反转录多聚酶链反应核心抗原和抗体检测丙肝的方法比较

目的通过应用酶联免疫法(ELISA)分别检测丙肝病毒核心抗原(HCV-cAg)和抗体(HCV-Ab),和反转录多聚酶链反应(RT-PCR)检测丙肝RNA,来了解三种方法对丙肝病毒(HCV)感染检测的优点和缺点。方法采用HCV游离核心抗原试剂盒、HCV-AbELISA试剂盒和丙肝病毒PCR检测试剂盒,对来自入院前或手术前筛查的180例临床样本和24例丙肝或疑似丙肝患者的血清样本进行HCV-cAg,HCV-Ab和HCV-RNA检测。结果200例筛查样本HCV-Ab均为阴性,HCV-cAg阳性3例,其中RT-RNA阳性1例;25例HCV-Ab阳性的样本检出HCV-cAg阳性13例,RT-RNA阳性15例。HCV-cAg与RT-RNA符合率为86.67%(13/15)。结论HCV核心抗原检出时间早于抗体,HCV-cAg检测试剂盒可作为HCV抗体检测的补充试剂,反转录多聚酶链反应(RT-PCR)是一个很敏感的方法,但其技术复杂,环境、条件要求较高,不易被多数实验室接受和推广,可用来对HCV感染作确证实验。     

丙型肝炎病毒核心抗原、丙型肝炎病毒抗体、丙型肝炎病毒RNA检测对丙型肝炎的诊断价值

目的探讨丙型肝炎病毒核心抗原(HCV-cAg)、丙型肝炎病毒抗体(HCV-Ab)、丙型肝炎病毒RNA(HCV-RNA)检测对丙型肝炎(丙肝)的诊断价值。方法对218例HCV感染者、100例健康体检者进行HCV-cAg、HCV-Ab、HCV-RNA检测,对3 1 5例丙氨酸氨基转移酶增高但HCV-Ab检测阴性的高危者进行HCV-cAg检测。HCV-RNA检测采用实时荧光定量PCR法,HCV-CAg和HCV-Ab检测采用ELISA法。结果 HCV感染组HCV-Ab检出阳性210例(96.3%),HCV-cAg检出阳性131例(60.1%),HCV-RNA检出阳性103例(47.2%)。HCV高危组中检出HCV-CAg阳性2例(0.6%)。对照组3项检测结果均为阴性。结论 HCV-cAg、HCV-Ab、HCV-RNA三项联合检测已成为HCV感染的主要指标,可提高HCV感染"窗口期"的检出率。     

HCV-cAg检测在丙型肝炎感染窗口期和免疫异常患者中的临床价值

目的：探讨丙型肝炎病毒核心抗原（HCV-cAg）检测在丙型肝炎（丙肝）感染窗口期和免疫异常患者中的临床价值。方法2011年6月至2014年1月分别对丙肝病毒抗体（HCV-Ab）阳性标本153份（Ⅰ组）,HCV-Ab阴性血液透析患者、吸毒患者和救助站“三无（无身份证、无工作、无住处）”人员的标本195份（Ⅱ组）,HCV-Ab阴性的肿瘤科患者标本207份（Ⅲ组）和HCV-Ab阴性的健康对照标本71份（Ⅳ组）,采用酶联免疫吸附试验法检测HCV-cAg;对HCV-cAg检测结果阳性标本进一步检测HCV RNA,对HCV-cAg和HCV-Ab均阳性的吸光度值（S/CO）结果进行比较分析。结果在Ⅰ、Ⅱ、Ⅲ、Ⅳ组中HCV-cAg的阳性率分别为29.4%（45/153）、5.6%（11/195）、3.4%（7/207）、1.4%（1/71）;HCV-cAg 与HCV RNA的符合率达95.3%;随着HCV-cAg水平的下降,HCV-Ab水平呈上升趋势。结论 HCV-cAg检测与HCV RNA符合率高,能防止窗口期和免疫异常丙肝患者的漏诊;HCV-cAg与HCV-Ab互为补充关系,二者联合检测能提高丙肝检出率。     

