Serological markers of hepatitis A and B virus infection in overseas students

Serological markers of hepatitis A and B virus infection were determined by radioimmunoassay in 83 overseas university students. Hepatitis B surface antigen (HBsAg) was detected in 8 students (9.6%), antibody to HBsAg and/or antibody to hepatitis B core antigen in 38 (46%), and antibody to hepatitis A virus (anti-HAV) in 74 (89%). These prevalences of hepatitis A and B markers were significantly higher than those in Japanese students. Liver function tests were abnormal in 7 overseas students (8%). Among groups of the overseas students, East Asian groups showed high prevalences of hepatitis B markers. High prevalances of anti-HAV were demonstrated not only in Asian groups but also in South American group.     

Recent changes in serological markers of hepatitis B virus infection in Japanese university students

University students were screened for serological markers of hepatitis B virus infection every year. Hepatitis B surface antigen (HBsAg) determined by reversed passive hemagglutination and antibody to HBsAg (anti-HBs) by passive hemagglutination were positive in 1.7% and 7.3% of the first-year students in 1978-80, respectively, and 1.1% and 3.8% in 1981-84. The difference in the prevalences of anti-HBs between 1978-80 and 1981-84 was statistically significant (p less than 0.001). Hepatitis B e antigen, which was positive by less sensitive immunodiffusion in 52% of HBsAg carrier students in 1976-79, was detected by more sensitive radioimmunoassay only in 19% in 1980-84. The difference was statistically significant (p less than 0.01). Recently changes in hepatitis B virus infection seem to be occurring in Japanese university students.     

广东高校学生“隐匿性”或“窗口期”乙型肝炎病毒感染调查分析

目的利用核酸扩增技术分析广东高校学生乙型肝炎病毒感染的潜在危险因子。方法在酶联免疫试验(ELISA)常规筛查血液的基础上,按要求进行8人份×150μl汇集,汇集阳性组再进行单检测,最终确定阳性个体,采用常规的碱裂解法从血清中提取HBVDNA应用荧光PCR方法在DA620微量荧光检测仪上进行扩增和检测分析结果,在2,6,12个月追踪随访潜在传染危险学生。结果体检学生8 231人,其中HBsAg阳性1 107人,占13.45%;抗-HBs阳性4 995人,占60.68%;HBsAg阴性且抗-HBs阴性者2 129人,占25.87%。在2 129名在校生中,经初筛共筛检出9例HBV-DNA阳性标本,再经复检后,最后确证6例HBV-DNA阳性标本。其HBV-DNA水平为8.5～51.0 IU/ml,"隐匿性"或"窗口期"HBV感染的发生率为2.82‰(6/2 129)。在6例感染者中,3例为血清学标志物均阴性,HBV-DNA阳性;3例为HBV-DNA阳性伴有抗-HBc阳性。结论在广东部分高校大学生存在着较高的"隐匿性"或"窗口期"HBV感染率。对HBsAg阴性人群(尤其是血清标志物全阴的人群)的最有效的乙型肝炎病毒预防是接种乙型肝炎病毒疫苗,使其产生抗-HBs,从而预防HBV感染。     

Serological survey of hepatitis B virus (HBV) markers in out- and in-patients in a university hospital

Of a total of 13,596 patients and 1,876 blood donors in a university hospital examined, 550 (4.1%) patients and 31 (1.7%) donors possessed hepatitis B surface antigen (HBsAg) in their blood. The higher incidence of HBsAg in the patient population than in the blood donors verified the view that medical personnel and hospitalized patients are at increased risk of acquiring HBV infection. To assess the actual hazard of the HBsAg-positive patients, we examined hepatitis Be antigen (HBeAg) and its antibody (anti-HBe) status of 228 HBsAg-positive patients and found that 39 (18%) were positive for HBeAg and 168 (74.5%) were positive for anti-HBe. This indicated that only one fifth of the HBsAg-positive patients should be drawn attention in terms of HBV transmission within a hospital.     

