抗-HBc单项阳性患者中的隐匿性HBV感染  

Occult HBV infection in patients with anti-HBc positive alone

作　　者：黄象艳[1] 李晓娣[1] 黄象娟 沈茜[3] 

机构地区：[1]济南军区总医院输血科,250031 [2]山东医学高等专科学校济南校区生化教研室 [3]第二军医大学附属医院长海医院实验诊断科

出　　处：《中华实验和临床病毒学杂志》2010年第3期221-223,共3页Chinese Journal of Experimental and Clinical Virology

摘　　要：目的 研究抗-HBc单项强阳性患者中的隐匿性HBV感染发生率并分析发生原因.方法 收集183例血清学检测抗-HBc单项强阳性（A≤0.1）患者血清标本,采用实时定量PCR进行HBV DNA含量检测.对于DNA定量阳性的标本,PCR扩增HBV pre-S/S区基因,并进行克隆测序.结果 183例血清标本中3例HBV DNA定量结果大于103拷贝/ml,占1.6%.这3例标本中有2例得到pre-S/S区测序结果,2例标本均存在S基因＂a＂决定簇内Q129R/P点突变,且突变株与野生型共存.结论 抗-HBc单项阳性患者中存在隐匿性HBV感染,HBsAg血清免疫学方法的漏检与HBV S基因突变有关,同时与循环中HBsAg量低于检测限也有一定关系.HBV隐匿感染不仅可以造成临床诊断失误,更为严重的是献血员HBV隐匿感染造成血液的污染.Objective This study was designed to explore the incidence rate of occuIt HBV infection in patients with anti-HBc positive alone and analyze the possible reasons of occuIt infection.Methods Sera of 183 patients carrying anti-HBc alone（A≤0.1） were collected and real-time PCR was used to select samples with HBV DNA positive.HBV pre-S/S amplification products were obtained by PCR,and clonal sequencing were then used for these samples with HBV DNA positive.Results DNA quantitative results of three samples were greater than 103 copies/ml in 183 samples,with a fraction of 1.6%.Pre-S/S sequencing results of two samples from these three samples were obtained.Point mutations within ＂a＂ determinant with Q129R/P mutations and co-existence of the mutant type and wild type were found in the two samples.Conclusions Occult HBV infection existed in samples with anti-HBc alone.Factors contributing to the loss of HBsAg detection by immunoassays include S gene mutations and low levels of cireulating antigen which are below the assay limit of detection.Occult HBV infection not only can lcad to a false clinical diagnosis,but also can result in hematological pollution due to such occult infection of blood donors.

关 键 词：肝炎病毒 乙型 肝炎抗体 感染控制 

分 类 号：R512.62[医药卫生—内科学]