乙型肝炎HBsAg/IgM复合物阳性患者血清IgG,IgA,IgM水平分析

乙型肝炎病毒ＨＢｓＡｇ/ＩｇＭ特异性复合物的存在 ,不仅和肝外症状有关 ,而且可以作为衡量机体免疫状态及清除病毒能力的一个标志。为了探讨ＨＢｓＡｇ/ＩｇＭ阳性患者体液免疫功能状态 ,笔者检测了 40例ＨＢｓＡｇ阳性、ＨＢｓＡｇ/ＩｇＭ阳性患者 ,2 0例ＨＢｓＡｇ/ＩｇＭ阴性的ＨＢｓＡｇ携带者以及 3 0例正常人血清ＩｇＧ ,ＩｇＭ ,ＩｇＡ值 ,现将结果报道如下。1　临床资料1 1　一般资料　本院门诊肝炎患者 ,经ＲＩＡ法测定ＨＢｓＡｇ/ＩｇＭ和ＨＢｓＡｇ均阳性组 40例 (男 2 4例 ,女 16例 ) ;经ＲＩＡ测定ＨＢｓＡｇ阳性而ＨＢｓＡ…     

HBV-M在慢乙肝、肝硬化及肝癌中的表达及意义

目的 比较HBsAg、HBeAg滴度与HBV DNA水平在慢性乙型肝炎、乙型肝炎肝硬化及HBsAg 阳性的原发性肝癌患者中的变化,并探讨其对病情进展的影响。方法 在149例慢性乙型肝炎患者,115例乙型肝炎肝硬化患者及146 例肝癌患者中,采用荧光PCR定量法和Abbott化学发光微粒子免疫分析技术分别测定HBV DNA定量水平及HBsAg和HBeAg的滴度, 分析它们在这三组患者中的变化。结果1.HBeAg定量值在三组患者中比较有统计学意义(F=9.944,P=0.007);乙型肝炎组与肝硬化组、肝癌组比较均有统计学意义(x2=4.147,P=0.042; x2=9.499,P=0.002);肝硬化组与肝癌组比较无统计学意义(x2=0.747,P=0.387)。2.在不同HBeAg状态下,HBsAg定量值在乙型肝炎组与肝硬化组患者中比较均有统计学意义(t=2.549,P=0.012;t=2.428,P=0.017);HBsAg定量值在肝癌组中无统计学意义(t=1.375,P=0.171);HBVDNA定量值在三组患者中比较,差异均有统计学意义(Z分别为3.148、6.544、4.520,P<0.05)。 结论 定量检测慢性乙型肝炎、肝硬化及肝癌患者血清中的HBsAg、HBeAg及HBV DNA的变化有一定的临床意义,将三者结合能更好地为临床提供准确可靠的诊断和治疗数据。     

Overview of expression of hepatitis B surface antigen in transgenic plants

Hepatitis B virus (HBV), a pathogen for chronic liver infection, afflicts more than 350 million people world-wide. The effective way to control the virus is to take HBV vaccine. Hepatitis B surface antigen (HBsAg) is an effective protective antigen suitable for vaccine development. At present, “edible” vaccine based on transgenic plants is one of the most promising directions in novel types of vaccines. HBsAg production from transgenic plants has been carried out, and the transgenic plant expression systems have developed from model plants (such as tobacco, potato and tomato) to other various plant platforms. Crude or purified extracts of transformed plants have been found to conduct immunological responses and clinical trials for hepatitis B, which gave the researches of plant-based HBsAg production a big boost. The aim of this review was to summarize the recent data about plant-based HBsAg development including molecular biology of HBsAg gene, selection of expression vector, the expression of HBsAg gene in plants, as well as corresponding immunological responses in animal models or human.     

