抗-HBs、抗-HBe和抗-HBc阳性人群的胸腺近期输出功能初步探讨

目的观察抗-HBs、抗-HBe和抗-HBc阳性人群外周血单个核细胞(PBMCs)中T细胞受体重排删除环(TRECs)的含量,从而推测其胸腺近期输出功能。方法利用实时荧光定量PCR方法检测30例抗-HBs、抗-HBe和抗-HBc阳性人群及22例正常人PBMCs中TRECs含量。结果抗-HBs、抗-HBe和抗-HBc阳性人群中TRECs含量为(5.67±1.55)cop ies/103PBMCs,与正常人TRECs水平(6.11±2.11)cop ies/103PB-MCs无差异(P>0.05)。结论抗-HBs、抗-HBe和抗-HBc阳性人群TRECs水平情况显示其胸腺近期输出功能与正常人比较无差异。     

HBeAb和HBcAb混合质控血浆制备

室内质控是全面质量管理体系中的重要环节,是室间质评的基础。室内质控结果的好坏,不仅涉及到报告能否发出,同时也反映了实验室的水平及能力。质控品是实施室内质控的重要物质保障。选择、应用合格质控品是实施室内质控的重要步骤。目前有不少商业质控品面市,但其种类、价格、运输和保存等因素都影响到质控品在实验室的应用。自己制备质控品,完善检测项目的室内质控,具有重要意义。笔者通过自制HBeAb和HBcAb混合质控血浆,用于室内质控,现报道如下。1材料和方法1.1材料1.1.1材料收集HBV-M模式为HBsAg-HBeAb-HBcAb、HBsAg-HBeAb、H…     

基层医疗机构乙肝五项检验质量状况与趋势分析

目的 通过分析基层医疗机构乙肝五项检验现状,了解基层检验质量及发展趋势,为切实提高基层检验质量、制定相应管理方案提供客观依据.方法 连续6年随机抽取我国县级妇幼医疗机构345±107家,应用盲样检测方法进行HBsAg、HBsAb、HBeAg、HBeAb和HBcAb检测,每个项目5个水平,对回馈的数据进行分类、核对、整理、分析与总结.结果HBsAg、HBsAb、HBeAg、HBeAb和HBcAb的检测方法主要有ELISA法、金标法、化学发光法、乳胶法、时间分辨法、酶法和其他未填写的方法等,并对各方法在2011年至2016年间的使用情况进行分析.6年间,乙肝五项各项目的室间质评及格率明显提升,尤其是HBcAb,由2011年第一次的43%提高到2016年的92%, HBsAg、HBsAb、HBeAg、HBeAb的室间质评及格率接近100%.结论 随着全国临床检验室间质量评价活动的开展和积极推进,基层医疗机构乙肝五项检验结果的准确性提高,服务机构的检验水平显著提升.     

Interferon treatment in hepatitis B surface antigen-positive hepatitis B e antibody-positive chronic hepatitis B: role of hepatitis B core antibody IgM titre in patient selection and treatment monitoring

Chronic hepatitis B infection with the hepatitis B e antigen (HBeAg)-negative variant is associated with a severe clinical course and a low response rate to interferon (IFN). In an attempt to improve the chances of sustained response to interferon we designed a pilot study, using titres of IgM antibodies to hepatitis B core antigen (HBcAb IgM) to guide treatment initiation. Eighteen adults who were HBeAg-negative with biopsy-proven chronic active hepatitis (seven with cirrhosis) entered the study. They were followed-up bimonthly with routine liver function tests, and HBcAb IgM titres were also determined. Treatment (lymphoblastoid IFN 5 million units (MU) m^–2 three times weekly for 6 months) was started when the HBcAb IgM titre was increasing. Fifteen (83.3%) patients had normal alanine aminotransferase (ALT) levels and undetectable HBV DNA at the end of treatment. HBcAb IgM decreased in all responders. We observed a relapse in four patients (three with cirrhosis), in the first year after treatment, with an increase in ALT, HBV DNA and titre of HBcAb IgM. Eleven patients (61.1%) had a sustained response and eight of these 11 patients were followed-up for more than 18 months; two responders cleared hepatitis B surface antigen (HBsAg). Hence, the rate of sustained response to IFN in HBeAb-positive patients with chronic hepatitis is improved if treatment is started when HBcAb IgM levels are increasing.     

ELISA法检测HBeAb和HBcAb误差的原因分析

我们在检测乙型肝炎病毒生物标志物(简称二对半)时经常会出现同一病人标本在不同医院或在同一医院不同时间段采用ELISA法检测,其中HBeAb和HBcAb 2项会有不同结果。为此,我们参考有关文献[1-4]做了如下实验,以探讨用ELSIA法检测二对半时怎样减少同一标本在不同时间段检测所出现的HBeAb和HBcAb的误差。实验留取106份本院用ELISA法已查出的含有HBeAb和HBcAb阳性标本或其中单项阳性的血清标本,再查出它们原来已检测出的每1份标本的A值及原来的COV值,作为第1次的分析结果(结果判断,标本A值大于等于COV为阴性,标本A值小于COV为…     

