吸毒人群中HIV/HCV核酸和抗体关系的分析

研究了高危人群中HIV/HCV核酸和抗体的关系.从新疆地区采集吸毒人群的血样,并对其进行HIV/HCV核酸和抗体的检测.320例吸毒人员血浆样品中HCV抗体阳性为80.3%,HIV抗体阳性率为41.9%,HIV和HCV共感染者为38.3%.HIV RNA与抗体的总符合率为98.8%,在186例HIV抗体阴性样品中可能有2例为HIV感染的窗口期.HCV抗体和HCV RNA的阳性符合率为92.6%,HCV RNA与HCV抗体的总符合率为90.0%,以上结果说明在HIV/HCV的高流行区进行HIV/HCV核酸检测可以发现病毒感染的窗口期,而约8%的HCV抗体阳性样品为病毒核酸阴性,也值得进一步研究.     

丙型肝炎病毒分片段抗体检测蛋白质芯片质控参比品的建立及质量验证

建立能同时检测丙型肝炎病毒(HCV)嵌合抗体、核心抗体和NS3、NS4、NS5抗体的蛋白质芯片质控参比品,对质控合格的芯片进行质量验证。用3种HCV EIA试剂分别检测从3家医院收集的丙型肝炎病毒感染患血清及其他非HCV感染患血清,从3种EIA试剂同时阴性或阳性的血样中挑取阳性和阴性血清,然后用RNA hyb PCR试剂进行检测,从中再选取部分样本用RIBA3．0进行检测,确定HCV分片段抗体检测蛋白质芯片质控参比品。经质检合格的芯片用中国药品生物制品检定所的HCV参比品进行检定。通过490例临床标本的检测对芯片的质量进行进一步的验证。从收集的240份丙型肝炎病毒感染患血清及其他非HCV感染患血清筛选出30份血样(15份阳性,15份阴性)作为HCV分片段抗体检测蛋白芯片质控参比品。中国药品生物制品检定所的80份HCV参比品检定结果表明,混合抗体阳性检出率为39／40,阴性符合率为40／40,总符合率为98．7％;核心抗体阳性检出率为27／40,阴性符合率为40／40;NS3抗体阳性检出率为26／40,阴性符合率为39／40;NS4抗体阳性检出率为19／40,阴性符合率为40／40;NS5抗体阳性检出率2／40,阴性符合率为40／40。490例临床标本的检测结果表明,对于194例HCV阳性标本,蛋白质芯片混合抗体与ELISA的符合率达99．5％,分片段抗体符合率达97．4％,两种方法检测结果不符的标本经RIBA试剂确认,蛋白质芯片与RIBA试剂的符合率高度一致。对于296例各种HCV抗体阴性标本,蛋白质芯片检测结果全部为阴性。以上结果表明,制备的丙型肝炎病毒分片段抗体检测蛋白质芯片质控参比品可用于芯片生产的质量控制,经质控合格的芯片符合国家标准的要求,可用于临床检测。     

中国HIV阳性参比品库的建立以及HIV不同生物标志物的意义

为建立HIV阳性样品库并分析HIV不同生物标志物的意义,从我国不同地区以及不同人群中收集HIV感染者或可疑感染者血浆,对其进行HIV抗体、抗原、核酸以及基因型的检测,并用WB试剂对其进行抗体的确认检测。结果显示,该样品库共有样品190份,均为HIV阳性,含有我国流行的主要基因型,即B′、BC、AE和B亚型;HIV抗体S/CO值小于10者占11.1%,在10~15之间者占63.2%,大于15的占25.8%;病毒载量在50~103copies/mL者占7.9%,在103~105copies/mL者占82.2%,大于105copies/mL者占10.0%。而且抗体S/CO值大于10者,均为HIV抗体确认阳性,小于10者仅有61.9%为抗体确认阳性,但核酸均大于50copies/mL,而且抗体不确定样品的病毒载量均大于105copies/mL,但抗体不确定的8份样品中仅有4份样品为P24抗原阳性。结果提示该样品库样品来自于HIV感染的不同时期,可用于对HIV的不同试剂进行评价;而且核酸的检测可有助于对HIV早期感染的明确诊断。     

RT套式PCR检测血浆HCV RNA及与抗HCV检测的比较

应用微量血清热变性法提取核酸,逆转录套式聚合酶链反应(RT-nest PCR)检测血浆HCV RNA,并与抗HCV ELISA检测结果比较,对HCV RNA阳性标本进行HGV RNA的筛查.结果在32例抗HCV阳性和20例抗HCV阴性血浆中,HCV RNA分别检出18例和2例,总符合率为70%,20例HCV RNA阳性者中有2例合并感染HBV,1例合并感染HGV.证明血浆样本中抗HCV与HCV RNA间存在很大的相关性.     

