Hepatitis B surface antigen (HBsAg) in feces of convalescent hepatitis B patients

In 1983, 13 subjects were selected from a factory where an outbreak of viral hepatitis B occurred in October 1982. About 5-7 months later, 13 patients with viral hepatitis B were studied by RPHA and ELISA for HBsAg in feces. Presence of HBsAg was confirmed by specific blocking procedure. HBsAg was found in feces in 69% (9/13) of patients and 30.2% (26/86) of samples collected. 14 fecal specimens found to be positive for HBsAg by RPHA or ELISA examined by immune electron microscopy. Small aggregates of 20-28 nm HBsAg spherical particles were found in three fecal samples. 40-50 nm Dane's-like particles were also observed in one sample. The results suggested that in convalescent period of viral hepatitis B the HBsAg might be excreted through feces.     

Chronic active hepatitis in hepatitis B surface antigen (HBsAg) carriers. The need for liver biopsy

Four cases of chronic active hepatitis were found in hepatitis B surface antigen (HBsAg) positive blood donors. Despite minimal symptoms, the full histologic spectrum of chronic hepatitis was seen. Because clinically occult liver disease can be histologically severe, liver biopsy is indicated when liver enzyme levels are persistently abnormal in long-term HBsAg carriers.     

CpG ODN联合HBsAg免疫BALB/c小鼠和HBV转基因C57BL/6J小鼠

目的:探讨人工合成硫代修饰的含CpG基序的寡脱氧核苷酸(ODN)作为佐剂对HBsAg诱导BALB/c和HBV转基因小鼠产生免疫应答的影响. 方法: 用人工合成CpG ODN与血源HBsAg联合免疫BALB/c和HBV转基因C57BL/6J小鼠,采用ELISA方法观察小鼠血清HBsAg及抗-HBs水平,用ELISPOT方法判断CpG ODN对HBsAg免疫小鼠脾T淋巴细胞分泌细胞因子的影响. 结果: CpG ODN联合HBsAg免疫BALB/c小鼠较HBsAg单独注射组同期抗-HBs滴度明显提高,尤其在首次免疫后6、8、12 wk,2组比较差异显著(P<0.05),联合免疫较CpG ODN单独免疫自首次免疫后4 ～16 wk差异显著(P<0.05).与HBsAg,CpG ODN 单独免疫比较,联合免疫能使HBsAg特异性分泌IFN- γ T细胞分别增加3或9倍;CpG ODN,HBsAg联合免疫可诱导转基因小鼠产生抗-HBs,随时间延长,抗体滴度逐渐升高,并能使更多小鼠产生抗体,而单用HBsAg组、CpG ODN组均不能诱导抗-HBs的产生,免疫后各组血清HBsAg浓度较免疫前明显下降(P <0.05),但组间无明显差别(P>0.05),与HBsAg,CpG ODN 单独免疫比较,联合免疫能使HBsAg特异性分泌IFN- γ T细胞分别增加3或11倍. 结论: CpG ODN作为佐剂可增强HBsAg诱导BALB/c小鼠产生体液及细胞免疫应答,CpG ODN ,HBsAg联合免疫可打破HBV转基因小鼠对HBsAg免疫耐受,可望成为慢性乙型肝炎的有效预防和治疗性疫苗.     

Polymerase chain reaction in the detection of hepatitis B virus carriers with sole positive anti-hepatitis B core antigen]

To assess the prevalence of serum HBV DNA in the individuals with positive anti-HBc alone, seroepidemiologic investigations in three populations were carried out with polymerase chain reaction. The detection of sole anti-HBc were 21 of 294 (7.1%), 193 of 1995 (9.7%) and 23 of 377 (6.1%) individuals respectively. Among the anti-HBc positive sera, HBV DNA was detected in 6 (28.6%), 68 (35.2%) and 7 (30.4%) respectively. Follow-up observations showed that 83.8%, 93.1% and 71.4% still remained HBV DNA positive respectively. These might be reasonably regarded as chronic asymptomatic HBV carriers with undetectable HBsAg.     

Post vaccination antibody titres of hepatitis B surface antigen (anti-HBs) in a mixed cohort of health care workers

BackgroundHepatitis B (HepB) is an important vaccine preventable infection among healthcare workers (HCWs). Vaccination against Hep B virus, remains the foremost preventive approach. This study aims to measure the antibody titres to Hep B surface antigen (anti-HBs) in a mixed cohort of HCWs. It also aims to study the association between time since vaccination and the anti-HBs titres thus evaluating the duration of seroprotectionMethodsA total of 200 HCWs, including nursing students (n = 112), nursing staff (n = 49), laboratory technicians (n = 30) and doctors (n = 9) who had received all three doses of the Hep B vaccine and met the inclusion criteria of having taken all three doses of vaccine were included in this study. Anti-HBs titres were estimated by bioMérieux mini VIDAS® automated immunoassay based on the principle of enzyme-linked fluorescence assay.ResultsTwo hundred subjects aged 19 to 52 years were included in the study; mean age was 27.29 ± 0.568 years. Duration since vaccination in the study cohort was ≤ 5 years in 149 (74.5.0%), 6–10 years in 20 (10.0%) and >10 years in 31 (15.5%) subjects. Postvaccination antibody titres were > 100 mIU/ml in 85.0%, 10-100 mIU/ml in 11.0% and ≤ 10 mIU/ml in 3.5%. There was a decline noted in antibody titres as duration after vaccination increased. Increasing age was associated with falling protective titres.ConclusionThe study revealed that majority of the HCWs had adequate anti-HBs titres and were protected after vaccination.     

