抗-HBe阳性患者血清乙型肝炎病毒大蛋白检测

目的 检测乙型肝炎病毒大蛋白( HBV-LP)对抗-HBe阳性慢性乙型肝炎患者病毒复制状况的诊断价值.方法 收集抗-HBe阳性慢性乙型肝炎患者血清308例,分别进行HBV-LP、HBV DNA、PreS1及PreS2检测并进行比较分析.结果 308例抗-HBe阳性患者中,HBV LP、HBV DNA、HBV PreS1和HBV PreS2阳性率分别为58.12％、28.90％、41.88％和40.91％;HBV-LP阳性者与阴性者比较,HBV DNA、PreS、PerS2阳性率差异均有统计学意义(x2分别为17.19、37.12、54.42,P＜0.05); HBV-LP与HBV PreS1、HBV PreS2有82例共同阳性,93例共同阴性.结论 HBV-LP在抗-HBe阳性慢性乙型肝炎患者血清中检测率较高,可以作为临床抗病毒治疗监测的一个良好指标.     

乙型肝炎病毒血清学标志物与DNA检测结果的对比分析

我国为乙型肝炎病毒（ＨＢＶ）感染高发区．约有１亿人为乙肝表面抗原携带者．ＨＢＶ感染后血清学检测组合的标志模式多且复杂．由于ＰＣＲ方法的引入,可以直接检测病毒核酸（ＤＮＡ）［１］,所以对患者体内ＨＢＶ复制及传染性有了更深刻地认识．然而,由于基层单位开展ＰＣＲ检测受到条件限制,仅以血清学检测结果作为实验诊断依据,可能会出现漏检．因此,将ＨＢＶＤＮＡ与血清学标志物（ＨＢＶＭ）进行对比分析,对临床诊断ＨＢＶ感染及治疗效果的判断具有重要作用．我们采用聚合酶链反应（ＰＣＲ）及酶联免疫吸附试验（ＥＬＩＳＡ…     

乙型肝炎病毒大蛋白及其检测的研究进展

乙型肝炎病毒大蛋白（hepatitis B virus large surface pro-tein, HBV-LP）存在于感染性颗粒（Dane颗粒）和亚病毒管状颗粒上,是病毒形成完整外膜的重要标志,与病毒复制、病毒颗粒组装和从细胞内释放调节密切相关。     

不同方法检测乙型肝炎病毒血清标志物的差异

目的 分析不同方法及试剂检测乙型肝炎病毒血清标志物（HBV—M）的差异。方法我院门诊及住院患者48例,经雅培12000配套试剂检测为乙型肝炎表面抗原（HbsAg）阳性,乙型肝炎e抗原（HbeAg）测定值COI〈50。依据HBsAg定量．将患者分为：A组,HBsAg≥250IU/L,共16例;B组,HBsAg介于20～250IU／L,共10例;C组,HBsAg≤20IU／L．共12例。HBVM检测采用3种方法：（1）ARCHITECT12000型仝自动免疫分析仪及配套试剂;（2）ROCHEE1711型全自动免疫分析仪及配套试剂;（3）酶联免疫分析（ELISA）试剂。结果两种进口发光方法检测HBsAg全部吻合．但ELISA检测C组有4份为阴性。三种方法检测HBeAg与抗HBe差异明显．国产ELISA试剂对HBeAg与抗HBe检出率远远为低于发光法．对A组26份标本HBeAg全部漏检。三种方法检测48份血样抗-HBc的符合率为100％。结论 在HBV—M的5项指标中如有低值,使用不同试剂检测出现不同模式的机会升高。建议接受抗病毒药物治疗的患苕尽量选择存同一家医院并使用同一种试剂作长期观察。     