合肥市蜀山区206例艾滋病高危人群HIV、HCV感染情况调查

目的了解合肥市蜀山区艾滋病高危人群中人类免疫缺陷病毒(HIV)、丙型肝炎病毒(HCV)感染情况,为艾滋病高危人群疾病防治工作提供依据。方法采集合肥市蜀山区206例艾滋病高危人群血清样本,分别运用金标法和酶联免疫吸附法(ELISA)进行HIV抗体、HCV抗体检测。HIV抗体筛查结果阳性或一阴一阳标本再经蛋白印迹法(WB)确证阳性为最终结果,并对结果和不同人群、年龄、性别的感染情况进行统计分析。结果在206份血清样本中检出HIV抗体阳性17例,阳性率为8.73%;检出HCV抗体阳性21例,阳性率10.19%。合并感染病例2例,占0.97%。结论检测结果提示,在高危人群中存在HIV/HCV流行和传播的风险,因此应持续加强高危人群的监测,有效阻止艾滋病和丙型肝炎的流行和蔓延。     

同时检测血清中多种抗体的蛋白质微阵列研究

建立一种用蛋白质微阵列法可同时检测血清中艾滋病毒（HIV）, 丙型肝炎病毒（HCV）和梅毒螺旋体（TP）抗体的方法.将基因工程HIV、HCV和TP 3种融合抗原共价结合于固相载体玻片上,制成蛋白质微阵列,血清样本经稀释、加样、孵育、洗涤后,加上Cy3荧光标记二抗,洗涤,激光共聚扫描,将获得的图片用Bio-discover公司的Imagene专用分析软件进行分析,所获数据在经过自行编写的软件,根据Cutoff值自动生成判断结果.用此蛋白质微阵列系统检测了400例阴性血清,确定了Cutoff值,检测中国药品生物制品检定研究所的HIV, HCV和TP 3种参比品,并与3种ELISA试剂盒的结果进行了比较.蛋白质微阵列的艾滋病毒阳性和阴性符合率均为100%(20/20); 丙型肝炎病毒阳性和阴性符合率均为95%(38/40).梅毒螺旋体参比品阳性符合率为100%(10/10),阴性符合率为100%(20/20),蛋白质微阵列与三种ELISA试剂检测国家HIV、TP、HCV参比品（共150份血清样本）,结果具有高度的符合率.     

丙型肝炎病毒不同标志物检测结果的相关性分析

目的分析丙型肝炎病毒(Hepatitis C virus,HCV)抗原、抗体及核酸标志物实验室检测结果之间的关联性,评价适合血源筛查与早期临床确诊联合检测HCV感染的实验室诊断技术。方法用HCV RNA定量试剂、HCV核心抗原试剂及HCV抗体试剂分别检测304份血浆样本中HCV RNA载量、HCV Ag和抗-HCV指标,并对HCV RNA阳性样本进行基因分型。结果在304份血浆样本中,检出HCV RNA阳性样本87份,其HCV RNA载量≥500 IU/m L、500~30 IU/m L之间和<30 IU/m L时,血清学标志物HCV Ag浓度≥3 fmol/L及抗-HCV信号值/判断值≥1的阳性率分别为92.0%(23/25):96.0%(24/25)、58.8%(10/17):82.3%(14/17)及11.1%(5/45):75.6%(34/45),HCV RNA载量低于基因分型试剂盒LOD要求为500 IU/m L时,基因分型检测率为24.2%(15/62)。HCV RNA阴性样本217份中,HCV Ag浓度≥3 fmol/L和抗-HCV信号值/判断值≥1的样本阳性率分别为3.2%(7/217)和32.7%(71/217)。血清学指标在不同HCV RNA载量的阳性率差异具有统计学意义(χ2=197.4,P<0.01),HCV RNA载量与HCV Ag和抗-HCV水平成正相关。结论在中国人群中存在低HCV RNA水平携带者,HCV Ag和基因分型检测能力需要进一步提高。     

