HBsAg阴性preS1Ag阳性的HBV携带者血清学标志物及其HBVDNA动态观察  

Serological Markers and HBV-DNA in HBV Carriers with Rare Serological Pattern of Negative HBsAg and Positive preS1Ag

作　　者：朱平安[1] 祝玲玲 申群喜[2] 谭德明[3] 朱红秋 谭萍 陈素文 

机构地区：[1]深圳市第七人民医院,深圳518081 [2]深圳市第二人民医院,深圳518035 [3]中南大学湘雅医院,长沙410008

出　　处：《热带医学杂志》2006年第5期507-509,共3页Journal of Tropical Medicine

基　　金：深圳市盐田区科技计划项目(No.200406)

摘　　要：目的探讨HBsAg(-)/HBeAg(+)/HBcAb(+)/preS1Ag(+)少见血清学模式形成的原因,了解该少见模式乙肝病毒携带者体内血清学标志物及其HBVDNA变化情况。方法采用ELISA、电化学发光免疫分析法(ECLIA)、巢式PCR和实时荧光定量PCR,对该少见模式乙肝病毒携带者HBV血清学标志物和HBVDNA进行检测,每隔3个月复查一次,持续15个月。结果在研究的时间内,国产ELISA试剂盒检测结果均为HBsAg(-)/HBeAg(+)/HBcAb(+)/preS1Ag(+);电化学发光免疫分析法检测HBsAg均为阳性,并随时间延续HBsAg水平逐渐下降;巢式PCR与实时荧光定量PCR检测HBVDNA为阳性,病毒载量上下波动。结论该乙肝病毒携带者血清学少见模式HBsAg为假阴性,动态观察HBsAg与HBVDNA水平,了解HBV复制情况,可为临床诊治提供可靠的依据。Objective To examine the cause of rare aerological pattern in a HBV carrier with HBsAg（-）/ HBeAg（＋）/HBcAb（＋）/preS1Ag（＋）, and study the alterations of HBV serological markers and HBV-DNA level in the carriers. Methods Serological markers were analyzed by enzyme-linked immunosorbont assay （ELISA）. The levels of HBsAg and HBV DNA were quantitatively determined by electrochemiluminescence immunoassay（ECLIA） and real-time polymerase chain reaction （PCR） technique, respectively. Nested PCR was used for HBV-S gene amplification. Results A rare serological pattern with HBsAg （-）/HBeAg （＋）/HBcAb （＋）/preS1Ag （＋） was confirmed by ELISA method. However, HBsAg was detected by ECLIA, and the level of HBsAg was progressively reduced. The level of HBV DNA was fluctuating, as measured by real-time PCR or nested PCR. Conclusion The HBV carrier with a rare serological pattern was partly due to the mutation of HBV-S gene. It is necessary to improve the sensitivity of ELISA kit for HBsAg and also to develop diagnostic kits for the measurement of HBV-S mutants. Measurement of both HBsAg and HBV DNA would facilitate diagnosis and management of hepatitis B.

关 键 词：HBSAG阴性 preS1抗原阳性 HBV DNA HBV S基因 

分 类 号：R512.62[医药卫生—内科学]