抗戊型肝炎病毒开放读码框架及IgM和IgG抗体的消长规律及临床意义

目的研究戊型肝炎病人抗戊型肝炎病毒（ＨＥＶ）开放读码框架２（ＯＲＦ２）和３（ＯＲＦ３）及ＩｇＭ和ＩｇＧ抗体的消长规律及其临床意义。方法采用ＨＥＶＯＲＦ２、ＯＲＦ３合成多肽单独和联合酶联免疫法,动态检测５２例病人血清抗ＨＥＶ。结果起病初期ＯＲＦ２抗体和ＯＲＦ３抗体水平均较高,随病程的延长两者均下降,ＯＲＦ３抗体尤为明显。联合检测ＯＲＦ２和ＯＲＦ３抗体可提高试验的敏感性。血清抗ＨＥＶＩｇＭ和抗ＨＥＶＩｇＧ阳性率于起病半个月内分别为７１．１％（３２／４５）和９７．８％（４４／４５）,随病程的延长抗ＨＥＶＩｇＭ较早阴转。结论ＨＥＶ抗体诊断试剂盒至少应含有ＯＲＦ２和ＯＲＦ３两种抗原。抗ＨＥＶＩｇＭ的特异性好而抗ＨＥＶＩｇＧ的灵敏度高。

Dynamics of anti-HEV ORF2, ORF3, IgM and IgG in serial sera of patients with hepatitis E and their clinical significance

Objective To study the dynamics of anti HEV ORF2, ORF3, IgM and IgG in serial sera of patients with hepatitis E. Methods Anti HEV was detected in serial sera of 52 patients, by an enzyme linked immunosorbent assay (EIA) based on two synthetic peptides separated or combined from open reading frame (ORF) 2 and 3 of HEV genome. Results Both anti ORF2 and anti ORF3 in serum were at the highest levels in early acute phase of the disease, and declined gradually with the course,especially anti ORF3. The sensitivity of the EIA using both ORF2 and ORF3 peptides was higher than that of either alone. The positive rates of anti HEV IgM and anti HEV IgG were separately 71.1% (32/45) and 97.8% (44/45) within 15 days after onset, then decreased more dramatically in IgM than in IgG with the course. Conclusion Both ORF2 and ORF3 proteins should be used for the development of anti HEV EIA kit. It seems to be more specific in anti HEV IgM and more sensitive in anti HEV IgG as a diagnostic marker of hepatitis E.