乙型肝炎病毒表面抗原与表面抗体同时阳性的血清学模式初步研究

摘要

目的 分析乙型肝炎病毒感染者乙型肝炎表面抗原与乙型肝炎表面抗体同时阳性的血清学模式与HBV DNA 的关系,并探究其原因及临床意义.方法 用酶联免疫分析法筛选出HBsAg和抗-HBs同时阳性的标本,用化学发光微粒子免疫分析法确认,用实时荧光定量聚合酶链反应检测其HBV DNA含量.结果 在选取的HBsAg和抗-HBs双阳性的56人中,共出现4 种HBV血清学模式:(1)HBsAg、抗-HBs、抗-Hbe、抗-HBc 阳性模式占42.8%,HBV DNA阳性率41.6%;(2)HBsAg、抗-HBs、HBeAg、抗-HBc阳性模式占30.4%,HBV DNA阳性率70.5%;(3)HBsAg、抗-HBs、HBcAb阳性模式占25%,HBV DNA 阳性率21.4%.(4)HBsAg、抗-HBs、HBeAg 、抗-Hbe、抗-HBc阳性模式占1.8%,HBV DNA阳性率100%.56 例样本中,有27例血清HBV DNA 检测阳性,阳性率为48.2%.结论 HBsAg和抗-HBs 双阳性伴HBeAg阳性者,血清中有较高水平的HBV DNA.HBsAg 和抗-HBs 双阳性并不代表疾病好转.%Objective To analyze of serum with HBsA g and anti HBs double positive in patients with Hepatitis B virus infec tion and discuss the relationship with HBV DNA. Methods to screening HBsAg and anti HBs double positive serum with enzyme linked immunosorbent assay and check the serum HBV markers and HBV DNA by Immunochemiluminescent technology and real time PCR respectively. Results Among the 56 cases with HBsAg and anti-HBs double positive, there were four HBV serology models: (1)HBsAg,anti-HBs, HBeAg and anti-HBc positive, with a positive rate of 42.8 ％ and HBV DNA positive rate 41.6 ％.(2)HBsAg,anti-HBs and anti-HBc positive with a positive rate 30.4％ and HBV DNA positive rate 70.5％. (3)HBsAg,anti HBs,anti HBe and anti HBc positive with a positive rate 25％ and HBV DNA positive rate 21.4％. (4)HBsAg,anti HBs,HBeAg,anti HBe and anti HBc positive model with a 1.8％ positive rate and whole positive of HBV DNA. There were 27 cases in 56 HBsAg and anti HBs double positive samples with a positive rate of 48.2％. Conclusion There were about 48.2％ cases in Viremia of four kind serology models both HBsAg and anti HBs double positive serum. High levels HBV DNA was detected in serum of HBsAg and anti-HBs double positive serum accompany HBeAg positive. HBsAg and anti HBs double positive were not a turn better signal in HBV infected patients.