用人工合成的丁型肝炎病毒抗原多肽检测丁肝病毒IgM抗全及其初步应用

用人工合成的丁型肝炎病毒抗原（ＨＤＶ－Ａｇ）肽建立了检测抗ＨＤＶ－ＩｇＭ抗体的ＥＬＩＳＡ方法。本法操作简便、快速、重复性好、特异性强,与抗ＨＡＶ－ＩｇＭ＇抗ＨＢｃ－ＩｇＭ、抗ＨＢｓ－ＩｇＭ、抗ＨＣＶ－ＩｇＭ、抗ＣＭＶ－ＩｇＭ、抗ＲＶ－ＩｇＭ、类风湿因子（ＲＦ）及抗核抗体（ＡＮＡ）阳性血清均不起反应,且可被２－巯基乙醇阻断而不起反应。经初步临床应用,３１例正常人血清抗ＨＤＶ－ＩｇＭ全部阴性,２８例慢     

乙型肝炎病人重叠感染丙型肝炎的评价

应用ＥＬＩＳＡ和ＰＣＲ法检测５０２例乙肝病人血清,４０１例ＨＢｓＡｇ阳性血清中,有１１４例（２８．４％）抗－ＨＣＶ和ＨＣＶＲＮＡ双项阳性,２５例（６．２％）ＨＣＶＲＮＡ单项阳性;２１例（５．２％）抗－ＨＣＶ单项阳性。将ＨＢｓＡｇ乙肝病人分成ＨＢＶＤＮＡ,ＨＢｅＡｇ阳性组和ＨＢＶＤＮＡ,ＨＢｅＡｇ阴性组。前者抗－ＨＣＶ阳性率为１１．６％～２０．５％,ＨＣＶＲＮＡ阳性率为１６．２％～２０．５％。后者抗－ＨＣＶ阳性率为２０．２％～５５．６％,ＨＣＶＲＮＡ阳性率为２３％～６０．３％。结果说明长期携带ＨＢＶ者和慢性乙肝病人均可重叠ＨＣＶ感染。ＨＢＶＤＮＡ阳性组抗－ＨＣＶ和ＨＣＶＲＮＡ阳性率明显高于ＨＢＶＤＮＡ阳性组     

TORCH系列病原体感染在产科的初步研究

本文应用酶联免疫吸附试验（ＥＬＩＳＡ）检测ＴＯＲＣＨ系列抗体,初步调查了产科孕产妇、异常妊娠史妇女及部分其它病人此类抗体水平。ＣＭＶ－ＩｇＭ阳性率,孕产妇１１．７％（６０／５４２）,不良妊娠史妇女２１．４３％（１５／７０）,其它病８．８２％（１５／１０７）;ＲＵＶ－ＩｇＭ阳性率孕产妇１５．７％（８５／５４２）,不良妊娠史妇女为３１．４％（２２／７０）;ＴＯＸ－ＩｇＭ阳性率分别为１６．９％（９２／５     

戊型肝炎病毒(HEV)合成肽及基因重组抗原免疫反应性研究

用ＯＲＦ２、ＯＲＦ３合成肽抗原（１～１０号）及基因工程重组的ＯＲＦ２抗原（１和２号）分别建立了酶联免疫方法（ＥＩＡ）,检测６０份戊型肝炎病人血清中ＨＥＶＩｇＧ及ＩｇＭ１０个合成肽抗原（Ｓｐ１－Ｓｐ１０）及２个重组抗原（Ｒｅ１、Ｒｅ２）,均和ＨＥＶ阳性血清发生特异反应,但阳性率和反应强度差别很大。以Ｒｅ１（ＯＲＦ２,４０２～６６０）检测的抗体阳性率最高,为９６．７％（５８／６０）;Ｓｐ６（ＯＲＦ３,８８～１２３）次之,为９３．３％（５６／６０）;以上两种抗原混合使用阳性率为１００％（６０／６０）。Ｓｐ６、Ｒｅ１及这两种抗原混合使用检测抗ＨＥＶＩｇＭ,阳性率分别为１８．３％（１１／６０）、６６．７％（４０／６０）和６６．７％（４０／６０）。研究结果表明：合成肽６号（Ｓｐ６）及重组抗原１号（Ｒｅ１）是制备戊肝抗体诊断试剂的理想抗原。     

