国内丙型肝炎病毒抗体酶联免疫法试剂评价参考品体系的建立

目的 建立国内丙型肝炎病毒抗体酶联免疫法(EIA)诊断试剂评价参考品.方法 收集2009-03/2010-10期间来自全国不同省份4833份供血人员血清样品,用国产5种抗HCV EIA试剂和国外2种抗HCV EIA试剂分别进行初筛和复检;用Chiron的RIBA HCV 3.0 SIA、Roche HCV定量试剂对筛选样品进行了确认试验,对确认阳性样品进行HCV基因型检测;选择不同强度的确认阳性、阴性样品、混合阳性系列稀释样品、部分特殊样品等建立抗HCV诊断试剂评价参考品.结果 设立了抗HCV诊断试剂评价参考品,包含30份强、中、弱阳性的抗HCV混合阳性样品,10份单片段抗体阳性确认阳性样品,6份评价灵敏度系列稀释样品,30份抗HCV确认阴性样品.结论 本研究设立的抗HCV评价参考品检测结果可靠,样品涵盖背景丰富,对新产品研发和筛选评价高质量的抗HCV诊断试剂有一定参考价值.     

人类免疫缺陷病毒1型RNA定量参考品的研制

目的　研制人类免疫缺陷病毒 1型 (HIV 1)RNA核酸国家参考品及制定相应标准。方法　收集各地HIV感染者阳性血浆和HIV非感染者血浆 ,应用HIV、HCV抗体和HBsAg检测试剂进行筛选 ,对HIV抗体筛查阳性者用新加坡Genelabs公司的HIVBLOT 2 2确证试剂进行确证。以世界卫生组织 (WHO)推荐的HIVRNA标准品对国家HIV核酸参考品中定量样品进行标定 ,并对其稳定性进行研究。结果　经过筛选 ,选出 8份样品为阴性参考品 ,8份样品为阳性参考品 ,3份为定量参考品 ,6份为灵敏度参考品 ,5份为线性参考品。几次独立标定 ,得到定量参考品HIVRNA的国际单位(IU) ,其中b1～b3的国际单位的对数值在 x±s以内 ,表明结果可靠。稳定性实验数据表明 ,该核酸参考品在 4℃以下可存放 4d。结论　初步建立了HIV核酸参考品 ,这将对HIV核酸诊断试剂的质量评价提供重要依据     

HIV抗体酶联免疫诊断试剂检测不同基因型抗体的研究

目的 分析不同HIV抗体酶联免疫诊断试剂对检测HIV不同基因型抗体的情况。方法 对不同地区的20份HIV抗体阳性样品中HIV核酸进行扩增，对PCR产物进行测序并进行基因型别分析。用不同试剂对系列稀释的不同基因型样品进行检测。结果 20份样品均为HIV RNA阳性，其中9份样品为HIV B亚型，9份样品为：HIV C或BC重组，2份为HIVAE重组。不同试剂对HIV不同基因型抗体的检测灵敏度无明显差异。结论 我国主要的商业化HIV抗体诊断试剂产品检测不同基因型抗体的能力无明显差异。     

检测抗HIV-1/2型抗体的双抗原夹心方法的建立及其试剂盒的研制

目的 建立更敏感的检测人免疫缺陷病毒（HIV）抗体的方法,并研制检测试剂盒。方法 根据HIV－1／2型的基因序列及其所编码氨基酸结构,采用固相法合成了HIV－1型的gp41.1、gp41.2、gp120、p24和HIV－2型的gp36五条多肽,混合包被酶标板作为固相抗原。用辣根过氧化物酶标记以上多肽抗原作为标记物,建立检测血清中抗HIV－1／2抗体的双抗原夹心ELISA法。同时,应用该方法制备检测HIV抗体的试剂盒,并检测三批中国卫生中药品和生物制品检定所HIV诊断试剂国家参比品。结果 建立了检测HIV－1／2抗体的双抗原夹心法。用检定所参比品检测,该方法特异性、灵敏度均为100％,变异系数小于10％。与间接法相比较其灵敏度、特异性均高于间接法（P＜0．05）。检测210份其他病种患者血清均为阴性。与GBI公司的HIV抗体诊断试剂比较,检测40份卫生部药品和生物制品检定所提供的质控参比品（阳性20份,阴性20份）,GBI试剂阴、阳性符合率及总符合率分别为100%(20/20)、85％（17／20）及92．5％（37／40）,而应用该方法所研制的诊断试剂盒、阳性符合率及总符合率为100％。该试剂已通过国家卫生部质检。与雅培公司HIV诊断试剂比较检测90份献血员血清和88份HIV－1／2型感染者血清,符合率为100％。试剂盒于37℃放置4d后的检测结果的阴、阳性判定不受影响。结论 本法特异性强、灵敏度高、稳定性好,适用于献血员的筛选和临床HIV感染的检测。     