深圳市外来劳务工乙型肝炎血清学检测分析

目的了解2007~2009年深圳市外来劳务工乙型肝炎感染模式和状况,探讨乙肝5项和HBV DNA检出率之间的关系,为深圳市劳务工群体乙型肝炎的预防和控制提供科学依据。方法利用酶联免疫吸附法(ELISA)和实时荧光定量PCR法对2007~2009年1 226份深圳市外来劳务工的血清标本进行乙肝5项检测和HBV-DNA测定。结果深圳市外来劳务工乙肝5项异常者的HBV DNA总阳性率为48.94%。共发现7种HBV感染模式,小三阳患者占HBV感染总例数的49.67%,大小三阳HBV DNA的检出率分别为94.11%和21.67%。20~30岁的青年劳务工乙肝感染人数在A-G感染模式中均超过该模式感染者总数的50%以上。结论深圳市外来劳务工乙肝5项异常者近半数携带HBV DNA,必须加强对大三阳和模式D组(HBsAg阳性和抗-HBc阳性)感染者以及20~30岁的青年劳务工的HBV DNA的监测,从而对外来劳务工HBV感染者的传染性进行正确的评估,为乙肝的防护和治疗提供依据。     

Serological characterization of occult hepatitis B virus infection among blood donors in India

IntroductionDiscovery of hepatitis B infections characterized by the presence of viral genome without detectable HBsAg (Occult Hepatitis; OBI) has initiated a considerable amount of research in this regard. Our study is a serological and molecular characterization of OBI among the donors who donated at our blood bank during the study period.Material and MethodDuring the study period HBsAg ELISA non reactive ID-NAT reactive donors samples were screened for presence of antibody against HBc, HBs and HBe. Molecular analysis of these NAT yield samples was undertaken for detection of the viral load and genotyping.ResultWe studied 28,134 HBsAg ELISA non reactive donor samples. On testing them with ID-NAT, HBV DNA was detected in 25 samples. Eighteen samples out of these 25 NAT yield were further worked up. The 66.6% of the NAT yield samples (12 out of 18) were reactive for antibody against HBc. The 25% (3 out of 12) of these NAT yield samples having antibody against core antigen also had antibody against HBs. The 27.7% (5 out of 18) of NAT yield detected by ID-NAT did not have any detectable serological marker in blood. Four out of 12 core antibody positive NAT yield samples had genotype A HBV infection.ConclusionAs per our study molecular detection of HBV DNA by ID-NAT, we were able to analyze 18 HBV NAT yield cases among 28,134 HBsAg ELISA non reactive donors. Out of 18, 12 donors were OBI whereas the rest (6) were in window period (WP yield) of HBV infection. One out of every 3.6 NAT yield detected by ID-NAT was non reactive for all serological markers.     

Chronic hepatitis B and hepatitis B surface antigen carriers in university students

A study was made of latent hepatic diseases in university students. 1.4% to 1.6% of the students were positive for hepatitis B surface antigen (HBsAg), and 10.3% for anti-HBs. Of 28 students with HBs-antigenemia, 2 had chronic persistent hepatitis, and 3 minimal hepatitis, 23 being healthy carriers. Hepatitis B e-antigen (HBeAg) was detected in 44% of the students with HBsAg, and anti-HBe in 13%. Anti-HBe was significantly more frequently found in female students with HBsAg than in male students. Though most of the students with HBsAg had high titer of antibody to hepatitis B core antigen (anti-HBc), there were a small number of cases showing low titer. HBsAg and anti-HBs was detected in the same serum specimens of 2 carrier students. Liver damage was also found in 3 students without HBs-antigenemia.     

原发性肝癌甲胎蛋白阳性与乙肝病毒标志物感染血清学的关系

目的：探讨原发性肝癌患者血清甲胎蛋白阳性与乙型肝炎病毒感染发生的关系。方法：采用化学发光免疫分析和ELISA法分别检测90例原发性肝癌患者、40例健康对照组进行了血清甲胎蛋白、乙型肝炎病毒血清五项标志物检测。结果：90例原发性肝癌患者中有87例乙肝五项标志阳性，乙型肝炎病毒总感染率为96．7％。乙型肝炎病毒总出现率：HBsAg（＋）为92．2％，HBeAg（＋）为17．8％，HBsAb（＋）为4．4％，HBeAb（＋）为57．8％，HBcAb（＋）为65．5％；5项指标全为阴性者占3．3％，明显高于健康对照组47．5％（19／40）（P〈0．01）和乙型肝炎病毒总感染率（52．5％）（P〈0．01）。肝癌组乙型肝炎病毒血清标志物感染模式，以HBsAg、抗-HBe和抗-HBC阳性模式多见，为40％。表明该模式的乙肝患者为原发性肝癌的高危人群。结论：乙型肝炎病毒与原发性肝癌之间的关系非常明确，乙型肝炎病毒感染不仅是肝癌发生的一个重要的危险因素，而且表明肝癌患者常伴有乙型肝炎病毒的复制活跃。因此，积极预防和控制乙型肝炎病毒感染流行，是减少原发性肝癌发生的关键所在。     