戊型肝炎病人血清抗—HEV IgG与IgM和HEV RNA的动态变化

利用酶联免疫试验（ＥＩＡ）及逆转录－聚合酶链反应（ＲＴ－ＰＣＲ）,检测了２１０份急性非甲非乙非丙肝炎患者血清和４０例戊型肝炎（戊肝）病人系列血清。在急性非甲非乙非丙肝炎血清中,抗－ＨＥＶ ＩｇＧ、抗－ＨＥＶ ＩｇＭ和ＨＥＶ ＲＮＡ阳性率分别为６２．８６％、４５．２３％和４０．４８％。在戊肝系列血清检测中,抗－ＨＥＶ ＩｇＧ阳性率发病１个月内为９２．５％,发病２￣６个月１００％,１２个月９４．７％,     

兰州地区孕妇和新生儿血清中风疹病毒特异性IgM抗体测定研究

本文采用ＥＬＩＳＡ抗ｕ抗体捕捉法检测了兰州地区７１２例孕妇和６２４例新生比血清中风疹病毒特异性ＩｇＭ抗体（ＲＶ－ＩｇＭ）。实验结果为：７１２例孕妇中,ＲＶ－ＩｇＭ阳性者有８例,阳性率为１．１２％：６２４例新生儿脐带血清标本中,ＲＶ－ＩｇＭ阳性者６例,阳性率为０．９６％。结果表明,兰州地区孕妇中有一定的风疹病毒原发感染病例,新生儿也存在一定的风疹病毒先天性感染问题。     

戊型肝炎病毒（HEV）合成肽及基因重组抗的免疫反应性研究

用ＯＲＦ２、ＯＲＦ３合成肽抗原（１－１０号）及基因工程重组的ＯＲＦ２抗原（１和２号）分别建立了酶联免疫方法（ＥＩＡ）,检测６０份戊型肝炎病人血清中ＨＥＶＩｇＧ及ＩｇＭ１０个合成肽抗原及２人重组抗原,均和ＨＥＶ阳性血清发生特异反应,但阳性率和反应强度差别很大。以Ｒｅｌ（ＯＲＦ２,４０２－６６０）检测的抗体阳性率最高,为９６．７％;Ｓｐ６（ＯＲＦ３,８８－１２３）次之,为９３．３％（５６／６０）;以上     

丙肝病毒IgM抗体检测方法的初步研究

选择东燃公司的重组结构区和非结构区抗原建立的抗ＨＣＶ－ＩｇＭ检测方法,简便、快速、特异性强、重复性好、敏感性高。只在丙肝病人组检出而健康献血员均为阴性,与抗ＨＡＶ、ＨＢＶ的ＩｇＭ抗体无交叉反应,且排除了ＲＦ干扰和ＩｇＧ占位引起的假阳性和假阴性,适用于抗ＨＣＶ－ＩｇＭ的临床检测。对２４例丙肝病人的抗ＨＣＶ－ＩｇＭ检测结果显示,急性丙肝病人血清抗ＨＣＶ－ＩｇＭ检出率较高（７５％,６／８）,且随ＡＬＴ正常而消失或滴度下降。慢性病人抗ＨＣＶ－ＩｇＭ检出率为５６．３％（９／１６）,其中７例ＩｇＭ持续阳性者为慢性活动性丙肝,说明慢性病人抗ＨＣＶ－ＩｇＭ与疾病的活动性密切相关。结果提示抗ＨＣＶ－ＩｇＭ的检测在急性肝炎的诊断及慢性丙肝的预后和转归上具有临床意义。     