8种第3代和4种第4代人免疫缺陷病毒抗体诊断试剂的比较

目的 分析第3代和第4代HIV抗体诊断试剂间以及同一代各种试剂间的差异.方法 用8种第3代试剂和4种第4代试剂分别检测989份人免疫缺陷病毒(HIV)阴性样品、185份HIV-1核酸阳性样品、HIV抗体第一代国际参考品以及9套BBI阳转血清,并判定检测结果.结果 第4代试剂对HIV感染的检出时间普遍早于第3代试剂,但不同的第4代试剂的检出时间并不相同,不同的第3代试剂在HIV抗体的检出时间方面没有明显的差别.各种试剂检测不同基因型的能力不同,尤其国产试剂检测HIV-1 O组和HIV-2的能力普遍较差.结论 本研究为试剂质量的进一步提高提供了实验数据.     

人类免疫缺陷病毒Ⅰ型和丙型肝炎病毒核酸联合检测试剂的评价

目的 了解人类免疫缺陷病毒Ⅰ型（HIV-1）和丙型肝炎病毒（HCV）核酸联合检测试剂检测的敏感性、特异性以及检测中国不同亚型样品的适应性。方法 用酶联免疫试剂对来自于不同地区的HIV感染者或可疑感染者献血员样品进行HIV抗体和HCV抗体检测。对HIV抗体阳性者进行抗体确证。用HIV-1和HCV核酸联合检测试剂对样品进行检测，对初次检测阳性者，用HIV RNA和HCV RNA鉴别试剂单独检测，区分是HIV RNA阳性或是HCV RNA阳性。结果 74份HIV和HCV抗体均阳性的样品，HIV／HCV RNA检测也为阳性，5份HIV和HCV抗体均阴性的样品，HIV／HCV RNA检测也为阴性；84份HIV抗体确证为阳性的样品，有82份检测为HIVRNA阳性，7份HIV抗体阴性的样品检测均为HIV RNA阴性，12份HIV抗体不确定的样品，有6份检测为HIV RNA阳性；81份HCV抗体阳性样品中有70份检测为HCV RNA阳性，22份HCV抗体阴性样品中有18份检测为HCV RNA阴性，4份检测为HCV RNA阳性。结论 该试剂的灵敏度较高，尤其在HCV抗体阴性样品中检出HCV RNA阳性者。因此，可用于献血员筛查，减少窗口期的传播。     

甲型肝炎病毒IgM抗体快速检测试剂国家参考品的建立

目的 建立甲型肝炎病毒IgM抗体快速检测试剂国家参考品,制订其质量标准,用于该类试剂的质量评价。方法 通过对200多份单采浆站收集到的血浆进行初筛,筛选出16份备选样本。经多家实验室协助标定,分析标定结果,确定参考品的组成及其质量标准,并对参考品稳定性进行评估。结果 本参考品由10份阴性参考品、1份最低检出限参考品和重复性参考品组成。质量标准为10份阴性参考品符合率（-/-）应为10/10,最低检出限参考品要求1:40稀释时检测阳性,重复性参考品要求1:15稀释时连续检测10次,结果应均为阳性,且显色度均一。稀释血浆应均为HCV、HBV和HIV标志物阴性。参考品在4℃放置3、7 d和反复冻融2次条件下相对比较稳定。结论 成功建立甲型肝炎病毒IgM抗体快速检测试剂国家参考品,可用于该类试剂的质量控制及评价。     