慢性乙型肝炎患者血清乙型肝炎病毒表面大蛋白水平检测意义探讨

目的探讨慢性乙型肝炎、乙型肝炎肝硬化和原发性肝癌患者血清乙型肝炎病毒表面大蛋白（HBV-LP） 水平差异及意义。方法选取2014年8月~2015 年12月我院诊治的慢性乙型肝炎患者508例,乙型肝炎肝硬化患者74例,原发性肝癌患者29例,采用ELISA 法检测血清HBV-LP水平,采用FQ-PCR法检测血清HBV DNA水平。结果慢性乙型肝炎、乙型肝炎肝硬化和原发性肝癌患者血清HBV-LP阳性率分别为77.2%、82.4%和89.7%,血清HBV DNA阳性率分别为78.9%、83.8%和93.1%;3组血清HBV-LP水平分别为（9.78±4.25）μg/L、（17.24±8.63）μg/L和（38.65±19.38）μg/L,差异有统计学意义（P<0.05）。结论HBV-LP是乙型肝炎病毒感染者血清重要的标记物,与血清HBV DNA存在某种相关性,其检测的意义值得探讨。     

血清乙型肝炎病毒表面大蛋白表达与HBV DNA的关系

乙型肝炎病毒（HBV）感染是目前较为关注的公共卫生问题,HBV感染后,病毒进入肝脏在体内大量复制引起机体产生应答,部分应答对肝细胞形成杀伤引起肝损伤。目前对HBV复制的检测主要依靠HBVDNA和血清HBeAg检测,近几年乙型肝炎病毒外膜大蛋白（L-HBs）的研究有了很大的进展,本研究对大蛋白的表达与血清HBVDNA进行比较。     

乙肝病毒大蛋白检测在乙型肝炎诊治中的临床意义

目的:探讨乙肝病毒(HBV)大蛋白(LP)在乙型肝炎诊治中的临床意义．方法:对162例HBV感染者YL47A正常对照血清采用酶联免疫吸附试验检测HBV-LP,HBV 前S1抗原,HBV前S2抗原及乙型肝炎血清标志物:FQ-PCR定量检测HBV DNA．结果:在HBV感染组中,HBV-LP与HBV DNA,HBeAg,HBVpreS2,HBVpreS1间相关显署(X2=9．22,11．89,60．35,99．87;均P<0．01),其含量与HBV DNA拷贝数成正相关(rs=0．64, P<0．001),不同HBV DNA拷贝数组别间HBV- LP含量存在差异显著性(X2=135．34,P<0．01); HBeAg,HBV DNA,HBVpreS2,HBVpreS1不同模式间HBV-LP含量及阳性率均存在差异显著性(Z=8．70,5．85,8．44,8．84,均P<0．001); HBeAg阴性感染血清中HBV-LP较HBV DNA, HBVpreS2,HBVpreS1更为敏感(76．8％)．HBV 感染组与正常对照组间HBV-LP含量存在差异显著性(P<0．01)．结论:HBV-LP是从蛋白水平反映HBV感染者体内病毒复制程度的可靠指标,尤其是 HBeAg阴性患者体内病毒复制及预后判断的良好血清学监测指标．     

乙型肝炎病毒大S蛋白基因纵向研究方法及应用

目的:建立乙型肝炎病毒(HBV)大S蛋白基因纵向研究方法,并将其应用于疾病进程中HBV的准种动态研究.方法:以2例HBV感染者(对象A,男,38岁;对象B,女,22岁.对象A研究期间未经任何抗病毒治疗,B则1年持续接受ADV抗病毒药物治疗)体内不同时期的血清样本核酸提取物为模板,通过特异性扩增获取病毒大S蛋白基因序列并克隆测序,依据生物信息学方法对发生于序列结构不同区域的变异进行分析,利用比对数据对不同样本HBV准种予以描述与评价.结果:所得24条HBV大S蛋白基因序列中2条源于对象B样本的基因序列PreS2编码区存在30 nt的缺失,其余22条序列大小均为1203bp;24条序列的HBV基因型均为c型.对象A大S蛋白基因序列分散值DA、DB、Dc分别为:0.29、0.16、0.23,对象B则为0.80、2.30、1.82.来自对象A的全部10条HBV大S蛋白基因序列内部的"a"决定簇与参考基因完全一致;对象B的14条序列期初有2条(29%)期终有6条(86%)存在G145R突变,期终序列中有1条序列"a"决定簇内发现4个位点的突变.结论:人体内感染HBV以准种形式存在且可以用分散值DA、DB、Dc对其进行描述,并应用于HBV准种动态的纵向研究.而抗病毒药物ADV的1年期治疗可使本例HBV准种分散性增高,可能增加本例耐药性突变出现的风险,同时增加本例"a"决定簇的变异出现.     