安徽省不同人群及各型肝炎患者庚型肝炎病毒感染检测分析

应用酶联免疫试验（ＥＩＡ）和逆转录套式聚合酶链反应（ＲＴ－ｎＰＣＲ）对１００ 例一般人群、３８５例献血员、５４ 例血液透析患者、７２ 例乙型肝炎、４１ 例丙型肝炎２７ 例非甲－戊型肝炎患者进行检测。结果抗－ＨＧＶ 阳性率分别为２．００％ 、７．５３％ 、２７．７８％ 、１８．０６％ 、１９．５１％ 和１４．８１％ ;抗－ＨＧＶ 阳性者中ＨＧＶＲＮＡ 阳性率分别为１００．００％ 、６２．０７％ 、６６．６７％ 、６９．２３％ 、７５．００％ 和 １００．００％ ,提示本地区不同人群存在ＨＧＶ 感染。献血员、血透患者、乙型肝炎、丙型肝炎、非甲－戊型肝炎患者的ＨＧＶ 感染率显著高于一般人群,提示献血员,血透患者及ＨＢＶ、ＨＣＶ 感染者是ＨＧＶ 感染的高危人群。ＨＧＶ 常与ＨＢＶ 或ＨＣＶ 重叠／联合感染,也可单独感染。抗－ＨＧＶ 阳性者中ＨＧＶ ＲＮＡ 阳性率为８３．８２％ ,提示抗－ＨＧＶＥＩＡ 可用于ＨＧＶ 感染的检测。ＡＬＴ 正常和异常献血员中抗－ＨＧＶ 阳性率无显著性差异。     

育龄妇女和母婴巨细胞病毒感染的流行病学调查

我们应用ＥＬＩＳＡ技术和ＰＣＲ技术对武汉市地区１０５１名育龄妇女和１　９　５对母婴的巨细胞病毒感染进行了血清流行病学调查。结果表明：１２４６名受检妇女ＣＭＶ　ＩｇＭ和　ＩｇＧ抗体阳性率分别为３．６％和８２．２％。１９５对母婴有２０名产妇尿中ＣＭＶ－ＤＮＡ阳性,所生子女中　有３名尿中ＣＭＶ－ＤＮＡ阳性,相关率为１５％。受检妇女中９８名有不良孕产史,其ＣＭＶ　ＩｇＭ和ＩｇＧ抗　体阳性率与无不良孕产史妇女比较均有显著性差异（ｐ＜０．０１）。     

我国25省市自治区丁型肝炎病毒感染的流行病学调查研究

应用本室先后建立的酶联免疫吸附法和核酸打点杂交法,检测我国25省布自治区、16个不同民族共9 758例乙型肝炎病毒感染者中的丁型肝炎病毒抗原、抗体和核酸。其中乙型肝炎病人4 714例,HBsAg慢性携带者5 044例。病人和携带者中丁型肝炎抗原阳性率分别为4.25％和3.0％,丁型肝炎抗体阳性率分别为1.46％和1.18％,丁型肝炎病毒核酸阳住率分别为3.70％和2.2％。在不同地区不同民族丁型肝炎的这些指标有一定差异。在16个民族中,维吾尔族、蒙族和藏族丁型肝炎抗体阳性率明显高于其他民族,黎族丁型肝炎核酸阳性率高于其他民族。但在1136例不同临床型乙型肝炎病人中,丁型肝炎感染率无明显区别。丁型肝炎感染与暴发性肝炎的关系有待进一步研究。     

Detection of antibody to hepatitis delta virus in human serum by double antigen sandwich ELISA

A simple rapid detection of antibody to hepatitis delta virus (anti-HDV) in human serum was developed by using double antigen sandwich ELISA. HDV gene fragment encoding HDAg was isolated from a Chinese patient infected with HDV by RT-PCR, and a high-efficient expression HD-PQE31 strain was constructed with the fragment. We obtained high titer and good quality hepatitis delta virus protein purified by Ni-NTA metal-affinity chromatography, which was identified by Western blot and ELISA, then we set up the double antigen sandwich ELISA for detection of anti-HDV in human serum, and the performance of the sandwich ELISA was evaluated in terms of specificity and sensitivity. Results were: 1) The purified HDAg protein's purity was 90%, and its ELISA titer was 1/100 000. 2) 42 anti-HDV positive sera were detected and showed that the sensitivity of sandwich ELISA was higher than that of competitive ELISA (t=2.44, p<0.01). 3) The inhibitory rates for 2 anti-HDV positive sera by the specific HDAg were 74% and 93% respectively. 4) For the assay of specificity, all 60 samples infected by other hepatitis viruses and 30 normal samples were negative for anti-HDV. These results suggested that the double antigen sandwich ELISA with purified recombinant HDAg showed higher specificity and sensitivity, It can be used in routine laboratories to diagnose the HDV infection.     

