乙型肝炎病毒表面抗原和抗体双阳性样本的产生机制研究  

Study on the Generation Mechanism of HBsAg and Anti-HBs Double Positive Samples

作　　者：朱浩稳[1] 刘丰伟[1] 李勇[1] 林曼跃[1] 

机构地区：[1]湖南省第二人民医院,长沙410007

出　　处：《现代检验医学杂志》2010年第5期8-11,共4页Journal of Modern Laboratory Medicine

基　　金：湖南省卫生厅院级课题：乙型肝炎病毒表面抗原亚型研究（2010年序号04）.

摘　　要：目的 研究乙型肝炎病毒表面抗原（HBsAg）和抗体（HBsAb）双阳性样本的产生机制.方法 运用酶联免疫吸附试验（ELISA）检测技术在血清HBsAg阳性样本中收集HBsAb同时阳性的样本作为研究组,利用HBsAg和HBsAb体外血清学中和反应为同时阳性的样本寻找配对的样本作为配对组,对筛选出的每一对样本进行乙型肝炎病毒（HBV）分型、HBV-DNA病毒载量测定、HBsAg亚型分析、HBV-S基因测序,记录结果.同时,收集HBsAg阳性并且HBsAb阴性的样本血清作为对照组,同步分析,记录结果.结果 20例研究组的血清学标志物中,乙型肝炎病毒核心抗体（HBcAb）均为阳性,基因型均为B型,HBV-DNA病毒载量均大于105 copies/ml,HBsAg亚型均为adw,有7例样本HBV-S基因有突变;20例配对组的HBcAb均为阳性,基因型均为C型,HBV-DNA病毒载量均大于105 copies/ml,HBsAg亚型均为adr,有6例样本HBV-S基因有突变.25例对照组样本的HBcAb均为阳性,HBV-DNA均大于105 copies/ml,其中12例样本基因型为B型,11例样本基因型为C型,2例样本基因型为B＋C型;HBsAg亚型16例为adr,7例为adw,2例为ayw;有8例样本HBV-S基因有突变.结论 HBsAg和HBsAb双阳性样本的产生机制可能由于机体在一定时期内感染了两种基因型和HBsAg亚型均不同的HBV而引起.Objective To study the generation mechanism of the hepatitis B virus surface antigen （HBsAg） and antibody （HBsAb） coexist positive samples. Methods Using enzyme-linked immunosorbent assay （ELISA） ,in serum HBsAg-posirive samples to collect HBsAb-positive serum samples classied as research group ,utilized HBsAg and HBsAb vitro serological reaction to find match group. Detected each of the research group samples of the hepatitis B virus （HBV） genotype, HBV-DNA hold,HBsAg subtype ,HBV-S gene sequence and recorded the results. To collect HBsAg-positive.and HBsAb- negative as a control group,synchronization analysis,record the results. Results 20 cases of research group-of hepatitis B virus core antibody （HBcAb） were positive,all of them were B-type genotype,HBV-DNA was more than 10scoples/ml, HBsAg subtype were adw,there were 7 cases of samples of HBV-S gene rnutation ;20 cases of match group of serum markers of HBcAb were positive,all of them were C-type genolype,HBV-DNA was more than 10s eoples/ml,HBsAg subtype was adr,there were 6 cases of samples of HBV-S gene mutation;Control group, 25 cases of serum samples were positive for HBcAb,any of them of HBV-DNA was more than 10s copies/ml,12 cases were B-type genotype,11 cases were C-type genotype,2 cases were B＋C type genotype;For HBsAg subtype 16 cases were adr,7 cases were adw,2 cases were ayw;8 cases had HBV-S gene mutation. Conclusion HBsAg and HBsAb coexist positive dual mechanism could produce in a period of time when the body is infected with two HBV genotypes and HBsAg subtypes in the same time.

关 键 词：乙型肝炎病毒表面抗原 乙型肝炎病毒表面抗体 双阳性 产生机制 

分 类 号：R512.62[医药卫生—内科学] R392.11[医药卫生—临床医学]