四种丙型肝炎病毒抗体试剂检测方法的性能评估

对血液筛查的四种丙型肝炎病毒(Hepatitis C virus,HCV)抗体试剂检测方法的性能进行评估。方法采用协作标定方式,应用四种检测方法(间接ELISA法、双抗原夹心ELISA法、间接CLIA法、双抗原夹心CLIA法)16种HCV抗体试剂,对经确证筛选出的70份(HCV抗体阳性35份、阴性35份)血浆样本进行检测,通过分析阳性、阴性符合率,评估四种方法 HCV抗体试剂的性能。结果间接ELISA法试剂检测阳性符合率为88.6%(31/35)~94.3%(33/35),双抗原夹心ELISA法、间接CLIA法、双抗原夹心CLIA法试剂检测阳性符合率为91.4%(32/35)~94.3%(33/35),四种检测方法 HCV抗体试剂阳性符合率之间的差异无统计学意义(P0.05);间接ELISA法和间接CLIA法试剂弱阳性样本检出率为11.4%(4/35)~31.4%(11/35),双抗原夹心ELISA法和双抗原夹心CLIA法试剂弱阳性样本检出率为5.7%(2/35)~11.4%(4/35),四种检测方法 HCV抗体试剂对弱阳性样本的检出率之间的差异有统计学意义(P0.05);间接ELISA法试剂检测阴性符合率分别为94.3%(33/35)~100%(35/35),间接CLIA法试剂阴性符合率分别为94.3%(33/35)~97.1%(34/35),双抗原夹心ELISA法和双抗原夹心CLIA法试剂阴性符合率均为97.1%(34/35),四种检测方法 HCV抗体试剂阴性符合率之间的差异无统计学意义(P0.05)。结论四种检测方法 HCV抗体试剂的性能基本一致,不同方法各有优缺点,建议应用多种检测方法对弱阳性样本进行确认检测。     

NASBA荧光分子信标技术定量检测丙型肝炎病毒

建立NASBA荧光分子信标探针检测技术,并对国家HCV标准品、人工构建HCVRNA野生株及HCV抗体阳性不同人群进行检测。实验结果:该方法检测HCV的灵敏度为103拷贝ml血清,阴性参比品的符合率为100%;检测的线性范围为103拷贝～109拷贝ml血清;精密性(CV值)小于6%,在HCV抗体阳性人群中HCVRNA的检出率在45%～65%之间。结论:该方法在HCVRNA临床定量检测中具有良好的灵敏度、特异性、重复性与实用性。     

HIV-1抗体蛋白印迹确认与核酸检测复核对比研究

应用病毒核酸载量法NASBA和HIV-1 RNA的巢式逆转录PCR(nested RT-PCR)法与HIV抗体蛋白印迹(WB)方法,对经过初筛的44例HIV-1抗体阳性标本进行了对照检测研究。发现了2例(gp160、p24)和1例(gp160g、p120p、66、p24)的特殊阳性样本,经NASBA法和该RT-PCR法核酸检测为阴性;WB确认的4例gp160阳性带、1例p24、p17阳性带和13例p24阳性带,经NASBA法和该RT-PCR法核酸检测也为阴性;而WB确认的其余全部带型的抗体阳性标本经过NASBA法和该RT-PCR法检测均为阳性。该研究表明对只有gp160p、24和gp160、gp120p、66、p24的特殊阳性标本和以p24为主的抗体不确定标本需要用RT-PCR或NASBA方法进行核酸检测,以进一步确认。     

A preliminary study on serological assay for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 238 admitted hospital patients

In this study, we aimed to evaluate the diagnostic value of serological assay for SARS-CoV-2. A newly-developed ELISA assay for IgM and IgG antibodies against N protein of SARS-CoV-2 was used to screen the serums of 238 admitted hospital patients between February 6 and February 14, 2020 with confirmed or suspected SARS-CoV-2. SARS-CoV-2 RNA was detected on pharyngeal swab specimens using real time RT-PCR. 194 (81.5%) of the serums were detected to be antibody (IgM and/or IgG) positive, significantly higher than the positive rate of viral RNA (64.3%). There was no difference in the positive rate of antibodies between the confirmed patients (83.0%, 127/153) and the suspected patients (78.8%, 67/85), whose nucleic acid tests were negative. The antibody positive rates were very low in the first five days after initial onset of symptoms, and then rapidly increased as the disease progressed. After 10 days, the antibody positive rates jumped from below 50% to over 80%. However, the positive rates of viral RNA maintained above 60% in the first 11 days after initial onset of symptoms, and then rapidly decreased. Overall, the suspected patients were most likely infected by SARS-CoV-2. Before the 11th day after initial onset of symptoms, nucleic acid test is key for confirmation of viral infection. The combination of serological assay can greatly improve the diagnostic efficacy. After the 11th day post-disease onset, the diagnosis for viral infection should be majorly dependent on serological assay.     