5985名学生乙肝疫苗接种后免疫效果分析

目的探讨中小学生乙肝疫苗接种后免疫应答状况,为制定有效的乙肝预防措施提供科学依据。方法应用ELISA法测定中、小学生血清三项乙肝感染标志（HBsAg、HBeAg、HBeAb）,对三项标志全阴性者再应用时间分辨荧光免疫分析法（TRFIA）测定血清二项感染标志（HBsAb、HBcAb）。结果血清三项感染标志（HBsAg、HBeAg、HBeAb）全阴性者其HBsAb阳性率为81.27%,中学生阳性率为80.27%,小学生阳性率为82.50%,差异有统计学意义（χ2=4.82,P〈0.05）。HBsAb有应答者HBcAb阳性率为5.12%,中学生阳性率为8.82%,小学生阳性率为0.68%,差异有非常显著性（χ2=164.58,P〈0.01）。HBsAb无应答者HBcAb阳性率为21.14%,中学生阳性率为19.73%,小学生阳性率为7.68%,差异有非常显著性（χ2=87.70,P〈0.01）。HBsAb有应答者和HBsAb无应答者其HBcAb阳性率差异有非常显著性（χ2=313.48,P〈0.01）。结论该地区学生HBsAb阳性率较低,免疫效果不理想,小学生HBsAb阳性率较高,中学生HBcAb阳性率较高,提示学生中乙肝疫苗接种需加强和改进。     

不同温度对罗氏核心抗体试剂检测结果的影响

目的探讨不同温度保存条件对罗氏公司核心抗体试剂的影响。方法以反复冻融试剂为试验组,4℃保存试剂为对照组,通过全自动电化学发光免疫分析仪器分别测定20次乙型病毒性肝炎核心抗体COI(Cutoffindex)值,比较二者之间的差异以及分析二者之间是否存在相关性。结果全自动电化学发光法分析发现试验组高值组COI值为2.1325±0.0532,而对照高组为2.4125±0.1008,二者之间差异有统计学意义(P0.01),但二者之间不存在正相关性(r2=-0.0676,P0.05)。试验组低值组COI值为0.5152±0.0057,而对照低组为0.7313±0.0116,二者之间差异亦有统计学意义(P0.01),且二者之间存在正相关性(r2=0.5567,P0.05)。结论不同温度条件下保存的罗氏公司核心抗体试剂对实验结果影响较大,试剂不适合保存在0℃以下,且不能反复冻融。     

一步竞争ELISA法检测HBcAb影响因素的探讨

目的:研究操作因素对一步竞争ELISA法检测HBcAb的影响.方法:改变加入酶结合物的量,提供不同的孵育方式和孵育时间.延迟不同的加入酶结合物的时间,研究加样因素、孵育因素和延迟加入酶结合物时间因素对一步竞争ELISA法检测HBcAb的影响.结果:随加酶结合物量的增加样本S/cutoff值升高;实验中严格做到阴、阳性及空白对照和样本同时处理,则孵育方式和时间对样本S/cutoff值影响不大;延长加入酶结合物的时间,导致样本S/cutoff值下降.结论:操作因素严重影响一步竞争ELISA法检测HBcAb,规范操作规程可以减少操作因素对结果的影响.     

Hepatitis B infection is highly endemic in Uganda: findings from a national serosurvey

Background

Infant immunization against hepatitis B began in Uganda in 2002.

Objective

To determine the baseline prevalence of hepatitis B virus (HBV) infection and explore risk factors.

Methods

A hepatitis B prevalence study was nested in the 2005 national HIV/AIDS serobehavioural survey. Demographic characteristics and risk factors were explored by questionnaire. One third of blood specimens (n=5875) from adults aged 15 to 59 years were tested for hepatitis B core antibodies (HBcAb); positive specimens were tested for hepatitis B surface antigen (HBsAg).

Results

HBcAb was present in 52.3% (95% CI: 51.0–53.6) of adults, and HBsAg in 10.3% (9.5–11.1). By 15–19 years of age, 40.0% had been infected with HBV. Prevalence of both markers was significantly higher across northern Uganda, in rural areas, among the poor and least educated, and in uncircumcised men. Other independent predictors of infection were age, ethnic group, occupation, number of sex partners, and HIV and HSV-2 status.

Conclusion

Hepatitis B virus infection is highly endemic in Uganda, with transmission occurring in childhood and adulthood. More than 1.4 million adults are chronically infected and some communities disproportionately affected. The hepatitis B infant immunization programme should be sustained and catch-up vaccination considered for older children.     

HBsAg和HBcAb阳性的乙肝患者血清前S_1抗原检测的临床意义

在乙型肝炎的血清学检测中，乙肝五项是常用的检测项目，HBsAg和HBcAb是一种比较特殊的模式。一方面由于HBeAg转阴，可能预示患者体内病毒清除，病情趋于好转；另一方面患者并未出现HBeAb、HBeAg转阴，可能是由于基因变异等原因造成的，患者体内仍存在强的病毒复制，仍需持续治疗。前S1抗原是一个新的乙肝血清学标志物，有报道认为其与HBV—DNA检测有良好的相关性，是一个很好的反映病毒复制的指标。本文将探讨其作为反映病毒复制的指标对HBsAg和HBcAb二者阳性的乙肝患者检测的意义。