Anti-HDV IgM as a Marker of Disease Activity in Hepatitis Delta

Background

Hepatitis delta frequently leads to liver cirrhosis and hepatic decompensation. As treatment options are limited, there is a need for biomarkers to determine disease activity and to predict the risk of disease progression. We hypothesized that anti-HDV IgM could represent such a marker.

Methods

Samples of 120 HDV-infected patients recruited in an international multicenter treatment trial (HIDIT-2) were studied. Anti-HDV IgM testing was performed using ETI-DELTA-IGMK-2-assay (DiaSorin). In addition, fifty cytokines, chemokines and angiogenetic factors were measured using multiplex technology (Bio-Plex System). A second independent cohort of 78 patients was studied for the development of liver-related clinical endpoints (decompensation, HCC, liver transplantation or death; median follow up of 3.0 years, range 0.6–12).

Results

Anti-HDV IgM serum levels were negative in 18 (15%), low (OD<0.5) in 76 (63%), and high in 26 (22%) patients of the HIDIT-2 cohort. Anti-HDV IgM were significantly associated with histological inflammatory (p<0.01) and biochemical disease activity (ALT, AST p<0.01). HDV replication was independent from anti-HDV IgM, however, low HBV-DNA levels were observed in groups with higher anti-HDV IgM levels (p<0.01). While high IP-10 (CXCL10) levels were seen in greater groups of anti-HDV IgM levels, various other antiviral cytokines were negatively associated with anti-HDV IgM. Associations between anti-HDV IgM and ALT, AST, HBV-DNA were confirmed in the independent cohort. Clinical endpoints occurred in 26 anti-HDV IgM positive patients (39%) but in only one anti-HDV IgM negative individual (9%; p = 0.05).

Conclusions

Serum anti-HDV IgM is a robust, easy-to-apply and relatively cheap marker to determine disease activity in hepatitis delta which has prognostic implications. High anti-HDV IgM levels may indicate an activated interferon system but exhausted antiviral immunity.     

Diagnostic value of dengue virus-specific IgA and IgM serum antibody detection

The diagnostic value of dengue virus (DV)-specific immunoglobulin A (IgA) serum antibody detection, by an indirect immunofluorescence assay (IFA) was evaluated. For this study, the kinetics of DV-specific IgA serum antibodies was analysed in two experimentally immunised macaques, paired samples from 35 patients suspected of a primary or secondary DV infection, paired sera from patients with high levels of IgA specific antibodies against influenza virus (n = 15), sera from patients with other viral infections (n = 40) and healthy blood donors (n = 10), which served as controls. The presence of DV-specific IgA serum antibodies in humans and in monkeys was compared with that of DV-specific IgM demonstrated in a capture enzyme-linked immunosorbent assay (ELISA). The development of DV-specific IgA and IgM antibodies in macaques proved to be similar to that observed in humans with a DV infection. In sera obtained from suspected primary DV patients during the acute phase and convalescent phase, DV-specific IgA was detected in 1/6 (17%) and 6/6 (100%), whereas IgM was detected in 4/6 (67%) and 5/6 (83%), respectively. In sera from suspected secondary DV patients during the acute phase and convalescent phase, DV-specific IgA was detected in 18/29 (62%) and 28/29 (97%), whereas IgM was detected in 20/29 (69%) and 28/29 (97%), respectively. The control group consisted of five paired serum samples from yellow fever vaccinated individuals and a patient with acute tick-borne encephalitis, 15 paired serum samples from patients with high levels of IgA antibodies specific for influenza virus and 40 serum samples from patients with specific IgM antibodies against other viruses. Ten serum samples from healthy blood donors were included. Among the control serum samples, in one patient, both DV-specific IgA and IgM antibodies were present, and in three sera DV-specific IgM antibodies could be demonstrated. These data suggest that detection of DV-specific IgA serum antibodies by IFA may have additional value for the diagnosis of DV infection.     