核心抗原检测在丙型肝炎病毒诊断中的临床价值分析

目的研究分析HCV-cAg(丙型肝炎病毒核心抗原)ELISA检测方法在诊断丙型肝炎病毒上的临床应用价值。方法以我院2011年4月至12月住院及门诊患者的70例HCV-Ab阳性标本、240例HCV-Ab阴性样本为研究对象,通过HCV-cAg检测法和HCV-RNA PCR定量分析法同时对HCV-Ab(-)、(+)标本进行检测,以HCV-RNA检测值为对照值,比较分析HCV-cAg检测法在临床上诊断丙型肝炎病毒的意义。结果本文240例HCV-Ab阴性标本,经HCV-cAg检测阳性标本4例,阳性率检出率为1.7%;70例HCV-Ab阳性样本中HCV-cAg阳性37例,检出率为52.9%,HCV-RNA检出的阳性标本为43例,阳性率为61.4%,HCV-cAg与HCV-RNA的符合率为87%;同时以HCV-RNA检测值为对照,可知HCV-cAg检测法的特异性与HCV-Ab(89.5%)比较高达97.4%,敏感性高达85.4%。结论 HCV-cAg ELISA检测法与HCV-Ab比较具较高的特异性和敏感性,并可有效缩短HCV临床诊断的窗口期;HCV-cAg可联合HCV-Ab检测方法对HCV的早期诊断出更加准确的判断。     

酶联免疫法测定丙肝病毒核心抗原和抗体的联合应用

目的对所选样本同时进行丙肝病毒核心抗原和抗体的ELISA检测,揭示此两种方法联合应用在丙肝诊断与治疗中的应用价值。方法从临床申请丙肝病毒RNAPCR法检测的临床标本中选取1298份标本（其中阳性结果191例,阴性结果1107例）,同时进行丙肝病毒核心抗原和抗体的ELISA检测。结果丙肝病毒核心抗原和抗体的ELISA检测都阳性,该标本数为60例,同时丙肝病毒RNAPCR法检测亦为阳性,阳性率100%,而传统单一丙肝病毒抗体的ELISA检测法,假阴性率为2.33%（3/129）;丙肝病毒核心抗原和抗体的ELISA检测都阴性,该标本数为1101例,仅有2例丙肝病毒RNAPCR法检测为阳性,假阴性率只占0.18%,而传统单一丙肝病毒抗体的ELISA检测法,假阴性率为1.56%（2/128）;丙肝病毒核心抗原ELISA检测结果阳性而抗体ELISA检测结果阴时,假阴性率为37.5（3/8）,若同时应用此种结果可提示进一步申请丙肝病毒RNAPCR法检测从而大大降低假阴性率。结论对临床样本同时进行丙肝病毒核心抗原和抗体的ELISA检测,能够明显提高丙肝诊断符合率,同时降低假阴性率。     

丙型肝炎病毒核心抗原检测对临床诊断的价值

目的应用酶联免疫吸附法分别检测丙型肝炎病毒核心抗原和抗体,以了解丙型肝炎病毒核心抗原检测的临床价值。方法应用丙型肝炎病毒游离核心抗原试剂盒、HCV-AbELISA试剂盒和丙型肝炎病毒PCR检测试剂盒,对来自笔者所在医院输血前及门诊筛查的260例样本和80例丙型肝炎或疑似丙型肝炎患者的血清标本进行HCV-cAg、HCV-Ab和HCV-RNA检测。结果 260例筛查样本HCV-Ab均为阴性,HCV-cAg阳性5例,HCV-cAg阳性率1.9%;其中HCV-RNA4例。80例HCV-Ab阳性的样本检出HCV-cAg阳性33例,HCV-cAg阳性率为41.25%;HCV-RNA47例。结论 HCV核心抗原检出时间早于抗体,HCV-cAg检测试剂盒可作为HCV抗体检测的补充试剂,尤其对术前HCV筛查的患者联合应用更具有临床价值。     

丙型肝炎核心抗原与丙型肝炎抗体联合检测的临床分析

目的了解丙型肝炎核心抗原（HCV-cAg）和丙肝抗体检测在丙型肝炎（简称丙肝）诊疗中的作用。方法采用ELISA试剂盒对安阳市中医院2012年10月至2013年4月期间512例健康体检者和968例住院患者进行HCV-cAg和丙肝抗体（抗．HCV）联合检测,HCV-cAg阳性标本用PCR荧光定量法检测HCV-RNA确认。结果512例健康体检者6例（1．17％）抗-HCV阳性,O例HCV-cAg阳性;968例住院患者15例（1．5％）抗-HCV阳性,7例（0．7％）HCV-cAg阳性,HCV-RNA确认5例,二者符合率为71．4％。结论HCV-cAg较抗-HCV的检测将丙肝病毒感染的／窗口期提前了,是HCV的早期诊断指标,HCV-cAg与抗-HCV联合检测有助于提高HCV的诊断率,对于HCV筛查有重要意义,是有效防范丙肝传播的重要手段,临床意义重大。     