慢性乙型肝炎患者肝组织内HBcAg表达的临床研究

目的 探讨慢性乙型肝炎（CHB）患者肝组织内HBcAg的表达与肝组织的炎症、纤维化程度、血清中的HBV DNA、HBsAg以及HBeAg定量之间的关系。方法 选择安徽医科大学第一附属医院2013年3月至2014年3月收治的103例CHB患者,按病理学结果分为S1组（36例）和S2~3组（67例）。利用免疫组化技术检测肝细胞内HBcAg的表达,同时利用FirbScan仪器测定患者的肝纤维化程度。结果 在S2~3组中,肝组织HBcAg的表达与血清HBV DNA、HBsAg、HBeAg水平及肝纤维化指标均呈现显著的相关性（P<0.05）,在S1组中均无显著相关（P>0.05）。结论 HBcAg在肝细胞中的表达与机体血清中DNA、HBsAg、HBeAg水平及无创肝纤维化程度存在一定的相关性。     

新的人抗HBsAg抗体Fab cDNA的克隆及序列分析

目的 从已构建的人抗－ＨＢsAg噬菌体抗体库中筛选出结合乙肝表面抗原（ＨＢsAg)的特异的人噬菌体抗体（Ｆab段）,并进行基础序列分析。方法 对噬菌体抗全库进行三轮“吸附－洗脱－扩增”的筛选,使特异性噬菌体抗体得到了富集,ＥＬＩＳＡ实验和ＥＬＩＳＡ竞争抑制实验鉴定出乙肝表面抗原的特异性抗体,同时对筛选出的克隆进行基因序列分析。结果 得到与乙肝表面抗原特异结合的抗体,并通过基因序列分析证明为抗乙肝ＨＢsAg的抗休天经地义人得到的抗惭肝ＨＢ－sAg的特异抗体为下一步表达纯化工作奠定了基础。     

HBsAg与抗-HBs同时阳性乙型肝炎血清56例临床分析

目的　探讨 HBs Ag、抗 -HBs同时阳性的乙型肝炎患者血清学标志物 (HBV-M)模式及 HBV感染状态。方法　 56例 HBs Ag、抗 -HBs均阳性的乙型肝炎患者分别采用 EL ISA法及PCR法进行 HBV-M检测及 HBV DNA检测。结果　 56例 HBV-M模式中其他 HBV血清学指标分别为 HBe Ag阳性 40例 (71.4% ) ,抗 -HBe阳性 4例 (7.14 % ) ,抗 -HBc阳性 53例 (94.6% ) ,抗 -HBc Ig M阳性 13例 (2 3 .2 % )。 12例进行血清 HBV DNA检测 ,阳性率 2 5.0 % (3 / 12 )。结论　 HB-s Ag、抗 -HBs同时阳性者其他血清 HBV-M模式复杂多样 ,并仍可有 HBV持续复制     

The prevalence of hepatitis B surface antigen and anti-HCV antibody in paediatric oncology patients in Hospital Universiti Sains Malaysia

This study examined the prevalence of hepatitis B and C markers in 55 paediatric oncology patients who had completed treatment at the Hospital Universiti Sains Malaysia in Kota Baru. All these children had received blood products and had been treated between 1985-1996. Forty seven per cent of patients were positive for hepatitis B or C. Twenty nine per cent were positive for hepatitis C and twenty two per cent were HBsAg positive. Two children were positive for both and none were HIV positive. Four children had an elevated ALT level and one child had jaundice and hepatomegaly. Some children were marker-positive despite immunization and screening of blood.     

Occurrence of hepatitis and hepatitis B surface antigen in adult patients with acute leukemia.

Fifty-eight adult patients with acute leukemia were screened at the onset of the disease for hepatitis B antigen (HBSAg) in the serum, and during the course of the disease for the development of hepatitis B. One patient had a positive test for HBSAg by the radioimmunoassay technique only at the time leukemia was diagnosed; this patient had received transfusions some years before. In six patients icteric hepatitis B developed; five recovered completely and one died of leukemia during the course of hepatitis. All patients in whom hepatitis developed had received transfusions as a part of supportive therapy for leukemia. The hepatitis risk for patients who received transfusions of blood found to be negative for HBSAg by counterimmunoelectrophoresis was 0.26 percent per unit of blood administered.     