慢性乙型肝炎病毒基因型与临床病理的关系

乙型肝炎病毒（HBV）在逆转录过程中由于不对称复制和缺乏校对酶的作用，突变率较高。根据HBV DNA全基因核苷酸序列的异质性≥8％为一种基因型，目前HBV可分为A～H8个基因型。临床上有关HBV基因型与病情轻重关系的研究较多，但是有关HBV基因型与临床病理关系的研究甚少。为此我们应用聚合酶链反应（PCR）微板核酸杂交酶联免疫吸附试验（ELISA）对86例慢性乙型肝炎（CHB）患者进行了HBV基因分型，并从血清HBV DNA水平、生化、肝组织病理学等方面来探讨HBV基因型与临床病理的炎系。     

时间分辨荧光免疫分析法和酶联免疫吸附实验法测定乙型肝炎病毒大蛋白的方法学比较

目的对时间分辨荧光免疫分析(time-resolved fluoroimmunoassay,TRFIA)和酶联免疫吸附实验(enzyme-linked immunosorbent assay,ELISA)检测乙型肝炎患者血清中病毒大蛋白(hepatitis B virus large surface protein,HBV-LP)进行方法学比较。方法收集30例正常体检血清标本作为阴性对照和150例慢性乙型肝炎患者血清标本,利用ELISA法检测HBV-LP,将其中70例阳性标本作为阳性样本,70例阴性标本作为阴性样本,再分别采用TRFIA法检测HBV-LP,对二者的灵敏度、特异度、一致性、检测线性范围、精密度、相关性及两种试剂盒的稳定性进行比较。其中TRFIA与ELISA结果不一致的12例标本采用PCR法进行验证。结果TRFIA检测HBV-LP的最小测定值为0.1 ng/ml,ELISA检测HBV-LP的最小测定值为2.5 ng/ml,二者的特异度均为100%。TRFIA和ELISA检测HBV-LP的Kappa值为0.83。12例ELISA和TRFIA检测不一致的标本,经PCR验证后有10例HBV DNA103拷贝数。TRFIA试剂检测的线性范围在0.625~10 252 ng/ml之间,ELISA试剂盒检测的线性范围在5~1 281.6 ng/ml。TRFIA法检测高、中、低3个浓度水平的批内CV平均为6.10%,ELISA法的批内CV平均为8.98%。TRFIA批间CV平均为6.91%,ELISA的批间CV平均为10.45%。TRFIA试剂盒的结合下降率为6.61%,ELISA试剂盒的结合下降率为23.59%。结论 TRFIA与ELISA具有高度的一致性,但是两者相比,前者有更高的灵敏度和精密度,且TRFIA试剂盒的稳定性更好。     

Changes in levels of hepatitis B virus markers in patients positive for low-titer hepatitis B surface antigen

