HBsAg和HBsAb双阳性检测结果的初步分析

A preliminary analysis of coexistence of hepatitis B surface antigen and antibodies to HBsAg

目的对临床检测中少见的HBsAg和HBsAb双阳性结果进行分析,寻找可能的产生原因。方法对3家医院初筛HBsAg和HBsAb双阳性的81份血标本进行同种和不同种试剂盒复检,并检测HBsAg145位氨基酸变异(G145R变异)、HBV DNA基因型和血清型分析。结果81份双阳性标本经复检有30例(37%)仍然为双阳性;对30例复检双阳性标本应用不同试剂盒再次检测,HBsAg/HBsAb仍为双阳性者18例(22.2%);18例双阳性标本G145R检测全部为阴性;其中8例HBV DNA阳性血清的基因型分布为B型2例和C型6例,血清型分布为adw 2例、adr 5例和ayr 1例,与9份对照血清的检测结果比无显著性差异。结论HBsAg和HBsAb双阳性检测结果大多数与操作或试剂的质量有关,少数可能为S基因变异或不同血清型的再次感染等有关。

Objective To explore the possible mechanisms of the concurrence of hepatitis B surface antigen （HBsAg） and antibodies to HBsAg. Methods Eighty-one serum samples with HBsAg/HBsAb double positive from three hospitals were retested with the same kit and a different kit,respectively,and mutation assay for G145R,HBV DNA sequencing,genotyping and serotyping were then carried out. Results Among 81 HBsAg/HBsAb double positive sera,30 （37%） samples were HBsAg/HBsAb double positive when detected by the same kit,while only 18 still positive when by different kit;All the 18 sera was G145R mutation negative;8 samples were found to be positive for HBV DNA,and out of them,2 were with genotype B and 6 were with genotype C;and 2 were with serotype adw,5 with serotype adr,and 1 with ayr, which was not significantly diffirent from 9 controlled sera. Conclusion HBsAg/HBsAb double positive sera is more commonly arised from reagent quality or testing procedure,and the S gene mutation or reinfection of viral subtypes should also be considered.