用重组结构区抗原检测抗丙型肝炎病毒IgM抗体方法？…

目的 检测抗丙型肝炎病毒（ＨＣＶ）结构区蛋白ＩｇＭ抗体。方法 采用丙型肝炎病毒Ｃ，Ｅ１、Ｅ２区重组抗原混合包被和分别包被酶标板；用兔抗人γ链血清处理人血清标本，再用固相包被羊抗兔抗体吸附兔抗人γ链－人ＩｇＧ复合物，建立了抗－ＨＣＶＩｇＭ检测方法。结果 对７６例现型肝炎病人血清进行抗－ＨＣＶ ＩｇＭ检测，同时与逆转录－巢式聚合酶链反应（ＲＴ＋ＰＣＲ）检测结果进行比较，再会得具有相关性（Ｐ〈０．００５     

丙型肝炎病毒感染者血清细胞因子的检测

目的 探讨丙型肝炎病毒（ＨＣＶ）感染慢性化的宿主免疫机制。方法 用酶联免疫吸附实验测定了１８例慢性ＨＣＶ感染者、１１例正常对照和１０例慢性ＨＢＶ感染者的Ｔ辅助淋巴细胞（Ｔｈ０细胞因子ＩＦＮ－γ,ＩＬ－２,ＩＬ－４和ＩＬ－１０的血清浓度。结果 ＨＣＶ感染者的ＩＬ－２（Ｔｈ１细胞因子）、ＩＬ－４的ＩＬ－１０（Ｔｈ２细胞因子）较正常对照均明显增高（Ｐ〈０．０５,Ｐ〈０．０２５,Ｐ〈０．００１）,但以Ｔｈ     

丙型肝炎病人抗丙型肝炎病毒IgM检测的临床应用

丙型肝炎病人抗丙型肝炎病毒ＩｇＭ检测的临床应用王业东，朱传琳，姚家，程云，王海清，耿业丽，李跃旗（中国人民解放军３０２医院，北京１０００３９）在丙型肝炎病人中检测抗丙型肝炎病毒ＩｇＭ抗体国内外已见报道［１－３］。其临床意义如何，各家观点多有共识也略有...     

用重组结构区抗原检测抗丙型肝炎病毒IgM抗体方法的建立

目的检测抗丙型肝炎病毒（ＨＣＶ）结构区蛋白ＩｇＭ抗体。方法采用丙型肝炎病毒Ｃ，Ｅ１，Ｅ２区重组抗原混合包被和分别包被酶标板；用兔抗人γ链血清处理人血清标本，再用固相包被羊抗兔抗体吸附兔抗人γ链－人ＩｇＧ复合物，建立了抗－ＨＣＶＩｇＭ检测方法。结果对７６例丙型肝炎病人血清进行抗－ＨＣＶＩｇＭ检测，同时与逆转录－巢式聚合酶链反应（ＲＴ－ＰＣＲ）检测结果进行比较，两者具有相关性（Ｐ＜０００５）；ＩｇＭ抗体组成分析结果表明采用全片段Ｃ、Ｃ＋Ｅ２区抗原血清标本中的抗－ＨＣＶＩｇＭ检出率分别可达９６６％和１００％。结论ＨＣＶ的Ｃ、Ｅ２重组抗原用于抗－ＨＣＶＩｇＭ检测具有较高的敏感度和特异性。     

胎儿肝内丙型肝炎病毒感染的检测

胎儿肝内丙型肝炎病毒感染的检测陈伟红，周永兴，闫荣，杜绍财，姚志强内型肝炎病毒（ＨＣＶ）主要传播途径是经输血或血制品，但约有４０％～５０％的散发病例并无明确输血或接触血液史，可能存在其它的传播途径〔１〕。近几年来国外报道了母婴垂直传播的若干病例，但尚...     

丙型肝炎病毒感染者的自身抗体分析

对161名丙型肝炎病毒(HCV)感染者进行了8种自身抗体(抗核抗体、类风湿因子、抗甲状腺球蛋白抗体、抗甲状腺微粒体抗体、抗双链DNA抗体、抗RNP抗体、抗Sm抗体、抗精子抗体)的检测。有52名检出69项次自身抗体,自身抗体检出率为32.3％,显著高于健康人对照组(P<0.005)(未计抗精子抗体)。认为HCV感染可能是诱发自身免疫反应的一个重要因素。     