Aim: Recently, patients positive for the low-titer hepatitis B surface antigen (HBsAg) have been found occasionally owing to the increase in the accuracy of detection methods. The aim of this study is to clarify the clinical status of acute hepatitis B virus (HBV) infection in patients positive for low-titer HBsAg. Method: Eight patients, who were positive for HBsAg at low titers and diagnosed as having acute HBV infection, were enrolled in this study. Assays of HBsAg, hepatitis B core antibody (anti-HBc), hepatitis B e-antigen (HBeAg), hepatitis B e-antibody (anti-HBe), hepatitis B surface antibody (anti-HBs) and HBV DNA, and biochemical tests were basically conducted every 4 weeks for at least 24 weeks. Result: The average cut-off index of HBsAg was 8.7 ± 9.6 (range, 1.0–25.7). All the patients were negative for anti-HBc, HBeAg, anti-HBe and HBV DNA on their initial visit. The genotype of HBV could be determined in four patients: two were infected with genotype B/HBV, one was infected with genotype A/HBV, and the remaining patient was infected with genotype C/HBV. Although HBsAg clearance was observed within 4 months in all the patients, none of the other HBV markers seroconverted during the observation period. Conclusion: HBV infection terminating with seronegativity for HBV markers may occur in transient HBV infection.     

A comparative study on serologic profiles of virus hepatitis B

INTRODUCTIONHepatitis B viral infection, one of the most-prevalent liver disorders in China and Korea, is aserious infectious disease as it has the potential ofprogressing into liver cirrhosis and primary hepaticcarcinoma. China and Korea both belong to high-risk endemic regions of viral hepatitis[1]. TheHBsAg positive rates in China ranged from 6.9% -17.9% by age, race and test methods[2-5].     

Value of anti-hepatitis B virus in serum tested by enzyme linked immunosorbent assay 3 in diagnosis of hepatitis B: A protocol for systemic review and meta analysis

Introduction:This protocol is for a meta analysis that aims to systematically review the diagnostic value of anti-hepatitis B virus in serum tested by the enzyme linked immunosorbent assay in patients with hepatitis B.Methods and analysis:The following electronic databases will be searched from inception to Mar 2021: PubMed, Web of Science, ScienceDirect, EMBASE, MEDLINE, Springer, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, VIP Chinese Science and Technology Periodical Database, and Wanfang Database. All study about enzyme linked immunosorbent assay reagents have been published at home and abroad to diagnose hepatitis B virus will be included. MetaDisc 1.4 soft will used to calculate pooled effect size in sensitivity, specifi city, likelihood ratio, diagnostic odds ratio and summary receiver operating characteristic curve, and area under the curve as well.Ethics and dissemination:Formal ethical approval is not required, as the data are not individualized. The findings of this systematic review will be disseminated in a peer-reviewed publication and/or presented at relevant conferences.Registration number:INPLASY2020100051.     

e抗原阴性慢性乙型肝炎患者血清表面抗原大蛋白水平与乙型肝炎病毒DNA之间的关系

我国约1／3的慢性乙型肝炎患者乙型肝炎e抗原（HBeAg）阴性，但仍然伴有高水平的乙型肝炎病毒（HBV）复制。在不能进行HBV DNA检测的单位，对这些患者HBV复制程度的判定难以进行。现探讨HBeAg阴性慢性乙型肝炎患者血清中乙型肝炎病毒表面抗原大蛋白（LHBs）与HBV DNA的关系，试图明确LHBs是否可以用作HBeAg阴性乙型肝炎患者病毒复制程度的判定指标。     

Analysis of hepatitis B surface antigen (HBsAg) using high‐sensitivity HBsAg assays in hepatitis B virus carriers in whom HBsAg seroclearance was confirmed by conventional assays

Aim

We investigated the utility of high‐sensitivity hepatitis B surface antigen (HBsAg) assays compared with conventional HBsAg assays.

Methods

Using serum samples from 114 hepatitis B virus (HBV) carriers in whom HBsAg seroclearance was confirmed by conventional HBsAg assays (cut‐off value, 0.05 IU/mL), the amount of HBsAg was re‐examined by high‐sensitivity HBsAg assays (cut‐off value, 0.005 IU/mL). Cases negative for HBsAg in both assays were defined as consistent cases, and cases positive for HBsAg in the high‐sensitivity HBsAg assay only were defined as discrepant cases.