Prevalence of HIV Indeterminate Western Blot Tests and Follow-up of HIV Antibody Sero-Conversion in Southeastern China

HIV-indeterminate Western blotting(WB) results are typically obtained in WB confirmatory assays, and the number of indeterminate samples may increase with the detection of HIV infections, which will present considerable challenges for the management of HIV/AIDS. Nucleic acid detection has been used as a laboratory test for screening suspected or indeterminate samples. However, the effectiveness of these assays for the differential diagnosis of HIV-indeterminate WB samples remained undetermined. In this study, 210 subjects with HIV-indeterminate WB results were detected from 6360 positive HIV screening samples between 2015 and 2016 in southeastern China, in which HIV-indeterminate WB results accounted for 3.30%. The highest proportion of indeterminate results was observed in pregnant and lying-in women receiving physical examinations(16.67%), followed by that in voluntary blood donors(8.82%). The most common WB band patterns were p24, gp160 and p24, and gp160. The follow-up study revealed that the highest negative and positive conversion rates of HIV antibodies were in samples with a single p24 band(80.28%), and with gp160 and p24 bands(86.21%), respectively. Among the Env, Gag, and Pol antibodies, samples with a Gag band showed the highest negative conversion rate(81.25%), whereas the highest positive conversion rate was observed in samples with an Env band(56.76%). In addition, quantitative and qualitative HIV nucleic acid testing exhibited the highest sensitivity(96.3%) and specificity(97.85%), respectively. Our results indicate a lower proportion of HIV indeterminate WB results in southeastern China compared to previous reports, and the follow-up re-examination of patients with HIV indeterminate results should be performed. Nucleic acid testing facilitates the identification of HIV infections.     

Development Of A Nucleic Acid Lateral Flow Strip For Detection Of Hepatitis C Virus (Hcv) Core Antigen

The object of this study was to develop a simple, rapid, specific, and highly sensitive method to detect HCV core antigen. A nucleic acid aptamer was designed with the high specificity and sensitivity in a nucleic acid lateral flow strip to compete with HCV core antigen and DNA probes. The lower detection limit of the test strip was calculated to be 10 pg/mL with the scanner and 100 pg/mL with naked eyes. Results showed that there were no cross-interactions with other proteins such as HCV NS3, E1/E2 antigens, HIV p24 antigens, or BSA proteins (HCV unrelated protein). When the viral load exceeded 10⁴ copies/mL, the positive coincidence rates of ELISA and strip detection, when compared with the HCV RNA assay, were 98.44% and 97.28%, respectively. The results indicated that the ELISA detection and strip assay were in good agreement with the measured value. The results indicated that a nucleic acid lateral flow strip was a simple, rapid, specific, highly sensitive, and cost-effective field-based method for detecting HCV core antigen. The strip assay is an acceptable alternative to diagnose HCV core antigen and to investigate its epidemiology in clinical laboratories lacking specialized equipment and skills.     

丙型肝炎病毒RNA打点杂交检测方法同RT－PCR方法的比较

采用ＨＣＶ基因组结构区Ｃ区ｃＤＮＡ探针和非结构区ＮＳ３－４区ｃＤＮＡ探针,建立了用打点杂交（ｄｏｔｂｌｏｔｈｙｂｒｉｄｉｚａｔｉｏｎ）检测血清中ＨＣＶＲＮＡ的方法,同采用ＨＣＶ基因组５’端非编码区的一对寡核苷酸引物通过逆转录－聚合酶链式反应（ＲＴ－ＰＣＲ）检测血清中ＨＣＶＲＮＡ的方法相比较,发现两种方法都能快速早期和特异地检出血清中ＨＣＶＲＮＡ,但ＲＴ－ＰＣＲ法敏感性优于ＲＮＡ打点杂交法。对于无血清学指标的慢性ＮＡＮＢ肝炎病人的诊断,可采用这两种方法。这两种方法的敏感性在很大程度上依赖于引物和探针的敏感性,以及ＲＮＡ提取方法。ＲＴ－ＰＣＲ法适用于诊断病毒血症和复制,打点杂交法适用于研究ＨＣＶＲＮＡ量的变化,对治疗的评价,以及为实验筛选较高滴度的ＨＣＶＲＮＡ阳性样本。     