乙型肝炎病毒血清标志物测定及结果解释的若干问题

我国人群乙型肝炎病毒（HBV）感染率高,HBV感染血清学标志物是临床实验室最主要的检测项目之一.经对乙型肝炎“两对半”、抗HBc IgM和HBV DNA检测及结果解释中存在的一些普遍问题进行阐述,并注意到可能存在的因试剂方法的局限性、病毒变异等所致假阴性和假阳性,以及对检测结果的进一步确认和适当的解释,对HBV感染血清标志物检测的正确使用有重要意义.     

Detection of hepatitis B virus infection markers in dried plasma spots among patients in Congo-Brazzaville

The detection of hepatitis B virus (HBV) infection markers by using dried plasma spots from 32 patients living in Congo has been assessed. Considering frozen plasma samples as gold standard, the sensitivity and specificity of HBV serologic markers detection in dried plasma eluted from filter paper were 100%. The sensitivity and the specificity of HBV DNA detection reached 96% and 100%, respectively, with plasma samples dried on filter paper compared to standard samples. Dried plasma samples can represent an alternative to conventional sampling for HBV detection and management of the infection in developing countries.     

Diagnostic markers of chronic hepatitis B infection and disease

Recent advances in therapy for patients with chronic hepatitis B (CHB) infection offer the potential for a more successful treatment outcome, but also raise a number of questions in clinical practice regarding diagnosis and staging of CHB to ensure such potential is realized. In patients without cirrhosis, some forms of antiviral therapy can switch patients from an active disease phase into an inactive hepatitis B surface antigen (HBsAg) carrier state, and eventually lead to HBsAg clearance and HBsAg antibody seroconversion, the closest to a cure in CHB; thus, one of the most important diagnostic questions that clinicians face is the identification of patients with early forms of CHB within a large cohort of asymptomatic HBsAg-positive individuals, most of whom are inactive HBsAg carriers. Two major categories of diagnostic markers are currently available: virus-specific markers and liver disease markers. Most markers involve the use of non-invasive serological testing, but invasive diagnostic procedures, such as liver biopsy, are also an option. In this article, we review current opinions on the appropriate use of diagnostic procedures, answering some important questions for the clinician, such as why, how, when and in whom they might best be used.     

乙型肝炎肝硬化患者乙肝病毒标志物的特点及临床意义

乙型肝炎(乙肝)病毒(HBV)感染是导致我国人群发生肝硬化最常见的原因,而HBV标志物阳性是诊断乙肝肝硬化的重要依据。本研究分析139例乙肝肝硬化患者自然病     

各类慢性乙型肝炎患者HBV前S2抗原与HBV感染血清标志物及HBVDNA的关系

目的探讨乙型肝炎病毒(HBV)前S2抗原(preS2Ag)与HBV感染5项标志物(HBV-M)、HBV DNA之间的关系及对慢性乙型肝炎分类诊断的临床意义。方法对584例各类慢性乙型肝炎患者血清采用放射免疫法(R IA)检测preS2Ag,用酶联免疫吸附试验(ELISA)检测HBV-M(HBsAg、抗HBs、HBeAg、抗HBe、抗HBc),用聚合酶链反应(PCR)检测HBV DNA。结果慢性乙型肝炎轻度、中度、重度及肝炎后肝硬化患者preS2Ag的检出率分别为45.98%、67.10%、83.87%及92.86%;preS2Ag在HBeAg阳性、HBV DNA>105拷贝/mL患者中检出率明显高于HBeAg阴性、HBV DNA<105拷贝/mL患者,差异有统计学意义(P<0.001)。结论preS2Ag的检出意味着病毒有复制或有传染性;开展preS2Ag的检测有助于慢性乙型肝炎的分类、慢性乙型肝炎急性发作和预后的判断。     