用DNA重组法表达HCV部分NS4—NS5基因

为研究丙肝病毒的复制机理,制备检测丙肝抗体的诊断试剂,需要大量纯化的各种丙肝病毒蛋白。我们在国内首次用DNA重组的办法,在大肠杆菌中表达了HCV部分NS4—NS5基因。在SDS—PAGE中,表达产物呈现一条约50kD的电泳带,表达蛋白约占菌体总蛋白的20％。该表达蛋白经分子杂交分析,可与抗-HCV非结构区抗体血浆发生特异反应。用部分提纯的表达蛋白制备的ELISA试剂,可特异地检测出我国抗—HCV诊断试剂参考品全部10个阳性样品,而对全部10个阴性样品均未发生特异反应,显示了该表达产物可用于制备抗—HCV诊断试剂的前景。     

抗SARS病毒N蛋白单克隆抗体的制备和初步应用

目的 制备抗SARS病毒N蛋白的单克隆抗体并研究其初步应用。方法 用基因重组N蛋白免疫小鼠，取免疫后的鼠脾细胞与骨髓瘤细胞融合，筛选分泌抗SAPS病毒N蛋白单克隆抗体细胞株。将阳性细胞株接种小鼠腹腔制备单克隆抗体腹水并对抗体进行纯化，分析纯化抗体的相对亲和力。选择亲和力较高的抗体制备检测SARS病毒抗原的酶联免疫诊断试剂，并对其敏感性和特异性进行分析。结果 共获得11株单克隆抗体细胞株，其中3株单抗与N蛋白具有较高的亲和力，4株纯化单抗与N蛋白反应很弱，其余4株单抗介于两者之间。用亲和力较高的单抗制备检测SARS病毒抗原的诊断试剂，其敏感性可达31PFU／ml，而且与其他呼吸道病毒无交叉反应。结论 该试剂特异性较好，可用于SARS病毒抗原的检测，其敏感性仍需用临床急性期样品进行评价。     

HCV非结构基因NS4的基因工程表达

用基因工程法在大肠杆菌中表达丙肝病毒(HCV)的部分非结构NS4基因,经分子杂交分析,表达产物可特异地与抗-HCV非结构区抗体反应。在SDS-PAGE中,表达产物呈现一条约49kD的融合蛋白带,约为菌体总蛋白的20％。用部分纯化的表达产物制备的ELISA试剂,可检测出国家丙肝诊断试剂参考品全部10个阳性样品中的8个,而对全部10个阴性样品均未出现假阳性反应,其检出率和P/C值均高于目前国内所用的5—1—1合成肽。显示了该表达产物用于丙肝诊断试剂及确证试剂的可能性。     

Evaluation of a simultaneous HIV antigen and antibody detection test in Korean population

Current diagnosis of human immunodeficiency virus (HIV) infection relies on the detection of anti-HIV antibodies by enzyme-linked immunosorbent assay (ELISA). Recently, kits detecting both p24 antigenemia and anti-HIV/anti-HIV2 antibodies have been developed. Thus, it is necessary to compare those kits developed as such. The aim of this study was to evaluate the diagnostic efficiency of a simultaneous detection test of p24 antigen and anti-HIV1/2 antibodies in a low prevalence area. Eight hundred and four randomly selected sera proven negative for HIV infection and 110 sera from 54 patients diagnosed as HIV infected, obtained between 1999 and 2000, were used for this study. One commercial lot of panels composed of consecutive sera obtained from known HIV-infected patient was included. Anti-HIV1/2 antibodies were detected by two different commercial ELISA kits, one from Korean and the other from German manufacturer. P24 antigen test was performed by ELISA. The simultaneous HIV antigen and antibody detection test was carried out. In the meantime, HIV RNA PCR and anti-HIV and anti-HIV2 western blot assays were also performed to confirm the test results in cases the test results didn't agree. The simultaneous detection kit showed 100% sensitivity and 99.6% specificity. Furthermore, the test displayed the possibility of earlier diagnosis than conventional anti-HIV1/2 ELISA with the results obtained from a group of consecutive panel sera infected with HIV. From these results, we concluded that the simultaneous HIV antigen and antibody detection test can be applied as a substitute clinical screening test in the place of conventional anti-HIV1/2 ELISA, and there is the probable benefit of early diagnosis.     

