中山市健康人群乙肝血清学监测情况分析

目的 了解乙肝疫苗接种效果情况，进而探讨如何更好地实行免费接种乙肝疫苗，确保接种质量。方法 随机抽取152名新生儿和1岁以上健康人群2495名，应用酶联免疫法对其血清进行HBsAg和anti．HBsAg检测。结果 152名新生儿，抗-HBs阳性141人，阳性率为92．7％。HBsAg阳性0人。2495名1岁以上健康人群，抗-HBs阳性1199人，阳性率为48．1％，HBsAg阳性259人，阳性率为10．4％。1～18岁844人，HBsAg阳性10人，阳性率为1．2％。18岁以上1651人，HBsAg阳性249人，阳性率为15．1％。结论 对新生儿及时进行乙肝疫苗全程免疫，能提高新生儿对乙肝的免疫力，预防乙肝。接种乙肝疫苗、提高接种质量能提高易感人群对乙肝的免疫力。降低人群乙肝感染率。1岁以上健康人群抗-HBs阳性率偏低，存在感染乙型肝炎病毒的危险。     

韶关市1～5岁儿童乙型肝炎血清学调查结果分析

目的了解乙肝疫苗纳入免疫规划后,韶关市1～5岁儿童乙肝病毒携带率与乙肝免疫水平,评价现阶段儿童乙肝的预防控制效果。方法从全市10个县（市、区）中采取分层整群随机抽样方法,选取2008年在幼儿园（托儿所）1～5岁儿童作为调查对象,收集血清样本采用酶联免疫吸附试验（ELISA）检测乙肝表面抗原（HBsAg）和表面抗体（抗-HBs）。结果共采集1～5岁儿童血清1485份,HBsAg阳性率为0.88%,随年龄增长有增高的趋势,男性0.93%、女性0.82%,经检验两者间差异无统计学意义（χ2=0.0586,P〉0.05）,地区间最高的是南雄市（0.97%）,最低的武江区（0.80%）,经检验两者间差异无统计学意义（χ2=0.0808,P〉0.05）;抗-HBs阳性率为65.86%,随年龄增长有下降趋势,男性65.01%、女性66.80%,经检验两者间差异无统计学意义（χ2=1.5424,P〉0.05）,地区间最高的武江区（66.27%）,最低的是乳源县（65.47%）,经检验两者间差异无统计学意义（χ2=0.0688,P〉0.05）。结论韶关市乙肝疫苗免疫规划实施后,5岁以下儿童HBsAg携带率明显降低,预防效果显著;抗-HBs阳性率偏低,加大新生儿乙肝疫苗接种剂量。     

三种不同免疫检测法对乙肝血清学标志物检测的结果对比分析

目的 探讨三种不同免疫检测法对乙肝血清学标志物(HBsAg)检测的结果.方法 选择我院2015年6月至2016年6月肝病门诊就诊患者50例,经病理确诊为乙肝患者25例.通过采用酶联免疫法对乙型肝炎抗体的检测;然后通过免疫胶体金法和电化学发光免疫分析法进行检查,对三种方式的检测结果进行对比分析.结果 ①乙肝病毒标志物中五项测试的阳性率最高的是电化学发光免疫分析法,酶联免疫法其次,阳性率最低的是胶体金法.②灵敏度:酶联免疫法低于电化学发光免疫分析法(χ2=3.030,P=0.082);电化学发光免疫分析法高于胶体金法(χ2=5.357,P=0.021);酶联免疫法高于胶体金法(χ2=0.439,P=0.508).灵敏度从高到低排序为:电化学发光免疫法、酶联免疫法、胶体金法,其中电化学发光免疫法和胶体金法差异显著,有统计学意义,P<0.05.特异性:电化学发光免疫分析法高于酶联免疫法(χ2=2.000,P=0.157);电化学发光免疫分析法高于胶体金法(χ2=3.030,P=0.082);酶联免疫法高于胶体金法(χ2=0.136,P=0.713).特异性从高到低排序为:电化学发光免疫法、酶联免疫法、胶体金法,各组间比较无明显差异,无统计学意义,P>0.05.结论 不同的乙肝表面抗原检测方法有着其各自的优缺点,应当根据具体的检测项目选择合适的检测方法,以提高临床乙肝病毒感染的诊断准确度,为及时的治疗提供科学的依据.     

