乙肝患者血清HBsAg与HBsAb双阳性的特殊模式分析

Analysis on the Special Mode of Patients with Positive HBsAg and Anti-HBs Simultaneously

目的报告乙肝表面抗原(HBsAg)与表面抗体(HBsAb)双阳性患者血清中这2种标志物波动情况及S区编码碱基序列变异特点。方法收集本院2005年7月收治的2例患者血清标本(经酶联免疫吸附试验定量检测HBsAg与HBsAb均阳性)并随访2月;PCR法扩增血清中HBV的S基因并测序。结果1例患者初始血清HBsAg与HBsAb分别为0.11IU/ml、18.44mIU/ml,2月后HBsAg消失;另1例患者初始血清HBsAg与HBsAb分别为24.09IU/Ml、840.06mIU/Ml,2月后HBsAb不能检出。在二者初始血清中扩增出完整HBV的S基因片段,序列分析显示为基因型D和血清亚型ayw,共同抗原决定簇α的aa145位甘氨酸编码序列未发生缺失或突变。结论2例HBsAg与HBsAb双阳性患者血清中仍存在HBV,其抗原决定簇α区未发生因aa145位甘氨酸突变导致的免疫原性改变。

Objective： To clarity the fluctuation of HBsAg and HBsAb and the characteristics of mutations in HBV S nucleotides and amino acid sequences from the patients with HBV infection, whose serum were detected both HBsAg and anti - HBs positive. Methods： Collected serum of two patients in our hospital in July, 2005, whose serum is both HBsAg and anti - HBs positive through ELISA, and followed up for 2 months. Results： The sequences of the HBV S gene belong to D gene type and ayw subtype. No deletion or mutation was detected. Conclusion： The phenomenon of both HBsAg and anti - HBs positive could not be attributed to mutation in HBV genome.