and inpatients hospitalized in a 3A-grade hospital were determined. The blocking test and 2-mercaptoethanol destructive experiment were used to confirm that the anti-HD IgM was true or false positive. The HBs Ag in the true positive samples were determined by ELISA and electrochemiluminescence( ELC). The false positive samples were determined for rheumatoid factor( RF). Results: A total of 155 anti-HD IgM positive samples were determined by ELISA,and 118 true positive and 37 false positive were confirmed. Among the 118 true positive anti-HD IgM samples,more than 50% of the HBs Ag was negative determined by ELISA and ELC;and 28 of the 37 false positive anti-HD IgM samples were RF positive. Conclusion: Anti-HD IgM positive and HBs Ag-negative may be HBV occult infection. The HBs Ag consumption is large,and its concentration is too low in HDV acute infection,which is difficult to detect.
Objective: To investigate the correlation between anti-hepatitis D IgM( anti-HD IgM)determined by enzyme-linked immunosorbent assay( ELISA) and HBs Ag. Methods: The anti-HD IgM in 4428 outpatients and inpatients hospitalized in a 3A-grade hospital were determined. The blocking test and 2-mercaptoethanol destructive experiment were used to confirm that the anti-HD IgM was true or false positive. The HBs Ag in the true positive samples were determined by ELISA and electrochemiluminescence( ELC). The false positive samples were determined for rheumatoid factor( RF). Results: A total of 155 anti-HD IgM positive samples were determined by ELISA,and 118 true positive and 37 false positive were confirmed. Among the 118 true positive anti-HD IgM samples,more than 50% of the HBs Ag was negative determined by ELISA and ELC;and 28 of the 37 false positive anti-HD IgM samples were RF positive. Conclusion: Anti-HD IgM positive and HBs Ag-negative may be HBV occult infection. The HBs Ag consumption is large,and its concentration is too low in HDV acute infection,which is difficult to detect.
引文
[1]张卓然,倪语星,等.临床微生物学和微生物检验[M].北京:人民卫生出版社,2006:386-387.
[2]Waar K;Herremans MM;Vennema H,et al.Hepatitis E is a cause of unexplained hepatitis in The Netherlands[J].J Clin Virol,2005,33(2):145-149
[3]Zheng X,Ye X,Zhang L,et al.Characterization of occult hepati-tis B virus infectio from blood donors in China[J].J Clin Microbiol,2011,49(5):1730-1737.
[4]Yuan Q,Ou SH,Chen CR,et al.Molecular characteristics of oc-cult hepatitis B virus from blood donors in southeast China[J].J lin Microbiol,2010,48(2):357-362.
[5]Candotti D,Lin CK,Belkhiri D,et al.Occult hepatitis B infection in blood donors from South East Asia:molecular characterisation and potential mechanisms of occurrence[J].Gut,2012,61(12):1744-1753.
[6]邹峥嵘,谢云峥,伍晓菲,等.上海地区无偿献血者乙型肝炎病毒隐匿性感染情况和突变分析[J].中国输血杂志,2013,6(8):701-704.
[7]Shih HH,Jeng KS,Syu WJ,et al.Hepatitis B surface antigen levels and sequences of natural hepatitis B virus variants influence the assembly and secretion of hepatitis d virus[J].J Virol,2008,82(5):2250-2264.
[8]Smedile A,Rosina F,Saracco G,et al.Hepatitis B virus replication modulates pathogenesis of hepatitis D virus in chronic hepatitis D[J].Hepatology,1991,13(3):413-416.
[9]Raimondo R,Allain JP,Brunetto MR,et al.Statements from the Taormina expert meeting on occult hepatitis B virus nfection[J].J Hepatol,2008,49(4):652-657.
[2]Waar K;Herremans MM;Vennema H,et al.Hepatitis E is a cause of unexplained hepatitis in The Netherlands[J].J Clin Virol,2005,33(2):145-149
[3]Zheng X,Ye X,Zhang L,et al.Characterization of occult hepati-tis B virus infectio from blood donors in China[J].J Clin Microbiol,2011,49(5):1730-1737.
[4]Yuan Q,Ou SH,Chen CR,et al.Molecular characteristics of oc-cult hepatitis B virus from blood donors in southeast China[J].J lin Microbiol,2010,48(2):357-362.
[5]Candotti D,Lin CK,Belkhiri D,et al.Occult hepatitis B infection in blood donors from South East Asia:molecular characterisation and potential mechanisms of occurrence[J].Gut,2012,61(12):1744-1753.
[6]邹峥嵘,谢云峥,伍晓菲,等.上海地区无偿献血者乙型肝炎病毒隐匿性感染情况和突变分析[J].中国输血杂志,2013,6(8):701-704.
[7]Shih HH,Jeng KS,Syu WJ,et al.Hepatitis B surface antigen levels and sequences of natural hepatitis B virus variants influence the assembly and secretion of hepatitis d virus[J].J Virol,2008,82(5):2250-2264.
[8]Smedile A,Rosina F,Saracco G,et al.Hepatitis B virus replication modulates pathogenesis of hepatitis D virus in chronic hepatitis D[J].Hepatology,1991,13(3):413-416.
[9]Raimondo R,Allain JP,Brunetto MR,et al.Statements from the Taormina expert meeting on occult hepatitis B virus nfection[J].J Hepatol,2008,49(4):652-657.