联合检测在丙型肝炎患者早期诊断中的应用

目的 探讨运用丙型肝炎病毒抗体(HCV-Ab)、丙型肝炎病毒核心抗原(HCV-cAg)、丙型肝炎病毒RNA(HCV-RNA)三种方法联合检测在丙肝患者早期感染诊断中临床应用.方法 收集2017年10月至2019年3月门诊及住院的丙型肝炎临床确诊患者313例,运用酶联免疫吸附试验(ELISA)方法检测HCV-Ab和HCV...     

酶联免疫吸附试验双抗体夹心法检测丙型肝炎病毒抗原的临床符合性研究

目的探讨丙型肝炎病毒抗原酶联免疫吸附试验(ELISA)检测试剂盒的临床符合性。方法采用科华公司HCV抗体ELISA检测试剂盒和HCV RNA基因扩增试验作为对照。结果对照两种方法,其敏感性均为100N,特异性分别为92％和90％,类风湿(RF)阳性血清无干扰,阳性和阴性血清的批内(n-10)变异系数分别为8．15％和11．08％。结论丙型肝炎抗原ELISA检测方法敏感性高,特异性好,操作简便易行,不需特殊的仪器设备、费用低廉,具有推广前景。     

丙肝病毒核心抗原检测对于丙型肝炎诊断的价值

目的探讨HCV-cVg检测对于现形丙型肝炎诊断的意义。方法对90例HCV-Ab阳性的感染者血清以及391例丙氨酸氨基转移酶（ALT）升高但HCV-Ab阴性的高危人群血清同时检测HCV-cVg,对阳性标本做HCV-RNA定量检测。结果90例丙肝抗体阳性组中,34例为HCV-cVg阳性,阳性率为37.78%;391例丙肝抗体阴性的高危人群组中,2例为HCV-cVg阳性,阳性率为0.51%。此2例经HCV-RNA定量检测确证为1例阳性,1例阴性。结论丙型肝炎病毒核心抗原检测能够有效缩短窗口期,操作简便,费用低廉,在临床上具有很好的推广前景。     

丙型肝炎病毒抗原抗体联合检测方法研究进展

丙型肝炎病毒(hepatitis C virus,HCV)是引起丙型肝炎的主要原因,目前,检测HCV感染的常用方法包括HCV RNA直接检测、HCV核心抗原检测和抗-HCV检测.HCV抗原抗体联合检测方法是一种同时检测HCV抗原和抗-HCV的新型酶免疫检测方法,可以缩短抗体阳转前的检测窗口期.此文就HCV抗原抗体联合检...     

丙型肝炎病毒抗原抗体联合检测方法研究进展

丙型肝炎病毒(hepatitis C virus,HCV)是引起丙型肝炎的主要原因,目前,检测HCV感染的常用方法包括HCV RNA直接检测、HCV核心抗原检测和抗-HCV检测.HCV抗原抗体联合检测方法是一种同时检测HCV抗原和抗-HCV的新型酶免疫检测方法,可以缩短抗体阳转前的检测窗口期.此文就HCV抗原抗体联合检测方法研究进展作一综述.     