Epidemiological,Clinical and Histological Characteristics of HBV/HDV Co-Infection: A Retrospective Cross-Sectional Study in Guangdong,China

Background

The epidemiology of hepatitis D virus (HDV) in China is fairly unknown. The mechanisms whereby HDV leads to accelerated liver disease in hepatitis B virus (HBV)/HDV co-infected patients and the histological characteristics of chronic hepatitis D (CHD) patients need further investigation.

Methods

The prevalence of HDV was retrospectively evaluated in all consecutive hospitalized patients with chronic HBV infection from May 2005 to October 2011. HBV/HDV co-infected patients and HBV mono-infected patients were compared clinically and histologically. Significant histological abnormality was defined as significant necroinflammation (grade ≥A2) and/or significant fibrosis (stage ≥ F2).

Results

6.5% of patients (426/6604) tested positive for IgM anti-HDV. HDV was more common in patients over 50 years old than those under 50 (11.7% vs. 5.1%, P<0.001). HBV/HDV co-infected patients had higher frequencies of end-stage liver disease (ESLD) than HBV mono-infected patients, and HDV co-infection was an independent risk factor for ESLD (OR: 1.428, 95%CI: 1.116–1.827; P = 0.005). The HBV DNA levels in the HBV/HDV group were significantly lower than the HBV group in chronic hepatitis patients (median: 6.50 log₁₀copies/mL vs 6.80 log₁₀copies/mL, P = 0.003), but higher than the HBV group in ESLD patients (median: 5.73 log₁₀copies/mL vs 5.16 log₁₀copies/mL, P<0.001). When stratified by alanine aminotransferase (ALT) level, 46.7%, 56.5% and 80.5% of CHD patients had significant necroinflammation and 86.7%, 87.0% and 90.3% had significant fibrosis with ALT 1–2×upper limit normal (ULN), 2–5×ULN and>5×ULN respectively.

Conclusion

The prevalence of HDV is not low in patients with chronic HBV infection. HDV may contribute to progression to ESLD through late-phase HBV DNA reactivation.     

病毒性肝炎HAV，HBV，HCV，HDV和HEV重叠感染的研究

采用ＥＬＩＳＡ法检测了１０８例乙型肝炎病毒（ＨＢＶ）感染者血清中的五种肝炎病毒──甲型（ＨＡＶ）、乙型（ＨＢＶ）、丙型（ＨＣＶ）、丁型（ＨＤＶ）和成型（ＨＥＶ）肝炎病毒的标志物,并采用ＰＣＲ技术检测了患者血清ＨＢＶＤＮＡ、ＨＣＶＲＮＡ及ＨＤＶＲＮＡ。结果五种肝炎病毒重叠感染者３５例（３２．４％）,单纯ＨＢＶ感染者７３例（６７．６％）。ＨＢＶ、ＨＡＶＭ重感染率为４．６％,ＨＢＶ、ＨＣＶ二重感染率为９．２％,ＨＢＶ、ＨＤＶＭ重感染率为１４．８％,ＨＢＶ、ＨＥＶ二重感染率为１．９％,ＨＢＶ、ＨＣＶ和ＨＤＶ三重感     

Hepatitis B and Delta Virus Are Prevalent but Often Subclinical Co-Infections among HIV Infected Patients in Guinea-Bissau,West Africa: A Cross-Sectional Study