人原发性肝细胞肝癌中丙型肝炎病毒C_（33c）抗原及HBxAg的分布及意义

作者应用抗ＨＣＶＮＳ３区Ｃ３３ｃ抗原２Ｂ６株单克隆抗体和抗ＨＢｘＡｇ多克隆抗体,采用ＡＢＣ法对１０２例人原发性肝细胞肝癌（ＰＨＣ）组织进行了ＨＣＶ及ＨＢＶ抗原定位研究。ＨＣＶＣ３。抗原及ＨＢｘＡｇ在ＰＨＣ中的阳性检出率分别是８１．４％及７４．５％,Ｃ３３ｃ抗原或ＨＢｘＡｇ阳性占所检病例９４．１％,相同病例二者同时阳性为６１．８％。１０２例ＰＨＣ中５０例有癌旁肝组织,其Ｃ３３ｃ抗原和ＨＢｘＡｇ的阳性检出率分别是６２％和９２％。ＨＣＶＣ３３ｃ抗原定位于肝癌细胞的胞浆内,胞核未见阳性信号。Ｃ３３ｃ抗原阳性细胞在ＰＨＣ中呈散在、局灶分布为主,在癌旁肝组织呈弥漫分布为主。本文结果提示ＨＣＶ感染在ＰＨＣ的发生中可能起重要作用。     

The first large-scale nucleic acid amplification testing (NAT) of donated blood using multiplex reagent for simultaneous detection of HBV, HCV, and HIV-1 and significance of NAT for HBV.

The first nationwide nucleic acid amplification testing (NAT) for hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus type 1 (HIV-1) of voluntarily donated blood after serological pre-screening and before release of cellular components and plasma for fractionation was implemented by the Japanese Red Cross Blood Transfusion Services. From February 1, 2000 to April 30, 2001, specimens from 6,805,010 units of serologically negative donation were screened in minipools of 50 samples within 24 hr after blood donation by NAT using multiplex HBV/HCV/HIV-1 reagent for blood transfusion including short shelf-life platelets. Among them, 112 HBV DNA-positives, 25 HCV RNA positives and 4 HIV-1 RNA positives were screened out and we could prevent transfusion of these NAT positive units. Subtypes/genotypes of HBV DNA, adr/C, adw/A, adw/B, adw/C, ayr/C and ayw/D were found and adr/C was predominant. A total of 61.6 % of them (69/112) were negative by overnight EIA. Sixth three of HBV NAT-positive samples carried virus loads less than 10(4) copies/mL and 92.1 % of them (58/63) were negative by overnight EIA. The virus growth curves of HBV in 6 cases obtained by retrospective and prospective follow-up study showed exponential straight lines in the early stage of serological window periods and the log times of HBV growth (10 fold increase) in serological window period were between 4.6 and 7.6 days. NAT screening with highly sensitive reagents in pool of specimens is useful to exclude blood units with low level of HBV and HBV mutants from blood transfusion.     

环介导逆转录等温扩增技术(RT-LAMP)在丙型肝炎病毒基因检测中的应用

该文介绍了一种便捷、灵敏而又特异的环介导逆转录等温扩增基因检测技术,该技术分别使用特异对应于靶序列中8个基因区段的3对特殊引物,并在反转录酶和Bst-DNA聚合酶的作用下对靶序列进行等温核酸扩增反应,整个检测反应只需1~2h。利用这种技术成功检测了丙型肝炎病毒基因,对60份经Real-time PCR或RT-PCR验证阳性的血清样品检测,阳性符合率为98%。同时,对扩增终产物进一步进行酶切分析,并与HIV、HBV和不同亚型流感病毒RNA进行交叉反应和特异性测试,均与预期结果吻合。将Real-time PCR定量后的RNA系列稀释后对检测方法的灵敏度进行了测试。结果显示,该技术的检测灵敏度在理论上可达到10个拷贝的RNA分子。以上结果证明,RT-LAMP扩增技术是一种检测程序简单、灵敏度和特异性较高的基因检测手段,在丙型肝炎病毒的快速检测方面具有一定的开发潜力。