丙型肝炎患者血清抗丙型肝炎病毒性抗IgM及HCVRN…

用酶联免疫吸附试验对住院病人抗丙型肝炎病毒抗体阳性血清标本进行抗－ＨＣＶＩｇＭ的检测，并与ＨＣＶＲＮＡ检测结果比较。结果表明，ＨＣＶＲＮＡ阳性、抗－ＨＣＶ阳性，ＨＣＶＲＮＡ阳性，抗－ＨＣＶ阴性及ＨＣＶＲＮＡ阴性，抗－ＨＣＶ阳性三类型中均有抗－ＨＣＶＩｇＭ阳性者。     

丙型肝炎病毒RNA在人外周血白细胞中的存在及其意义

丙型肝炎病毒ＲＮＡ在人外周血白细胞中的存在及其意义雷学忠综述王锦蓉、雷秉钧审校本世纪七十年代初，人们就已经注意到一种与输血密切相关的肝炎，而其病原又非甲型或乙型肝炎病毒（ｈｅｐａｔｉｔｉｓＡｏｒＢｖｉｒｕｓ），因此称之为非甲非乙型肝炎（ｎｏｎ－Ａ，ｎ...     

152例重症病毒性肝炎中丙型肝炎病毒感染及其临床分析

１５２例重症病毒性肝炎中丙型肝炎病毒感染及其临床分析胡国龄，谭德明，张铮，任培上有马晖勝丙型肝炎病毒（ＨＣＶ）是肠道外传播的非甲非乙型肝炎的主要病原之一。ＨＣＶ感染易致肝炎慢性化和肝硬化。ＨＣＶ和ＨＡＶ或ＨＢＶ重叠感染可使病情加重，促使重症肝炎的发生...     

丙型肝炎病毒感染的血清学检测

目的了解丙型肝炎病毒（ＨＣＶ）感染及病毒血症存在情况。方法用酶联免疫吸附试验（ＥＬＩＳＡ）和聚合酶链反应（ＰＣＲ）对不同人群的血清标本做了抗－ＨＣＶ、抗－ＨＣＶＩｇＭ和ＨＣＶＲＮＡ的检测，并对三项指标间的关系进行了对比分析。结果抗－ＨＣＶ在普通成年人、献血员、急性肝炎和肝硬化患者中的检出率分别是３５７％，８５８％，６２５％和４８３８％；与ＨＣＶＲＮＡ的符合率分别是１１４３％，６１１１％，８００％和７３３３％。相同人群抗－ＨＣＶＩｇＭ与ＨＣＶＲＮＡ的符合率分别是７５％，９０９％，８１８１％和１００％。结论抗－ＨＣＶＩｇＭ比抗－ＨＣＶ能更客观地反映ＨＣＶ病毒血症的情况，个别抗－ＨＣＶ阴性血清检测到了抗－ＨＣＶＩｇＭ和ＨＣＶＲＮＡ。     

庚型肝炎病毒IgM抗体检测方法的建立及其临床意义

目的建立一种早期、快速诊断庚型肝炎的血清学检测方法。方法以辣根过氧化物酶标记庚型肝炎病毒（ＨＧＶ）多肽ＮＳ３,ＮＳ５区段抗原,建立了捕获酶联免疫吸附试验（ＥＬＩＳＡ）,用于检测血清中ＨＧＶＩｇＭ抗体。结果本法不受特异性ＩｇＧ的竞争和类风湿因子的干扰;与其它致肝炎的病毒（ＨＡＶ、ＨＢＶ、ＨＣＶ、ＨＥＶ、ＣＭＶ、ＥＢＶ）无交叉反应。检测４６例非甲、乙、丙、戊型肝炎患者血清,抗－ＨＧＶＩｇＭ阳性１４例,阳性率３０．４３％,其中,６例同时为ＨＧＶＲＮＡ阳性,阳性符合率为４２．８６％（６／１４）,检测１２例庚型肝炎病人双份血清,其中,急性期血ＨＧＶＩｇＭ抗体均为阳性。结论该法检测ＨＧＶＩｇＭ抗体特异性强,敏感性高,且简便快速,适用于临床对庚型肝炎新近感染的早期诊断,有推广应用价值。     