BackgroundCo-infection with human immunodeficiency virus (HIV) and hepatitis B virus (HBV) may lead to accelerated hepatic disease progression with higher rates of liver cirrhosis and liver-related mortality compared with HBV mono-infection. Co or super-infection with hepatitis Delta virus (HDV) may worsen the liver disease and complicate treatment possibilities.MethodsIn this cross-sectional study we included HIV-infected individuals who had a routine blood analysis performed at an HIV clinic in Bissau, Guinea-Bissau between the 28^th of April and 30^th of September 2011. All patients were interviewed, had a clinical exam performed and had a blood sample stored. The patients'' samples were tested for HBV and HDV serology, and HBV/HDV viral loads were analyzed using in-house real-time PCR methods.ResultsIn total, 576 patients (417 HIV-1, 104 HIV-2 and 55 HIV-1/2) were included in this study. Ninety-four (16.3%) patients were HBsAg positive of whom 16 (17.0%) were HBeAg positive. In multivariable logistic regression analysis, CD4 cell count <200 cells/ µl and animist religion were significantly associated with HBsAg positivity. Due to scarcity of available plasma, virological analyses were not performed for eight patients. HBV DNA was detected in 42 of 86 samples (48.8%) positive for HBsAg and genotyping was performed in 26 patients; 25 of whom had genotype E and one genotype D. Among 9 patients on antiretroviral treatment (ART), one patient had the [L180M, M204V] mutation associated with lamivudine resistance. Among the HBsAg positive patients 25.0% were also positive for anti-HDV and 4/9 (44.4%) had detectable HDV RNA.ConclusionHBV and HDV were frequent co-infections among HIV positive patients in Guinea-Bissau and chronic infection was associated with severe immunosuppression. Lamivudine was widely used among HBsAg positive patients with the risk of developing resistant HBV.     

ELISA法检测流行性腮腺炎病毒感染特异性IgM抗体的研究

用流行性腮腺炎(流腮)病毒Enders株接种鸡胚尿囊腔培养,尿囊液经聚乙二醇6000处理制备流腮病毒抗原,用ELISA法检测流腮患者血清中特异性IgM抗体,其敏感性,特异性、重复性和稳定性都很高。 79份流腮患者血清,检出特异性IgM72份,阳性率为91％,32例非流腮患者IgM全部阴性、两者有极显著差异(P<0.01)。 10份血清作血清倍比稀释至1∶3200测IgM仍全部阳性,1∶6400稀释仅1例阴性,1∶12800稀释5例中仍有2例阳性。 10份血清作流腮抗原特异性抗体阻断试验,光密度抑制率均大于50％,平均为87％,10份标本作2-ME和SPA阻断后检测IgM抗体,结果2-ME阻断标本全部阴转,而SPA阻断标本仍阳性,证实所检测为流腮特异性抗体。 24份标本2次重复检测流腮IgM,其阴、阳性结果一致,这期间抗原放4℃ 1个月,提示抗原的稳定性和方法的重复性都很好。本方法敏感性明显高于血凝抑制试验,其阳性率分别为91％和61％,两者有显著差异。而且所用试剂简单经济,操作简便,快速,适用于临床早期诊断,易于广泛推广应用。     

Parvovirus B19 infections in state of Rio de Janeiro, Brazil: 526 sera analyzed by IgM-enzyme-linked immunosorbent assay and polymerase chain reaction

In this study were analyzed 526 sera; the patients aged from two days to 65 years old presenting exanthema, which was the most frequent symptom observed, besides fever, adenomegaly, and arthralgia. These sera were negative by enzyme-linked immunosorbent assay (IgM-ELISA) for either rubella (495), toxoplasma (41), cytomegalovirus (12), measles (40), dengue (56), and they were submitted to nested polymerase chain reaction (PCR) for B19 DNA and commercial IgM-ELISA for B19. In 39 abortion cases, IgM or DNA were not detected, therefore they were not took into account for analysis. Specific DNA and IgM were detected respectively in 71 (14.5%) and IgM in 62 (12.7%) sera from 487 sera analyzed. IgM and DNA were simultaneously detected in 43 (8.8%), while agreement among the results by PCR and IgM-ELISA was observed in 440 (90.4%). The sera were collected from January 1999 to December 2000, most of them in 1999 (325), during winter and spring. The major number of clinical cases was observed in the age group from one to ten years old. IgM or DNA were detected in 23 from 51 municipal districts of the state of Rio de Janeiro, where the samples were collected.