乙型肝炎表面抗原阴性、核心抗体阳性样本的临床意义

目的]探讨乙型肝炎病毒(hepatitis B virus,HBV)表面抗原阴性而核心抗体筛查阳性与乙型肝炎病毒DNA含量及乙型肝炎病毒前S1抗原(Pre-S1-Ag)的关系及临床意义。方法]采用酶联免疫吸附试验(enzyme-linked immunosorbent assay,ELISA)检测乙型肝炎病毒标志物(HBV-M),其中核心抗体阳性的标本采用酶联免疫吸附试验检测Pre-S1-Ag和实时荧光定量聚合酶链反应(PCR)测定乙型肝炎病毒DNA含量,对检测结果进行比较分析。结果]290例乙型肝炎病毒核心抗体(抗-HBc)阳性标本中单独抗-HBc阳性28例,占9.7%;乙型肝炎病毒表面抗体(抗-HBs)、抗-HBc两项阳性54例(18.6%);乙型肝炎病毒e抗体(抗-HBe)、抗-HBc阳性78例(26.9%);抗-HBs、抗-HBe、抗-HBc阳性130例(44.8%)。前S1抗原有2例阳性,占0.7%。HBV-DNA阳性3例,占1.0%。抗-HBc阳性血液中,单独抗-HBc阳性的血液中检出1例HBV DNA及前S1抗原阳性的血液,占单独抗-HBc阳性血液的3.6%。HBeAb、HBcAb同时阳性的血液中检出2例HBV DNA阳性及1例前S1抗原阳性,分别占其2.6%、1.3%。在所有抗-HBc阳性血液中检出3例HBV DNA阳性及2例前S1抗原阳性,阳性率分别为1.0%、0.7%。结论]虽然在HBsAg阴性、抗-HBc阳性血液中HBV-DNA阳性率并不高,但是对于受血者来说,输注这种血液将会有很高的感染风险,如果在献血者检查中加入抗-HBc和前S1抗原检测,既不用增加太多成本,同时操作比较容易,这样就能筛选出绝大部分的HBV-DNA阳性标本,从而减少输血感染HBV的风险。

THE CLINICAL SIGNIFICANCE OF THE HEPATITIS B VIRUS SURFACE ANTIGEN NEGATIVE AND CORE ANTIBODY POSITIVE SAMPLE

Objective]To study the clinical significance of hepatitis B virus surface antigen-negative and core antibody positive and to study relationship of hepatitis B virus DNA levels and hepatitis B virus Pre-S1-Ag.Methods]ELISA was used to detect HBV-M and pre-s1 antigen. PCR was used to detect hepatitis B virus DNA levels.Results]There were 28 cases separate anti-HBc-positive(9.7%);54 cases(18.6%)both surface antibody(anti-HBs)and anti-HBc-positive;78 cases(26.9%)both antibody(anti-HBe)and anti-HBc-positive;1...