戊型肝炎病毒感染实验室诊断方法研究进展  

Research Progress in Laboratory Diagnostic Methods for HEV Infection

作　　者：纪文芳 温桂平[1,2,4] 唐自闽 夏宁邵[1,2,3,4] 郑子峥[1,2,4] 

机构地区：[1]厦门大学分子疫苗学与分子诊断学国家重点实验室,厦门361102 [2]厦门大学国家传染病诊断试剂与疫苗工程技术研究中心,厦门361102 [3]厦门大学生命科学学院,厦门361102 [4]厦门大学公共卫生学院,厦门361102

出　　处：《病毒学报》2016年第3期385-392,共8页Chinese Journal of Virology

基　　金：国家基金(81373061);重大新药创制(2013ZX09101017);厦门大学校长基金(20720150137)

摘　　要：戊型肝炎是由戊型肝炎病毒(Hepatitis E Virus,HEV)引起的急性病毒性肝炎,已经成为威胁人群健康的公共卫生问题。HEV主要通过消化道传播,但随着HEV输血传播病例的报道,HEV给输血安全带来的风险也受到人们的重视。通过分析戊型肝炎现有的诊断手段,以对献血员的HEV筛查提供借鉴作用,这对输血安全中戊型肝炎的预防和控制具有重大意义。目前常用的戊型肝炎检测指标主要包括:HEV RNA、HEV抗原、抗-HEV IgM、抗-HEV IgG。核酸检测是戊型肝炎诊断的"金标准",对于慢性戊型肝炎患者、免疫缺陷人群及无肝炎症状的HEV感染者都有着特别优势。HEV抗原作为HEV现症感染指标,对于血站HEV筛查和急性戊型肝炎诊断有很好的应用价值。抗-HEV IgM是HEV近期感染的标志,不能作为HEV现症感染的单一指标。而抗-HEV IgG只能指示HEV既往感染,不适用于急性戊型肝炎的诊断。目前,献血员HEV检测主要以核酸检测为基础,而HEV抗原检测可能弥补HEV RNA的检测不足。在未来,抗原检测和抗体检测对于献血员HEV筛查的价值还有待更多的研究评价。Hepatitis E,an acute self-limited disease is caused by hepatitis E virus（HEV）and is a publichealth concern for people worldwide.HEV is transmitted primarily via the fecal-oral route while direct evidence for blood-borne transmission has been reported.So the risk of blood transfusion safety caused by HEV has been widely paid attention.Here,we aim to provide some references to HEV screening for blood donors through analyzing the existing diagnostic methods for HEV,which are of great significance for the prevention and control of HEV infection.Currently,the primary detection indexes for HEV primarily include HEV RNA,HEV antigen,anti-HEV IgM,and anti-HEV IgG.HEV RNA testing is considered to be the ＂gold standard＂ for the detection of HEV infection.This test takes advantage of patients with chronic Hepatitis E,immunosuppressed people,and patients with nonhepatic manifestations of hepatitis E.HEV antigen testing is regarded as a current infection index for HEV,which could be used to detect HEV in blood donors and diagnose acute HEV infection.Anti-HEV IgM is a mark of HEV recent infection,but not a single index to diagnose a current infection with HEV.Anti-HEV IgG indicates that HEV was the previous infection,and it is not suitable to diagnose acute HEV infection.At present,blood donors screening for HEV were mainly based on nucleic acid detection,and an antigen test possibly could cover its’ shortage.To confirm the value of the antigen and antibody tests for blood donor screening,further studies are required in the future.

关 键 词：戊型肝炎病毒 诊断方法 核酸检测 抗原检测 抗体检测 

分 类 号：R373.9[医药卫生—病原生物学]