丙型肝炎患者血清抗丙型肝炎病毒抗体IgM及HCVRNA检测结果的比较

用酶联免疫吸附试验（ＥＬＩＳＡ）对住院病人抗丙型肝炎病毒抗体（抗－ＨＣＶ）阳性血清标本进行抗－ＨＣＶＩｇＭ的检测，并与ＨＣＶＲＮＡ检测结果比较。结果表明，ＨＣＶＲＮＡ阳性、抗－ＨＣＶ阳性，ＨＣＶＲＮＡ阳性、抗－ＨＣＶ阴性及ＨＣＶＲＮＡ阴性、抗－ＨＣＶ阳性三种类型中均有抗－ＨＣＶＩｇＭ阳性者。结果还表明ＨＣＶＲＮＡ阳性病例的抗－ＨＣＶＩｇＭ阳性率明显高于ＨＣＶＲＮＡ阴性的病例（Ｐ＜０．０５），在临床诊断上ＨＣＶＲＮＡ阳性与阴性病例的肝病大多数为急性肝炎（ＡＨ）和慢性活动性肝炎（ＣＡＨ），ＨＣＶＲＮＡ阳性与阴性比较，各类肝病的病例数无明显差别。     

IgM and IgG antibodies to hepatitis C virus in patients with mixed cryoglobulinaemia

To assess the relationship between hepatitis C virus (HCV) infection and essential mixed cryoglobulinaemia (EMC), sera from 23 patients with EMC were tested for IgG and IgM antibodies to HCV antigens and for HCV RNA. Quantitative HCV antibody studies were performed on scrum and purified cryoglobulin fractions. HCV antibodies of both IgG and IgM class were found in 22 (96%) patients. Ten of these were also HCV-RNA positives. Higher litres of anti-HCV IgM were present in the 11 patients with evidence of liver damage. Anti-HCV IgG antibodies were shown to be concentrated in the IgG fraction of cryoglobulins in all eight patients studied. These results strongly suggest a role for HCV in the pathogenesis of EMC.     

Significance of anti-hepatitis C virus core IgM antibodies in patients with chronic hepatitis C

Antihepatitis C virus (HCV) IgM antibodies were found in patients with both acute and chronic hepatitis C. The aims of the study were to determine the significance, in terms of liver disease and virological parameters, of anti-HCV core IgM antibodies in the serum of patients with chronic hepatitis C, and the possible relationship between the presence of these antibodies before treatment and biochemical and virological responses to interferon therapy. Sixty-one patients with chronic hepatitis C were studied. Tests for serum anti-HCV core IgM antibodies were carried out before treatment. The patients received 3 mega units of interferon alpha-2a subcutaneously thrice weekly for at least 3 months (6months when alanine aminotransferase activity was normal at month 3). A biochemical response to interferon therapy was defined as normal alanine aminotransferase activity at the end of treatment (month 6: biochemical response) and 6 months later (month 12: sustained biochemical response). A sustained virological response was defined as serum HCV RNA negativity by a polymerase chain reaction-based detection method (PCR) in patients with normal alanine aminotransferase at month 12. Anti-HCV core IgM antibodies were detected in 28 of the 61 patients (46%). The prevalence of these antibodies was significantly higher in patients infected with HCV genotype 1 (including subtypes la and 1b) than in patients infected with other genotypes (including 2a and 3a) (57% vs. 17%; P < 0.01). No significant difference was found between IgM-positive and IgM-negative patients as regards the mean age, sex ratio, serum alanine aminotransferase and gamma-glutamyl transpeptidase activities, the prevalence of cirrhosis in liver biopsy specimens, detection of HCV RNA by PCR, and quantitation by branched DNA assay. At month 6 of interferon therapy, normal alanine arninotransferase activity was significantly more frequent in lgM-negative than in IgM-positive patients (52% vs. 21%, respectively; P < 0.02). At month 12, normal alanine aminotransferase activity and PCR negativity were significantly more frequent in IgM-negative than in IgM-positive patients (18% vs. Ooh, P < 0.04). It is concluded that antiHCV core IgM antibodies in serum are significantly more frequent in patients infected by HCV type 1 than by other types. This suggests that their overall prevalence in patients with chronic hepatitis C in industrialized countries, where HCV type 1 accounts for the majority of infections, would be of the order of 50%, that antiHCV core IgM antibodies are not associated with characteristic features of liver disease, and that their presence before treatment is associated with a failure of interferon alpha therapy to clear the virus. © Wiley-Liss, Inc.     

