丙型肝炎病毒窗口期感染核酸阳性血清检测和基因型别分析  

Detection and Genotyping of Serum HCV RNA during the Preseroconversion Window

作　　者：杨振[1] 祁自柏[1] 于洋[1] 谷金莲[1] 李河民[1] 

机构地区：[1]中国药品生物制品检定所,北京100055

出　　处：《中国预防医学杂志》2008年第7期602-605,共4页Chinese Preventive Medicine

摘　　要：目的分析丙型肝炎病毒(HCV)早期感染血液样品核酸(RNA)检测的意义,并对检出的核酸阳性血清进行基因分型。方法对8 649份自然供血员及566份HCV可疑感染者血清进行核酸(TMA RNA试剂)检测,检测出的HCV RNA阳性样品利用基因分型芯片进行分型。同时利用HCV核心总抗原(HCVc Ag)和游离抗原(HCV free Ag)试剂以及抗体(Anti-HCV)试剂进行检测。并对检测数据进行比较分析。结果在所有血液样品中发现1份HCV抗体、HCVc Ag、HCV free Ag全部阴性但RNA阳性的样品,基因型别为1b型。在8 649份自然供血员血清中筛出1份HCVc Ag、HCV free Ag以及HCV RNA阳性但抗体阴性血清,基因型别为1b型。在566份HCV可疑感染者血清中,筛出1份HCV free Ag和核心抗体同时阳性血清,基因型别为1b型。TMA试剂筛出5份RNA阳性血清但微粒子抗体试剂检测阴性,TMA试剂筛出6份RNA阳性的血清而酶标抗体试剂检测阴性。这6份血清,利用傲拓HCV总抗原试剂检测,其中5份HCV总抗原阳性。在澳大利亚国家血液中心进行复核。其中5份RNA阳性。在566份血清中,TMA试剂检出RNA阳性495份,阳性率87.4%。对RNA阳性血清进行型别分析,以1b、2a型为主,分别为46.5%和27%。结论由于检出了HCV RNA单独阳性的窗口期样品,认为利用HCV抗体试剂对血液进行筛查的同时,使用HCV RNA试剂做必要的补充实验,可以减少因窗口期造成的漏检。型别分析认为,窗口期感染样品基因型别也以1b,2a型为主。Objective To evaluate the significance of detecting HCV RNA during the p on window Methods A total of 8 649 blood donor sera and 566 suspicious samples were detected by HCVcAg EIA kit, HCVc free Ag EIA and HCV RNA TMA kit. The results were analyzed and compared. Results Two positive HCVcAg sera were found using HCV- tag kit, in which one was also found with positive antibodies to core antigen, and the other was only with positive HCVcAg dur- ing the preseroconversion window. The suspicious samples were confirmed with neutralization test and RIBA. Six serum samples were found with positive HCV RNA by TMA and negative anti - HCV by ORTHO ELISA. Five of these samples were confirmed with positive antigens. Conclusion Hepatitis C core antigen and HCV RNA can be effectively detected during the preseroconversion window by the kits mentioned.

关 键 词：肝炎病毒 丙型 试剂 基因型别 

分 类 号：R446.6[医药卫生—诊断学] R450[医药卫生—临床医学]