A standard panel of human immunodeficiency virus-positive and -negative blood sera for assessing the sensitivity and specificity of diagnostic immunoenzyme test systems

The materials on the development of a reference panel of HIV-positive and negative blood sera required for quality control of diagnostic enzyme-immunoassay systems are summarized. Ninety sera (50 HIV-antibody positive and 40 negative) were examined in 2 test systems of national and 3 test systems of foreign companies as well as by immune blotting and immunofluorescence tests. Each serum was characterized by optic density values and antibody titer (for positive sera). The conditions of storage and transportation of serum panels as well as those for control tests were determined. The license and instructions for use for the serum panel have been approved. The serum panel is used in 9 institutions engaged in working out and manufacture of diagnostic test systems.     

国产丙型肝炎病毒NS3抗原的质量检定

目的为了研究我国丙型肝炎病毒（ＨＣＶ）诊断试剂用抗原的质量，加快改进丙型肝炎病毒抗体诊断试剂。方法特选国内“八五”攻关课题研究出的丙型肝炎ＮＳ３抗原和目前我国的主要使用的两种国外丙型肝炎ＮＳ３抗原，建立了单片段检测ＮＳ３抗体的试剂，对ＮＳ３抗原质量利用我国抗－ＨＣＶ第二代国家检验参考品以及中国药品生物制品检定所最近收集的部分血清样品，对其抗原性进行了比较研究。结果发现我国生产单位对ＮＳ３抗原的纯化条件及在试剂中的组装条件的研究尚嫌薄弱，使得在利用这些ＮＳ３抗原组成诊断试剂检测时出现了检出率较低及假阳性等问题。结论提示国内有关单位应加强对这方面的研究。     

20例SARS患者特异性抗体变化规律

目的：了解严重急性呼吸道综合征(SARS)特异性IgM和IgG抗体的变化规律。方法：采用间接酶联免疫吸附试验(ELISA)检测20例SARS患者系列血清中特异性IgM和IgG抗体，系列血清包括患者发病后1周，2周，3周，4周，8周，12周所采集的样本。结果：20例患者发病后第1周IgM和IgM抗体均为阴性；第2周时16例IgM抗体阳性，17例IgM抗体阳性；第3周后所有患者IgG抗体阳性并持续至第12周，而IgM抗体阳性患者逐渐减少，至第12周时所有患者均为阴性。结论：SARS特异性IgG抗体消失较早，其存在是近期感染的标志；IgG抗体的持续存在可能是获得病后免疫力的标志。     

Multi-laboratory comparison of eight commercially availableHelicobacter pylori serology kits

The performance of eight commercially available EIA kits in detecting antibody toHelicobacter pylori was evaluated by a panel of 17 laboratories using serum from 59 patients selected from endoscopy clinics in Belgium, Ireland, Italy, the Netherlands and Switzerland. Each laboratory received a randomly numbered set of sera and was ignorant of the culture results of the patients. The performance of the kits was assessed in terms of diagnostic accuracy compared to culture (measured by sensitivity and specificity), the interlaboratory variability in diagnostic accuracy and the number of laboratories that experienced problems in using the kits. Grey zone results, which are routinely used to highlight the uncertain interpretation of results that lie near the cut-off point between positive and negative diagnoses, were accounted for in the analysis. Laboratories experienced practical problems in using some kits, whilst other kits were found to have high inter-laboratory variation or low diagnostic accuracy. There was no single kit that performed better on every criterion than the others. The Orion kit was a good all-round performer, whilst the Roche kit was excellent at detecting positive results, although it had a slightly raised false-positive rate.     