公务员乙肝病毒感染血清学研究

目的 了解公务员乙肝的感染和流行情况,为乙肝防治工作提供科学依据。方法 采用ELISA法对1364名公务员保健体检进行HBV感染的血清学分析。结果 HBsAg阳性率为13．12％（179／1364）,其中男15．0％（109／722）,女10．90％（70／642）,男性明显高于女性,且有随年龄增长而呈下降的趋势。HBsAg阳性者的血清标志物的6种组合模式中,以HBsAg、抗－HBe、抗－HBc均为阳性的组合模式最多37．99％（68／179）,单项则以抗－HBc阳性最多69．27％（124／179）。结论 深圳市公务员HBV感染情况严重。     

秦皇岛市10499例不同人群乙肝五项定量检测结果分析

目的 收集2014年秦皇岛市学龄前儿童、孕产妇、公务员体检人群乙肝五项定量检测结果,分析其乙肝流行趋势和特点,为本地区不同人群的乙肝病毒的防护和乙肝疫苗的接种做科学指导.方法 采用时间分辨荧光免疫分析法(TRFIA)进行乙肝五项定量检测.结果 本资料乙肝阳性255例,不同人群乙肝表面抗体含量差异有统计学意义(P＜0.05),各年龄段乙肝表面抗体含量差异有统计学意义(P＜0.05),20 ～35岁表面抗体阳性率最高,50岁以上老年人最低,但高免疫应答率各组均不高.结论 建议医院利用信息化平台的优势,加强乙肝防护知识的宣传,发挥定量检测的优势,加强疫苗接种的有效性,为本地区不同人群乙型肝炎的防治提供科学指导.     

永川区大安镇人群甲亢患病率现况调查结果分析

目的了解重庆市永川区大安镇甲状腺机能亢进症（以下简称甲亢）的患病现状,探索食盐加碘对甲亢患病情况的影响。方法通过筛查大安镇甲亢病例和临床确诊甲亢病例,计算甲亢人群患病率,并进行三间分布分析。结果大安镇人群甲亢患病率为5.36‰;50～岁年龄组患病率最高（11.80‰）,不同年龄组之间患病率比较差异有统计学意义（χ2=101.22,P〈0.05）;3个不同食盐加碘时间段的发病密度比较差异有统计学意义。结论永川区大安镇甲亢年均患病率随食盐加碘量的增加有升高趋势。不同人群食用合适的碘盐问题值得关注,需进一步深入研究。     

健康体检人群3632例乙肝五项检测结果分析

目的 了解健康体检人群中HBV感染率及乙肝五项血清学标志物感染模式的分布状况. 方法 采用ELISA方法 检测被检者乙肝血清学标志物.结果 通过统计学分析显示,健康体检人群中,HBV感染率为12.61%,其中"大三阳"模式占2.70%,"小三阳"模式占6.75%,HBsAb(+)、HBeAb(+)、HBcAb(+)模式占5.95%, HBsAg(+)、HBcAb(+)模式占3.03%, HBeAb(+)、HBcAb(+)模式占4.10%,单项HBsAb模式占41.0%;HBsAg(+)总检出率女性10.92%,男性13.86%; HbsAb(+)总检出率49.56%,其中女性54.32%,男性46.06%,青年组53.50%,老年组36.00%;乙肝五项血清学标志物全部为阴性的34.25%(1244/3632).结论 本次调查健康体检人群中的HBV感染率为12.61%;HBsAg(+)检出率男性高于女性;HBsAb(+)检出率女性高于男性,青年组高于其他组别,老年组最低;乙肝五项血清学标志物模式为10种,主要以常见模式为主.     

孕妇血清中乙肝前S1抗原和其他乙肝血清学指标及HBV-DNA定量间的相关性研究

目的 了解孕妇血清中乙肝前S1抗原、其他乙肝血清学指标及HBV-DNA定量结果间的相关性.方法 用荧光定量PCR法检测其他乙肝血清学指标阳性孕妇血清中HBV-DNA.结果 254例不同乙肝血清学指标阳性孕妇血清中乙肝前S1抗原总阳性率为47.6%,HBV-DNA总阳性率为42.9%;其中乙肝前S1抗原阳性组、阴性组HBV-DNA阳性率分别为47.1%、39.1%,无显著性差异(P＞0.05);乙肝血清学指标HBVsAg/HBVeAg/HBVcAb(简称1.3.5)阳性组、HBVsAg/HBVcAb(简称1.5)阳性组及HBVsAg/HBVeAb/HBVcAb(简称1.4.5)阳性组的乙肝前S1抗原阳性率分别为57.6%、43.1%、44.6%,无显著性差异(P＞0.05);HBV-DNA阳性率1.3.5阳性组为86.3%,1.5阳性组32.8%,1.4.5阳性组25.4%,其结果1.3.5阳性组较1.4.5阳性组阳性率高,有高度显著性差异(P＜0.005),而1.5阳性组无差异.1.3.5阳性组HBV-DNA含量90%左右在107～108 copy/ml之间,1.5阳性组和1.4.5阳性组85%左右在103～104 copy/ml之间.结论 我们的检测结果提示乙肝前S1抗原与其它乙肝血清学指标及HBV-DNA定量结果间无相关性;而HBVeAg与HBV-DNA复制和传染性有相关性.     