De novo HCV infection among dialysis patients: a prospective study by HCV core antigen ELISA assay

BACKGROUND: Dialysis patients remain a high-risk group for hepatitis C virus infection. The current diagnosis of hepatitis C virus in dialysis patients includes serological measurement of anti-hepatitis C virus antibody; however, nucleic acid amplification technology for assessing hepatitis C virus viraemia is commonly used in other populations. An enzyme-linked immunosorbent assay test for detecting antibody to hepatitis C nucleocapsid core antigen (hepatitis C virus core antigen) in human serum has been recently developed (hepatitis C virus Core Antigen enzyme-linked immunosorbent assay test). It is conceived for screening of donor blood products to significantly reduce the 'serologic window' occurring before seroconversion during acute hepatitis C virus. AIM AND METHODS: A cohort (n = 72) of patients on maintenance haemodialysis in a single unit in the years 2000-2003 was included. Study patients were tested monthly by hepatitis C virus Core Antigen enzyme-linked immunosorbent assay in a prospective, clinical trial. Routine results obtained by hepatitis C virus Core Antigen enzyme-linked immunosorbent assay test were confirmed by assessing hepatitis C virus viraemia by branched-chain DNA (bDNA) signal amplification assay. RESULTS: De novo hepatitis C virus infection was identified in three patients during the study period; the hepatitis C virus incidence was 1.38% (95% confidence intervals, 1.31-4.09) per year. In each patient, hepatitis C virus core antigen testing allowed the serological identification of acute hepatitis C virus before anti-hepatitis C virus seroconversion. Hepatitis C virus RNA testing confirmed the results obtained by hepatitis C virus Core Antigen enzyme-linked immunosorbent assay in all cases. The time from initial hepatitis C virus detection by hepatitis C virus Core Antigen Assay and anti-hepatitis C virus seroconversion was not greater than four weeks. Two (67%) of three patients with de novo hepatitis C virus acquisition were HBsAg negative; both these patients underwent an initial phase of hepatitis C virus viraemia that was associated with an increase in alanine aminotransferase activity and preceded the seroconversion to anti-hepatitis C virus antibody. Nosocomial transmission of hepatitis C virus between haemodialysis patients was implicated in at least two (67%) of these three patients. CONCLUSIONS: Serological testing for hepatitis C virus core antigen can identify acute hepatitis C virus infection before anti-hepatitis C virus seroconversion. The time from initial hepatitis C virus detection by hepatitis C virus core antigen assay and anti-hepatitis C virus seroconversion was not >4 weeks. De novo acquisition of hepatitis C virus in haemodialysis was associated with a rise in alanine aminotransferase levels. Hepatitis C virus core antigen enzyme-linked immunosorbent assay test results can be obtained in routine laboratories without the need of special equipment or training. Hepatitis C virus core antigen testing among anti-hepatitis C virus negative patients on maintenance dialysis is suggested in order to early assess de novo hepatitis C virus within dialysis units.     

丙型肝炎病毒核心抗原检测试剂的初步应用

目的应用丙型病毒性肝炎核心抗原（HCV—cAg）ELISA检测试剂，检测丙型病毒性肝炎（HCV）病毒标志物。方法对单项抗-HCV ELISA试剂A阳性15份和单项试剂B阳性17份血清标本分别再用HCV—cAg ELISA试剂和HCVRNA荧光定量RT—PCR试剂检测，对其余血清标本仅行荧光定量RT—PCR试剂检测。结果对32份阳性血清标本中HCV—cAgELISA试剂和HCV—PCR荧光定量法阳性率分别为18．75％（6／32）和15．6％（5／32）。结论HCV-cAg ELISA法的敏感性与HCVRNART—PCR荧光定量检测结果相类似，有助于可疑抗HCV阳性结果的证实。     

Hepatitis B Virus Reactivation: Risk Factors and Current Management Strategies

Hepatitis B virus (HBV) is a global disease with significant morbidity and mortality. Worldwide, ~257 million people are chronically infected with HBV, defined as having a positive hepatitis B surface antigen, but millions more have prior HBV exposure indicated by positive hepatitis B core antibody. Reactivation of hepatitis B implies a sudden increase in viral replication in a patient with chronic HBV infection or prior HBV exposure. Hepatitis B virus reactivation (HBVr) can occur spontaneously, but it is more commonly triggered by immunosuppressive therapies for cancer, immunologic diseases, or transplantation. Elimination of hepatitis C virus (HCV) in HBV-HCV coinfected individuals treated with direct-acting antivirals (DAAs) has also been identified as an important cause of HBVr. Hepatitis B virus reactivation is an underappreciated but important complication of common medical therapies that can delay treatment or result in clinical episodes of hepatitis, hepatic failure, or death. In this review, factors associated with HBVr, particularly medication-related risks, are explored. We review data involving rituximab and ofatumumab, doxorubicin, corticosteroids, tumor necrosis factor antagonists, tyrosine kinases, bortezomib, hematologic stem cell transplantation, and DAAs for HCV treatment. In addition, we discuss screening strategies, choice of antiviral prophylaxis, and the optimal duration of therapy for HBVr. With additional awareness, screening, and appropriate antiviral therapy, it is expected that most cases of HBVr can be prevented.     