探讨慢性乙型肝炎患者的HBeAg血清转换

对于HBV E抗原（HBeAg）阳性的慢性HBV感染者而言,HBeAg的血清转换是抗病毒治疗停药的指标之一。发生HBeAg血清转换的患者有更好的预后,并且HBeAg血清转换发生的时间越早,预后也越好。     

92例艾滋病患者死亡原因分析

目的了解艾滋病患者的死因结构,改善防治对策。方法对收治的92例艾滋病死亡病例进行回顾性分析。结果大部分死亡患者均未高效抗逆转录病毒治疗（HAART）,总的机会性感染致死占88.1﹪（81/92）。已进行HAART的患者死因：非艾滋病相关的因素、药物副作用及感染。未进行HAART的患者94.2﹪（81/86）死于机会性感染。CD4＋T淋巴细胞≥200个/μl时引起死亡的病原菌与非HIV感染者相似。CD4＋T淋巴细胞〈100个/μl的死亡原因是肺部感染、马尔尼菲青霉病（PSM）、结核病、耶氏肺孢子菌肺炎、感染性休克、隐球菌性脑膜炎等均是致死的重要原因。CD4＋T淋巴细胞〈50个/μl时因PSM死亡的占33.3%（16/48）。结论机会性感染仍是艾滋病患者主要的死亡原因,不同CD4＋T淋巴细胞水平、不同的地域及是否HAART死因均有差异,适宜时机及时HAART可降低患者死亡率。     

获得性免疫缺陷综合征的肺部病变：151例尸检材料病理学研究

研究纽约ＭｏｕｎｔＳｉｎａｉ医学中心１５１例尸检材料的肺部病变，旨在概括艾滋病患者肺剖病学的频谱及其病理特征，所有病例均按常规解剖、取材、福尔马林固定，石蜡包埋，苏木素伊红染色。必要时作组织化学染色和免疫组化研究。     

HBsAg阳性人群中谷胱苷肽S转硫酶M1和T1基因缺失与肝癌遗传易感性的研究

目的探讨HBsAg阳性人群中谷胱苷肽S转硫酶M1和T1(Glutathione-S-Transferase M1;GSTMI和Glutathione-S-Transferase T1;GSTT1)基因缺失性与肝癌遗传易感性的关系。方法应用PCR技术检测62例HBsAg阳性人群中肝癌患者和73例无症状单纯HBsAg异阳性对象的GSTMI和GSTT1。结果肝癌组GSTMI缺失基因型的频率为58．9％,对照组GSTMI缺失基因型的频率为39．7％,二者差异显著(χ^2=5．34,P=0．021),OR值为2．246(95％CI=0．76～2．13)。肝癌组GSTT1缺失基因型的频率为67．1％,对照组GSTT1缺失基因型的频率为52．1％,二者差异显著(χ^2=10．58,P=0．001),OR值为3．210(95％CI=0．82～2．22)。结论具有GSTMI缺失基因型或GSTT1缺失基因型的HBsAg阳性个体中,患肝癌的危险性增加。     

乙肝患者针对抗-HBs的抗独特型体液和细胞免疫反应

目的探讨针对抗-HBs分子上独特型决定簇的攸液及细胞免疫反应的免疫调节意义。方法采用淋巴细胞转化试验观察在急性和慢性乙肝患者体内针对抗-HBs分子上独特型抗原决定簇的体液及细胞免疫反应，并与患者对HB-sAg的体液及细胞免疫反应进行对比。结果25例AVH患者，针对肝HBsAg的体液及细胞免疫反应明显延迟。针对表面抗体的体液及细胞免疫反应．在1wk已达到较高水平，维持4～6wb后逐渐下降。31例CAH，机体对HBsAg的体液及细胞免疫反应明显低下或缺乏。而抗独特型抗体(Ald)阳性单明显高于其它组，且针对抗-HBs独特型的LTT反应也十分活跃。结论这种针对抗-HBs独特型的免疫反应可能涉及一种是缺陷的反馈抑制，导致抗-HBs的产生抑制及HBV携带者状态的维持。     

乙型病毒性肝炎病毒表面抗原阳性手术病人乙肝防治知识知晓率及影响因素

目的了解乙型病毒性肝炎(简称乙肝)病毒表面抗原(HBsAg)阳性病人乙肝防治知识知晓率及影响因素,为制定针对性的护理干预措施提供参考。方法选取北京市某院收治的208例HBsAg阳性病人作为研究对象,调查其乙肝防治知识知晓状况,分析其影响因素。结果 HBsAg阳性病人乙肝防治知识知晓率为29. 8%,属于较低水平,各知识点知晓率为26. 4%～39. 9%;不同文化程度、居住地、平均月收入的HBsAg阳性病人对慢性乙肝知识知晓率的比较,差异均有统计学意义(χ~2=8. 348、5. 348、8. 114,P 0. 05); Logistic回归分析显示,文化程度高、个人月收入高、居住在城市是HBsAg阳性病人乙肝防治知识知晓率高的影响因素。结论 HBsAg阳性病人乙肝防治知识知晓率属于较低水平,应加强开展健康宣教活动,尤其是文化程度低、月收入低、居住在农村的病人。