Prevention of perinatal hepatitis B transmission in Haimen City,China: Results of a community public health initiative

In regions where hepatitis B virus (HBV) is endemic, perinatal transmission is common. Infected newborns have a 90% chance of developing chronic HBV infection, and 1 in 4 will die prematurely from HBV-related liver disease. In 2010, the Hepatitis B Foundation and the Haimen City CDC launched the Gateway to Care campaign in Haimen City, China to improve awareness, prevention, and control of HBV infection citywide. The campaign included efforts to prevent perinatal HBV transmission by screening all pregnant women for hepatitis B surface antigen (HBsAg), following those who tested positive, and administering immunoprophylaxis to their newborns at birth. Of 5407 pregnant women screened, 185 were confirmed HBsAg-positive and followed until delivery. At age one, 175 babies were available for follow up testing. Of those, 137 tested negative for HBsAg and positive for antibodies to HBsAg, indicating protection. An additional 34 HBsAg-negative babies also tested negative for antibodies to HBsAg or had indeterminate test results, were considered to have had inadequate immune responses to the vaccine, and were given a booster dose. A higher prevalence of nonresponse to HBV vaccine was observed among babies born to hepatitis B e antigen (HBeAg)-positive mothers and mothers with high HBV DNA titers. The remaining 4 babies tested positive for HBsAg and negative for antibodies, indicative of active HBV infection. The mothers of all 4 had viral loads ≥8 × 10⁶ copies/ml in the third trimester. Although inadequate response or nonresponse to HBV vaccine was more common among babies born to HBeAg-positive and/or high viral load mothers, these risk factors did not completely predict nonresponsiveness. All babies born to HBV-infected mothers should be tested upon completion of the vaccine series to ascertain adequate protection. Some babies of HBeAg-positive mothers with high viral load may still become HBV infected despite timely immunoprophylaxis with HBV vaccine and HBIG.     

无锡市锡山区体检人员HBsAg、HBeAg和ALT检测结果分析

目的了解无锡市锡山区体检人员HBsAg携带情况,结合丙氨酸转氨酶（ALT）及HBeAg分析,探讨HBV感染者与肝功能异常的相关性。方法采用酶联免疫吸附试验（ELISA）法检测HBsAg,对其中部分阳性者进行HBeAg检测,同时用全自动生化分析仪检测血清中ALT。结果2006-2008年92349名体检人员,HBsAg携带率为3．47％,有呈逐年下降的趋势,各年度间差异有统计学意义（Х^2=8．046,P〈0．05）;其中1452例HBsAg阳性者中HBeAg阳性的人员ALT异常率为31．79％,与HBeAg阴性人员的ALT异常率14．10％之间差异有统计学意义（Х^2=51．37,P〈0．01）。结论要加强宣传乙型肝炎相关防护知识,对HBsAg阳性者应做乙肝标志物并结合肝功能（ALT）来判断其病情和传染性。     

海南省9市县农村人群HBsAg携带状况分析

[目的]分析海南省9市县农村人群HBsAg携带状况,为海南省农村乙型肝炎疫情预防控制提供客观依据.[方法]采用酶联免疫吸附试验(ELISA)进行HBsAg检测,并对人群资料归类统计分析. [结果]共检测7 840例标本,HBsAg阳性713例,携带率为9.09%,各市县间差异有统计学意义(P<0.01);HBsAg携带率20岁以上男性组最高,女性组次之,7岁以下儿童组最低,分别为17.02%、11.31%、1.90%,三者间比较差异有统计学意义(P<0.01);人群HBsAg携带率与地区及经济水平之间差异有统计学意义(P<0.01). [结论]海南省农村人群HBsAg携带状况虽总体有所好转,但仍是海南省HBV感染的高发人群;HBsAg携带状况与地区、经济水平显著相关;加强乙肝疫苗的接种是农村乙肝预防控制工作的重点.     