Results

There were 55 (48.2%) discrepant cases, and the range of HBsAg titers determined by high‐sensitivity HBsAg assays was 0.005–0.056 IU/mL. Multivariate analysis showed that the presence of nucleos(t)ide analog therapy, liver cirrhosis, and negative anti‐HBs contributed to the discrepancies between the two assays. Cumulative anti‐HBs positivity rates among discrepant cases were 12.7%, 17.2%, 38.8%, and 43.9% at baseline, 1 year, 3 years, and 5 years, respectively, whereas the corresponding rates among consistent cases were 50.8%, 56.0%, 61.7%, and 68.0%, respectively. Hepatitis B virus DNA negativity rates were 56.4% and 81.4% at baseline, 51.3% and 83.3% at 1 year, and 36.8% and 95.7% at 3 years, among discrepant and consistent cases, respectively. Hepatitis B surface antigen reversion was observed only in discrepant cases.

Conclusions

Re‐examination by high‐sensitivity HBsAg assays revealed that HBsAg was positive in approximately 50% of cases. Cumulative anti‐HBs seroconversion rates and HBV‐DNA seroclearance rates were lower in these cases, suggesting a population at risk for HBsAg reversion.     

Progressive and sufficient decrease of hepatitis B core antibody can predict the disappearance of hepatitis B virus DNA in Japanese patients with hepatitis B surface antigen clearance

The aim of this study was to elucidate the relationships among serum levels of hepatitis B virus (HBV) DNA, periods after hepatitis B surface (HBs) antigen clearance, and the titer of hepatitis B core (HBc) antibody in 200-fold diluted serum. Twelve patients who had clearance of HBs antigen from serum were studied. Five patients had not received any treatment (group A), and seven had received prednisolone withdrawal therapy. The patients in groups A and B were followed up for 86 months and 108 months (median), respectively. Serum HBV was measured by the nested polymerase chain reaction method. In both groups, serum HBV tended to become gradually undetectable after HBs antigen clearance. The positive rate of HBV in the sera 5 years or more after HBs antigen clearance was significantly lower than that in the sera at less than 5 years, both in group A (P = 0.004) and group B (P = 0.010). In both groups, the titer of HBs tended to decline every year after HBs antigen clearance. HBV was still detectable in the sera of some patients for a long period of time after they showed seroconversion to HBs antibody. The results suggest that detection of HBV was difficult in sera with an HBc titer of 30% or lower and at more than 5 years after HBs antigen clearance in both groups. It is important to note that HBV DNA rarely exists in the serum, even when HBs antigen and HBc are both negative. Received: November 22, 1999 / Accepted: April 28, 2000     

乙肝表面抗原大蛋白与HBV DNA的比较及其与ALT的关系

目的:检测不同模式乙肝患者血清中乙肝表面抗原大蛋白(HBV-LP)、乙肝前S1,HBV DNA以及ALT,比较HBV-LP以及乙肝前S1的检出与HBV DNA及ALT之间的关系,探讨HBV-LP用于乙肝患者临床诊断的意义．方法:采用酶联免疫吸附实验(ELISA)检测177例HBV患者血清HBV-LP和乙肝前S1,荧光定量PCR方法检测患者HBV DNA,全自动生化分析仪检测ALT．结果:相同乙肝模式患者血清HBV-LP与HBV DNA检出率无显著差异;HBeAg阳性患者血清中HBV-LP与HBV DNA阳性率均明显高于HBeAg阴性患者(95．45％vs 44．36％,P<0．05; 93．18％vs 41．35％,P<0．05):相同乙肝模式患者血清乙肝前S1的检出低于HBV DNA的检出,两者差异显著(P<0．05);HBV-LP阳性患者的ALT明显高于HBV-LP阴性患者．结论:乙肝表面抗原大蛋白与HBV DNA有较高的符合率,是反映乙肝患者体内病毒复制情况的可靠指标;而且乙肝表面抗原大蛋白阳性患者ALT较阴性患者高,表明HBV-LP同时也反映了乙肝病情的活动情况．