泉州市2004-2009年乙肝流行病学特征分析

目的分析泉州市2004-2009年乙型病毒性肝炎（乙肝）的流行病学特征,为制定乙肝控制策略提供科学依据。结论采用描述流行病学方法进行分析。结果乙肝报告发病率显著呈逐年增高趋势,从2004年的80.89/10万增至2009年的127.26/10万,年均报告发病率为92.65/10万;2004-2008年未见明显的季节性高峰,2009年1月份报告病例数突然增多,并呈逐月下降趋势;年均发病率沿海区县高于山区县;发病以20～岁组至45～岁组的青壮年为主,10岁以下儿童发病率最低;男女比例为2.77∶1;发病以农民、工人、学生等为主;2006年血清流行病学调查显示,1～59岁HBsAg阳性率为12.78%,5～岁组以下儿童阳性率最低（1.30%）,25～岁组阳性率最高（19.62%）,经χ2检验,差异有统计学意义（χ2=80.532,P=0.000）。结论乙肝疫苗接种取得显著成效,但发病仍未得到有效控制,应采取以阻断母婴传播为主,并加强对20～岁组至45～岁组农民、工人、学生等重点人群、高危人群的乙肝疫苗接种等综合性防治措施。     

High levels of viral replication during acute hepatitis B infection predict progression to chronicity

To assess the pattern of development of serologic markers during acute hepatitis B, levels of HBsAg, HBeAg, and hepatitis B virus (HBV) DNA were assayed in stored serum samples obtained sequentially from 12 subjects infected with HBV during experimental studies conducted in the 1950s. Six patients developed acute self-limited hepatitis, three developed chronic hepatitis, and three had an asymptomatic infection without HBsAg. HBsAg was the first serologic marker detected (mean = 52 days after exposure), followed by HBeAg (62 days) and HBV DNA (72 days). Peak HBsAg levels occurred before onset of symptoms and correlated with peak titers of HBeAg and HBV DNA. Patients who developed chronic hepatitis had higher peak levels of viral markers than those with self-limited disease: HBsAg (30 versus 5.4 μg/ml), HBeAg (1:2,000 versus 1:60 titer) and HBV DNA (3,192 versus 444 pg/ml). Thus, chronic HBV infection is characterized by high levels of viral replication appearing early during the acute phase of infection. © 1994 Wiley-Liss, Inc.

1 This article is a US Government work and, as such, is in the public domain in the United States of America.

     

江门市健康体检成人乙型肝炎血清流行病学调查

目的探讨江门市健康体检成人乙型肝炎病毒血清流行病学状况,为乙型病毒性肝炎防治提供可靠依据。方法收集2009年1-6月江门市体检成人共计11208人,分别统计分析年龄、性别、乙型肝炎＂两对半＂结果和肝功能。结果江门市健康体检成人HBsAg阳性率为9.06%,男性和女性HBsAg阳性率分别为10.8%和6.88%,男性明显高于女性;乙型肝炎病毒感染者中HBeAg阳性和HBeAg阴性分别占19.49%和80.51%;HBsAb阳性率为67.34%,乙型肝炎标志物全阴为22.08%。结论江门市健康体检人群HBsAg阳性率与全国平均水平相当,预防控制乙肝仍要加强以乙肝疫苗接种为主的综合预防措施。     

Acute type A hepatitis during chronic hepatitis B virus infection: association of depressed hepatitis B virus replication with appearance of endogenous alpha interferon

Two patients with chronic type B hepatitis and intercurrent episodes of acute type A hepatitis are presented. Serological markers of hepatitis B virus replication decreased or became undetectable in both patients during the acute illness, while interferon activity was transiently detected in serum. The presence of serum leukocyte (alpha) interferon was confirmed by neutralization with specific antisera and tests of pH2 stability. These observations suggest a role for natural leukocyte (alpha) interferon in the modulation and control of hepatitis B virus infection and provide further evidence to support trials of exogenous leukocyte (alpha) interferon in the chronic infection.     