各类慢性乙型肝炎患者HBV前S2抗原与HBV感染血清标志物及HBV DNA的关系

目的探讨乙型肝炎病毒（HBV）前S2抗原（preS2Ag）与HBV感染5项标志物（HBV-M）、HBV DNA之间的关系及对慢性乙型肝炎分类诊断的临床意义。方法对584例各类慢性乙型肝炎患者血清采用放射免疫法（RIA）检测preS2Ag,用酶联免疫吸附试验（ELISA）检测HBV-M（HBsAg、抗HBs、HBeAg、抗HBe、抗HBc）,用聚合酶链反应（PCR）检测HBV DNA。结果慢性乙型肝炎轻度、中度、重度及肝炎后肝硬化患者preS2Ag的检出率分别为45.98%、67.10%、83.87%及92.86%;preS2Ag在HBeAg阳性、HBV DNA〉105拷贝/mL患者中检出率明显高于HBeAg阴性、HBV DNA〈105拷贝/mL患者,差异有统计学意义（P〈0.001）。结论preS2Ag的检出意味着病毒有复制或有传染性;开展preS2Ag的检测有助于慢性乙型肝炎的分类、慢性乙型肝炎急性发作和预后的判断。     

Intrafamilial spread of hepatitis B virus infection

Summary Two hundred and forth household contacts of 85 chronic HBsAg carriers were studied to assess the relationship between liver histology and ‘e’ antigen or antibody positivity in the index carrier, and evidence of HBV infection within the family. Liver biopsy results were available in 54 index carriers. The prevalence of HBsAg and anti-HBs in the families of 29 carriers with chronic hepatitis and 25 carriers with either a normal liver or minimal inflammatory changes was not significantly different. Serum from 72 index carriers was available for HBeAg and anti-HBe testing. The prevalence of HBsAg and anti-HBs in the families of 5 HBeAg positive carriers, 59 anti-HBe positive subjects, and 8 carriers negative for both HBeAg and anti-HBe was again not significantly different. Infectivity of a carrier thus does not appear to correlate either with histological evidence of liver damage or with the ‘e’ antigen or antibody positivity of the carrier.     

Decrease in female university students positive for hepatitis B e antigen

Since 1976 university students were screened for hepatitis B surface antigen (HBsAg) every year, and sera positive for HBsAg were tested for hepatitis B e antigen (HBeAg) and antibody to HBeAg (anti-HBe). Yearly changes in the prevalences of HBeAg in the male HBsAg carrier students were relatively small and statistically not significant. In the female HBsAg carrier students, however, HBeAg which was positive by immunodiffusion in 47% of the students in 1976-79 was not detected by radioimmunoassay in 1981 and 1982. The difference of the prevalences of HBeAg between 1976-79 and 1981-82 was statistically highly significant (p less than 0.001). It is suggested that seroconversion from HBeAg to anti-HBe in female HBsAg carriers is recently accelerated.     

乙型肝炎病毒DNA与血清标志物的关系

目的探讨乙型肝炎(下称乙肝)免疫标志物(HBV-M)两对半模式与乙肝病毒核酸(HBV DNA)阳性率及复制水平之间的关系和临床意义。方法乙肝患者血清分别采用酶联免疫吸附试验(ELISA)检测乙肝两对半免疫指标(HBsAg、抗-HBs、HBeAg、抗-HBe、抗-HBc),实时荧光定量-聚合酶链反应(FQ-PCR)检测HBV DNA含量,并对结果进行对比分析。结果在HBV-M不同模式中,HBV DNA的阳性率不同,HBV DNA含量也不相同;在HBV-M中HBeAg阳性与HBV DNA检出率呈正相关。以HBsAg(+)HBeAg(+)抗-HBc(+)组(大三阳组)HBV DNA的阳性率最高,病毒载量较高。结论不同HBV-M具有不同的临床意义,而HBV DNA是衡量乙肝传染性的最精确指标,是确定HBV感染不同复制状态的检测手段,HBV DNA阳性表明有完整的病毒颗粒复制,即有传染性。因此,联合检测HBV-M和HBV DNA,不仅可以提高检出率,避免漏诊,而且为临床对HBV感染、复制、传染性判定以及抗病毒治疗的疗效评估提供了更为可靠的判定依据。