我国戊型肝炎ELISA诊断试剂的质量比较

目的对戊型肝炎(戊肝)诊断试剂进行质量评价。方法选择北京万泰生物药业(万泰),北京现代高达生物技术(高达),上海科华生物工程(科华),GeneLabs Diagnostic Inc(GeneLabs),和河南华美生物工程(华美)共5家公司生产的检测戊肝病毒IgG(HEV-IgG)抗体的ELISA试剂,分别检测戊肝诊断试剂参比品、可疑戊肝临床患者和正常人群血清HEV抗体。结果对24份阳性和30份阴性参比品检测,以万泰试剂检测符合率最高,阳性和阴性符合率分别为95.83%(23/24)和96.67%(29/30),总符合率为96.30%,其次为高达试剂87.50%(21/24)和100%(30/30),总符合率为94.44%,华美试剂87.50%(21/24)和96.67%(29/30),总符合率92.59%,GeneLabs66.67%(16/24)和100%(30/30),总符合率为85.18%,科华试剂45.83%(11/24)和100%(30/30),总符合率为75.93%。对42份可疑戊肝患者血清HEV抗体检测阳性率,高达试剂为100%(42),万泰和华美试剂均为97.62%(41),GeneLabs和科华试剂均为90.48%(38)。对230份正常人群HEV抗体检测阳性率,从高到低依次为万泰试剂31.74%(73),华美试剂为23.91%(55),高达试剂为17.39%(40),GeneLabs和科华试剂分别是7.83%(18)和3.48%(8)。结论5家试剂检测急性期戊肝患者抗体阳性率均能达90%以上,具有很高的一致率,而应用于普通人群HEV感染的调查,其抗体阳性率从31.74%~3.48%不等。不同的试剂存在假阳性或和阳性漏检现象。依本室参比品和人群血清阳性率来看,万泰试剂检出率较高。     

Sensitivity and specificity of commercial ELISA kits for screening anti-LAV/HTLV III

Two panels consisting of 236 and 258 anti-LAV/HTLV III positive and 64 and 50 negative sera, respectively (determined in Western blots), were tested with 8 different, commercially available ELISA test kits for detecting LAV/HTLV III antibodies (Abbott, Dupont, Electro-Nucleonics, Litton, Organon, Pasteur, Sorin, Wellcome). Positive sera were selected for levels of antibodies ranging from average to very high, and the negative sera included both negative sera and sera with antibodies to cellular components such as HLA antigens or nuclear membranes. In examination of the 2 panels, the sensitivity of the tests ranged from 97.2 to 100%, and the specificity from 70.0 to 100%. No test was ideal.     

HBsAg diagnostic kits in the detection of hepatitis B virus mutation within "a" determinant

The performance of currently available hepatitis B surface antigen (HBsAg) commercial kits was analyzed by using a panel of 212 well-characterized plasma donors all over the country and a panel of nine recombinant HBsAg mutants containing single point or combinations of mutations between amino acid residues 124 and 147 of the "a" determinant. HBsAg commercial kits in this study were machine-based immunoassays with a one-step sandwich ELISA method using either an automatic closed system or manual system. The sensitivity of all machine-based assays evaluated with 105 HBsAg plasma panels was 100% (95% CL = 95.6-99.9%), whereas the specificity with 107 HBsAg negative plasma ranged from 99.07% to 100% (95% CL = 94.2-99.9%). The relative performance of these kits to detect the hepatitis B virus (HBV) mutant panel members of the "a" determinant was found to differ. Interestingly, any commercial kits with monoclonal antibody capture and polyclonal antibody detection (mono/poly), but not mono/mono Ab capture and detection, could pick up the common HBsAg Gly145Arg mutant either solely or in combination with other mutations within the "a" determinant. New versions of HBsAg test kits should recognize multiple HBsAg epitopes in order to detect mutant HBsAg, together with providing good analytical sensitivity and specificity, because of the importance of these assays in HBV diagnosis and in protecting the safety of the blood supply.     

Metabolic inhibition test for louping-ill,measles and herpes simplex virus in plastic panels

Summary A metabolic inhibition test in plastic panels with HeLa cells and a continuous line of human amnion cells was developed for titration of louping-ill, herpes simplex and measles viruses and antibodies. The loupingill and herpes simplex virus titers were the same or slightly lower, and measles virus titers considerably lower in panel titration than in tube titration based on the cytopathogenic effect. In the neutralization tests with various human sera and animal immune sera, the louping-ill neutralization titers were about the same in panel and tube titrations. The herpes simplex and measles panel neutralization titers were comparable with the corresponding complement-fixing antibody titers.In HeLa cells with lactalbumin hydrolysate medium herpes simplex virus caused a clear metabolic inhibition, but in Eagle's minimum essential medium the diluted virus increased cell metabolism.This study was supported by grants from the Rockefeller Foundation and the Sigrid Juselius Foundation.