Hepatitis B virus DNA in asymptomatic HBsAg carriers: comparison with HBeAg/anti-HBe status

Sera of 17 HBeAg positive and 104 anti-HBe positive asymptomatic HBsAg carriers from two cohorts were tested for HBV DNA. HBV DNA was found in 13 of 17 HBeAg positive carriers (76.5%) and in only 7 of 104 of anti-HBe positive carriers (6.7%). Eleven of the 17 HBeAg positive carriers were retested for HBV DNA over a period of 7 to 36 months after the initial test. HBV DNA disappeared from the serum in 2 patients in spite of persistence of the HBe antigen. Of the 104 anti-HBe carriers, 89 were retested for HBV DNA over a period of 6 to 52 months after the initial test. HBV DNA disappeared from the serum in 5 of the 7 who were previously positive for HBV DNA, and persisted in 2. These findings indicate that there is an inconstant relationship between the time of seroconversion of HBeAg to anti-HBe and the disappearance of HBV DNA. In one HBeAg positive patient, HBV DNA, which was absent in the serum on first testing, was present on retesting. This suggests that the presence of HBV DNA in the serum of some patients may be intermittent. The presence of HBV DNA in the serum of some anti-HBe positive carriers accounts for the finding that they may be infective. All but one of the HBV DNA positive anti-HBe carriers were born outside North America, most in Asia. HBV DNA were found more frequently in the serum of anti-HBe positive carriers who had biochemical and histological evidence of liver disease than in carriers without such evidence.     

Hepatitis B virus genotypes and spontaneous hepatitis B e antigen seroconversion in Taiwanese hepatitis B carriers

Hepatitis B virus (HBV) is classified into eight genotypes (A-H), and genotype C is associated with more aggressive liver disease compared to genotype B. However, the mechanisms responsible for the clinical differences remain unclear. To test whether genotype C patients had with lower rates of spontaneous hepatitis B ge antigen (HBeAg) seroconversion than genotype B patients, stored serum samples from 146 Taiwanese adult HBeAg-positive hepatitis B carriers followed-up for a mean of 52 months (range, 12-120 months) were tested for HBV genotype by a molecular method. Genotype C patients were significantly older than genotype B patients (mean age, 37 +/- 12 vs. 29 +/- 10 years, P < 0.001). During the follow-up period, genotype C patients had a significantly lower rate of spontaneous HBeAg seroconversion than genotype B patients (27 vs. 47%, P < 0.025). Spontaneous HBeAg seroconversion occurred one decade later in genotype C patients compared with genotype B patients. Multivariate analyses identified age < or =35 years (odds ratio: 2.08; 95% confidence interval [CI], 1.07-4.0; P < 0.05), high baseline serum alanine aminotransferase level (odds ratio: 2.34; 95%CI, 1.39-4.09; P < 0.005), and HBV genotype B (odds ratio: 1.94; 95%CI, 1.03-3.63; P < 0.05) as independent factors associated with spontaneous HBeAg seroconversion. In conclusion, genotype C patients, compared to genotype B patients, have a delayed HBeAg seroconversion in the immune clearance phase of chronic HBV infection, which may contribute to a more progressive liver disease and more refractory to antiviral therapy.     

Occult hepatitis B virus infection in patients with leprosy

Leprosy patients may present with immune system impairment and have a higher hepatitis B virus (HBV) seroprevalence, justifying the investigation of occult HBV infection in these individuals. The aim of this study was to verify the frequency and the clinical factors associated with occult HBV infection in leprosy patients. Between 2015 and 2016, leprosy patients from a reference center in Brazil were interviewed to assess clinical data. Blood samples were collected for the screening of HBV serological markers using enzyme-linked immunosorbent assay. Patients with negative hepatitis B surface antigen (HBsAg) that had positive anti-HBc and/or anti-HBs were selected for HBV DNA detection using real-time polymerase chain reaction. SPSS was used for data analysis. Among 114 selected patients, six were identified with occult infection (5.3%) and five of them with multibacillary leprosy. Three patients with occult infection had a history of a type 2 reaction (P = 0.072; OR, 4.97; 95% CI, 0.87-28.52). Only two patients with occult infection had isolated anti-HBc, while three had isolated anti-HBs, including those with the highest HBV DNA titers. In conclusion, in leprosy patients with negative HBsAg and positive anti-HBc and/or anti-HBs, occult HBV infection occurs in 5.3% and can be found even in patients with isolated anti-HBs.     