大理白族自治州无偿献血者HBsAg携带情况

我国是HBV感染的高流行地区,根据2002年的全国HBV感染者血清流行病学调查HBsAg携带率为9．09％,约1．2亿人,其中慢性乙型肝炎病人约为2000—3000万。为了解大理白族自治州各类人群中HBV的感染情况,我们对2006-2007年间25530份无偿献血者的血液检测结果进行了分析,有关情况报告如下。     

长沙市健康体检人员HBsAg血清学检测结果分析

目的 分析从业人员不同年龄组、不同性别乙肝标志物HBsAg携带情况.方法 采用ELISA方法检测长沙市疾病预防控制中心健康体检所有收集到的211 557份有效血清标本HBsAg所有数据来源于体检数据录入统计系统;采用SPSS13.0统计软件进行X2检验处理.结果 健康体检人群HBsAg总体携带率3.65%,男性携带率为4.67%,女性携带率为3.10%;男性HBsAg携带率4.67%高于女性HBsAg携带率3.10%(X2=337,55,P<0.01). 结论 长沙市HBaAg携带率趋于中等水平,但仍不容乐观,应当加大对健康人群乙肝防治知识的宣传教育力度,加强对乙肝的预防与管理.     

平顶山市无偿献血人群HBV、HCV感染现状调查

目的：了解平顶山市无偿献血人群乙型肝炎病毒（HBV）、丙型肝炎病毒（HCV）的感染现状,为制定新时期献血员的招募策略提供依据,促进无偿献血事业又快又好的发展。方法：采用随机抽样方式,对平顸山市10个县（市、区）无偿献血人群20471人进行乙型肝炎和丙型肝炎的血清流行病学调查,采用酶联免疫吸附试验（enzyme linked immunosorbent assay,ELISA）检测乙型肝炎病毒表面抗原（HBsAg）和丙型肝炎病毒抗体（抗-HCV）。结果：平顶山市无偿献血人群乙型肝炎病毒阳性率为：1．29％;丙型肝炎病毒（HCV）抗体阳性率为：0．55％。结论：目前平顶山市无偿献血人群HBV和BCV感染率均低于全国的总体感染水平（P〈0．01）.     

Improved immunization practices reduce childhood hepatitis B infection in Tonga

Background

Hepatitis B infection is hyper-endemic in Tonga and 19% of pregnant women test positive for hepatitis B surface antigen (HBsAg). Routine childhood immunization against hepatitis B was introduced in 1989 and the target for elimination was set at <1% HBsAg prevalence in children. A study conducted in 1998, a decade after the introduction of hepatitis B immunization, found the HBsAg prevalence to be 3.8% in pre-school children. The finding resulted in the strengthening of the delivery of hepatitis B vaccine with emphasis on providing the first dose within 24 h after birth. The aim of this study was to measure the impact of improved immunization practices on the prevalence of hepatitis B infection in pre-school children, and to assess the progress towards hepatitis B elimination in Tonga.

Measured outcome

Prevalence of HBsAg antigen.

Type of study

Cross-sectional study.

Methods

Children aged 6–59 months who were admitted to Vaiola Hospital, Nuku’alofa, Tonga, and had blood collected for clinical investigation, were tested for HBsAg with a rapid serological test (Abbott Determine^®). A total of 449 children were recruited and interviewed and 375 (84%) were tested for HBsAg. Convenience testing was chosen, as it was likely to be a relatively unbiased method in this situation where all children on the island have good and equitable access to hospital services. Immunization status was checked against the children's immunization cards and cross-checked against the records kept by the public health nurses. Information about socio-economic status, parent education, blood transfusion, breast-feeding, mode of delivery, and place of birth was collected through interviews with mothers using a standardized questionnaire.

Results

Three children tested positive for HBsAg resulting in a prevalence of 0.8% (CI 0.2–2.5%). Hepatitis B 1 (Hep B 1) immunization coverage was found to be high, 99.1% (CI97.7–99.7) and 91.9% (CI 88.9–94.2) of children received the first dose of hepatitis B vaccine within 24 h after birth. Coverage for the third dose of hepatitis B vaccine was 97.6% (CI 95.5–98.7) and of the children with complete immunization 84.7% (CI 80.9–87.9) had received all three doses by 6 months of age.

Conclusions

The results show that the instituted changes in the delivery of hepatitis B vaccine have been effective in reducing the transmission of hepatitis B to children and indicate that Tonga appears to have achieved the elimination target of less than 1% HBsAg prevalence in children. This convenience survey used a simple, cost effective and reproducible study design. Convenience testing can be recommended for surveillance of the effectiveness of immunization programmes in settings where the population has good access to health services.