联合检测丙型肝炎抗体和核心总抗原的临床价值探讨

目的探讨联合检测丙型肝炎抗体和核心总抗原（HCV—cAg）在临床中的应用价值。方法用酶联免疫吸附试验（ELISA）法联合检测HCV抗体和HCV—cAg,并与荧光定量PCR法检测丙型肝炎核酸（HCV—RNA）的结果进行对照。结果157例患者中共检出HCV抗体阳性149例、HCV—cAg阳性99例、HCV-RNA阳性115例;5例HCV抗体阴性而HCV—cAg阳性的患者,经HCV—RNA证实为HCV感染;共检出HCV抗体或HCV—cAg阳性154例,另外3例经HCV—RNA排除HCV感染。结论联合检测HCV抗体和HCV—cAg提高了HCV感染的检出效率,可有效避免漏检,适合在普通医疗机构推广使用。     

丙型、丁型、庚型肝炎与原发性肝癌的相关因素分析

目的 探讨由RNA病毒引起的丙型、丁型、庚型肝炎与原发性肝癌(PLC)发生的关系。方法 采用免疫病理学观察,比较丙型肝炎病毒NS_5抗原(HCV-NS_5),丁型肝炎病毒抗原(HDVAg),庚型肝炎病毒NS_5抗原(HGV-NS_5)在肝细胞肝癌(HCC)组织中的表达特点。结果 在72例HCC中HCV-NS_5,HDVAg,HGV-NS_5的检出率分别为26.39％、19.44％、6.94％。总检出率为29.17％。3种病毒抗原信号在癌组织及癌旁组织中均有表达,虽其表达的主要部位有差异。3种病毒抗原的表达在HCC的分化程度方面无明显相关性,而与HCC患者的预后有一定的相关性。结论 HCV和HDV与PLC的发病关系密切,没有证据表明HGV是PLC发生的高危因素。     

微粒子化学发光法检测丙型肝炎病毒核心抗原及临床意义

目的探讨丙型肝炎病毒核心抗原在丙型肝炎诊断中的意义。方法采用微粒子化学发光免疫分析方法检测血浆276份,样品同时用酶联免疫吸附试验检测抗HCV、用荧光定量PCR技术检测HCV—RNA。结果187份HCVAb反应性标本中检出HCVAg45份,HCVAg检出率为24．06％;89份HCVAb非反应性样本中HCVAg检出8例,HCVAg检出率为8．99％,两者样本检出率差异有统计学意义（χ2=2．01,P〈0．05）,HCVAg与HCVAb的检测符合率为45．65％。55份HCVRNA阳性样本中,有HCVAg反应性样本50份;221份HCVRNA阴性样本中,HCVAg非反应性样本218份,两种方法检测结果的符合率为97．10％。两样本检出率差异无统计学意义（χ2=0．00,P〉0．05）。结论微粒子化学发光检测HCVAg与荧光定量PCR检测HCV—RNA具有良好的相关性,丙型肝炎核心抗原检测可以作为抗HCV检测的补充。     

Characterization of former heroin addict patients with Hepatitis C virus antibodies in a methadone maintenance treatment (MMT) clinic in israel

AIMS: To compare characteristics, retention in treatment and cessation of drug abuse of 249 positive hepatitis C (HCV+) with 188 negative hepatitis C (HCV-) antibody patients. METHODS: Data on Hepatitis C, Hepatitis B and HIV results, urine-proven drug use, and modified ASI of all patients admitted to the Adelson MMT clinic between June/1993-Dec/2002 were prospectively collected. RESULTS: HCV+ patients manifested more ever injecting drug use, immigrants, positive HIV antibody, hepatitis B antigen, years of opiate addiction pre-MMT and benzodiazepines misuse after one year in MMT than HCV- patients, with similar 1-year retention and proportion of opiate use cessation. CONCLUSIONS: Although characteristics of HCV+ and HCV- differed, they manifested similar outcomes: treatment retention and proportion of opiate use cessation.