Long-term follow-up of hepatitis B virus and hepatitis C virus replicative levels in chronic hepatitis patients coinfected with both viruses

Dual infection with hepatitis B and C viruses is often encountered in endemic areas of both viruses. However, understanding of the clinical and virological implications is limited. The aim of this study was to investigate the role of each virus in liver injury and the interaction between the two viruses in dual infection with hepatitis B and C viruses. Three patients who had chronic infection with both hepatitis B and C viruses were examined, and a longitudinal study of both serum hepatitis B virus DNA and hepatitis C virus RNA levels over 4 years was undertaken. The results were correlated with serum alanine aminotransferase levels. Serum alanine aminotransferase values showed a relationship with hepatitis B virus replicative levels, but not with hepatitis C virus replicative levels in all 3 patients. Serial changes of replicative levels of both viruses were studied, and it was found that hepatitis C virus replicative levels were enhanced after the decline of hepatitis B virus replication in 1 of the 3 patients. In the remaining 2 patients, a transient rise of hepatitis C virus replicative levels in association with a decrease of hepatitis B virus replication was also observed during part of the follow-up period. These findings indicate that hepatitis B virus may play a dominant etiological role in liver injury, and that a suppressive action between hepatitis B and C viruses may occur in dual infection with both viruses. © 1995 Wiley-Liss, Inc.     

State of hepatitis B virus DNA in leucocytes of hepatitis B patients

Hepatitis B virus (HBV) DNA in leucocytes from 50 hepatitis patients with various patterns of HBV serological markers and serum HBV DNA and 13 normal controls were examined by Southern blot hybridization with 32P-labeled 3.2 Kb HBV DNA. A free form of HBV DNA was observed in leucocytes of 8 patients, 7 of whom were positive for serum HBeAg, and in 6 patients an integrated form of HBV DNA was identified. HBV DNA was not identified in leucocytes from 13 normal controls. The free form of HBV DNA in leucocytes existed as a heterogeneous smear from 2.0 to 3.2 Kb, similar to the pattern in liver and hepatocellular carcinoma cells but different from serum HBV DNA in which the 3.2 Kb band was absent. The banding pattern of the integrated form of HBV DNA in leucocytes varied among different patients. During preparation of white blood cells and purification of HBV DNA probes, it was important to remove plasma contamination and traces of pBR322, respectively. The presence of extrachromosomal DNA sequences partially homologous to pBR322 could cause false results. The presence of a free and integrated form of HBV DNA in leucocytes is important for explaining the biology of HBV, the harbouring and replication sites of extrahepatic origin, the mechanism of recurrent infection, and the rationale of the treatment of hepatitis B.     

Serum hepatitis B surface antigen levels correlate with high serum HBV DNA levels in patients with chronic hepatitis B: a cross-sectional study

Purpose: The hallmark of chronic hepatitis B (CHB) infection is the presence of hepatitis B surface antigen (HBsAg) positivity for at least 6 months. Recently, serum levels of HBsAg have been compared with serum HBV DNA as a surrogate marker to monitor CHB patients. However, data correlating these two markers are scarce. Hence, the present study was done to correlate HBV DNA with HBsAg in CHB patients. Materials and Methods: Consecutive patients of CHB were included. HBV DNA was measured by real-time polymerase chain reaction (PCR). Serum HBsAg was measured by Architect HBsAg. Results: Of the 198 patients enrolled, 166 fulfilled the inclusion criteria (mean age 43 ± 14 years, 87% males) and the median HBV DNA was 1.7 × 10³ (range 6.0–1.1 × 10⁸) IU/ml. Median HBsAg was 8.7 × 10³ (range 5.0–3.2 × 10⁵) IU/ml. Overall correlation between HBV DNA and HBsAg was weak but significant (Spearman ρ = 0.443, P < 0.01). Correlation in HBe antigen-positive group was better (ρ = 0.402, P < 0.01) in comparison to HBe antigen-negative group (ρ = 0.193 P = 0.05). Good correlation existed in treatment-naïve group (ρ = 0.538, P < 0.01). Correlation was regardless of normal or raised alanine transaminase (ALT). Eighty (48%) patients had high HBV DNA (≥2000 IU/ml). Correlation in high DNA group was significant (P < 0.01). The best cut-off of HBsAg for diagnosing high DNA is 3.36 ×10³ IU/ml. Conclusions: Serum HBsAg correlates with HBV DNA in CHB patients, especially in high serum HBV DNA, HBe antigen-positive and treatment-naïve group. HBsAg levels can be used for predicting high serum HBV DNA levels.