Variability of IgM response in hepatitis C virus infection

The IgM and IgG antibody response to various hepatitis C virus (HCV) antigens was studied in 8 patients who acquired posttransfusion HCV infection. IgM anti-HCV was detectable in only 4 of these patients, coincident with (1 patient) or later than (3 patients) the IgG anti-HCV response. Seven patients had initially decreasing IgG anti-HCV titres, indicating passive transfer of antibodies from donor to recipient. All 8 patients showed active IgG seroconversion, as demonstrated by increasing IgG anti-HCV titres, on average, 75 days after infection. Five years after infection, all patients were still reactive for IgG anti-HCV antibodies and 7 were positive for HCV RNA by the polymerase chain reaction (PCR). Two of these PCR positive patients were also reactive for IgM anti-HCV. It is concluded that the serology of HCV infection does not follow the classical pattern of IgM response preceding detection of IgG. The IgM response may be absent, late, or persistent after HCV infection. The serological diagnosis of recent HCV infection should be based on the polymerase chain reaction or rising IgG titres in at least 2 sequential patient blood samples. © 1993 Wiley-Liss, Inc.     

Significance of persisting IgM anti-HBc antibodies in hepatitis B virus infection

IgG and IgM antibodies to the core antigen of hepatitis B virus (HBV) were measured in 136 patients who developed acute HBV hepatitis and who were followed prospectively. After acute hepatitis all the patients developed transiently IgM anti-HBc lasting for two to five months. In contrast, IgM anti-HBc persisted 8 and 9 months in two patients who developed persistent hepatitis and were continuously detected for two years in nine patients who developed aggressive hepatitis. The results presented suggest that the determination of IgM anti-HBc might be useful to predict the outcome of chronic hepatitis B infection.     

血清中丙型肝炎NS3抗原ELISA检测方法的建立和初步应用

目的 评价血清中丙型肝炎病毒(HCV)游离NS3抗原的酶联免疫吸附(ELISA)检测方法的特异性和灵敏度,初步探讨该方法在临床应用中的意义.方法 对77例正常人血清标本,173例抗-HCV阳性标本和3708例抗-HCV阴性的其他类型肝炎血清标本检测HCV游离NS3抗原;对部分HCV NS3抗原阳性标本进行验证,包括HCV RNA测定、中和试验和免疫斑点试验;对11例患者的25份系列血清标本进行了HCV游离NS3抗原、HCV RNA和HCV抗体的联合检测,并结合临床资料综合分析.结果 3708例抗-HCV阴性的其他类型肝炎血清标本中有48例为HCV NS3抗原阳性,其中3030例单纯乙型肝炎和445例其他类型肝炎血清标本中分别有44例和4例为HCV NS3抗原阳性;173例HCV抗体阳性标本中有42例为HCV NS3抗原阳性;77例正常人血清标本的HCV NS3抗原检测结果均为阴性;15例HCV NS3抗原阳性标本中有9例为HCV RNA阳性;23例HCV NS3抗原阳性标本的中和率和免疫斑点试验的阳性率分别为87.0%和69.6%;25份系列血清标本的检测结果显示其HCV NS3抗原的吸光度值与时间呈负相关,并有2例HCV NS3抗原阳性标本随着血清中HCV NS3抗原的吸光度值下降,其HCV抗体转阳.结论 血清中HCV游离NS3抗原的ELISA检测方法有较好的特异性和敏感度,在发展中国家应用此方法进行HCV感染的早期诊断有一定的临床意义和推广价值.     

散发性戊型肝炎病毒感染的诊断

用基因工程重组的戊型肝炎病毒基因结构区第二码框架和第二读码框架具有免疫表位的嵌合抗原，建立了间接酶联免疫法，检测散发性急性肝炎病人血清中抗－ＨＥＶＩｇＧ和ＩｇＭ抗体。在４６例急性肝炎病人中出抗－ＨＥＶＩｇＧ抗体阳性７例，阳性率为１５．２２％，７例ＩｇＧ抗体阳性中，有５例ＩｇＭ抗体也阳性，占７１．４％。     

Serological diagnostics of hepatitis E virus infection

Development of accurate diagnostic assays for the detection of serological markers of hepatitis E virus (HEV) infection remains challenging. In the course of nearly 20 years after the discovery of HEV, significant progress has been made in characterizing the antigenic structure of HEV proteins, engineering highly immunoreactive diagnostic antigens, and devising efficient serological assays. However, many outstanding issues related to sensitivity and specificity of these assays in clinical and epidemiological settings remain to be resolved. Complexity of antigenic composition, viral genetic heterogeneity and varying epidemiological patterns of hepatitis E in different parts of the world present challenges to the refinement of HEV serological diagnostic assays. Development of antigens specially designed for the identification of serological markers specific to acute infection and of IgG anti-HEV specific to the convalescent phase of infection would greatly facilitate accurate identification of active, recent and past HEV infections.