CAJ | 학술논문

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.
목적 연구항-HBc단항강양성환자중적은닉성HBV감염발생솔병분석발생원인.방법 수집183례혈청학검측항-HBc단항강양성(A≤0.1)환자혈청표본,채용실시정량PCR진행HBV DNA함량검측.대우DNA정량양성적표본,PCR확증HBV pre-S/S구기인,병진행극륭측서.결과 183례혈청표본중3례HBV DNA정량결과대우103고패/ml,점1.6%.저3례표본중유2례득도pre-S/S구측서결과,2례표본균존재S기인"a"결정족내Q129R/P점돌변,차돌변주여야생형공존.결론 항-HBc단항양성환자중존재은닉성HBV감염,HBsAg혈청면역학방법적루검여HBV S기인돌변유관,동시여순배중HBsAg량저우검측한야유일정관계.HBV은닉감염불부가이조성림상진단실오,경위엄중적시헌혈원HBV은닉감염조성혈액적오염.
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.