摘要
目的探讨血清ＨＢｅＡｇ阴性（双抗体夹心法）与ＨＢｅＡｇ／ＩＣ形成及ＨＢＶ变异株Ａ１８９６的关系，评价ＨＢｅＡｇ／ＩＣ检测的临床意义．方法单克隆抗ＨＢｅ固相ＥＬＩＳＡ检测血清中ＨＢｅＡｇ／ＩＣ；套式多聚酶链反应检测ＨＢＶＤＮＡ；３＇碱基特异多聚酶链反应判断Ａ１８９６变异；ＥＬＩＳＡ检测ＨＢｅＡｇ、抗ＨＢｅ，研究对象为１１７例慢性ＨＢＶ感染者，２０例健康对照统计处理采用卡方检验．结果ＨＢｅＡｇ／ＩＣ阳性血清中ＨＢＶＤＮＡ检出率明显高于ＨＢｅＡｇ／ＩＣ阴性血清，Ｐ＜０００１（９１３％ｖｓ３６２％）；２９份ＨＢｅＡｇ阴性、ＨＢＶＤＮＡ阳性血清中仅５例（１７２％）检出Ａ１８９６，而且其中２例与野毒株（Ｇ１８９６）混合感染并伴ＨＢｅＡｇ／ＩＣ阳性．２９份中１７份（５８７％）为ＨＢｅＡｇ／ＩＣ阳性的Ｇ１８９６感染；血清抗ＨＢｅ阳性组Ａ１８９６检出率高于抗ＨＢｅ阴性组，Ｐ＜００５（２５％ｖｓ３２％）．结论ＨＢｅＡｇ／ＩＣ为ＨＢＶ活跃复制指标；临床ＨＢｅＡｇ阴性、ＨＢＶＤＮＡ阳性患者仍多数为Ｇ１８９６感染，ＨＢｅＡｇ／ＩＣ形致双抗体夹心法不能检出ＨＢｅＡｇ；
AIM To explore the relation between serum HBeAg negative and HBeAg specific immune complex (HBeAg/IC), HBV mutant A 1896 , to evaluate the clinical significance of HBeAg/IC detetion. METHODS The serum HBeAg/IC was deteted by ELISA using monolonal antibody against HBeAg. The serum HBV DNA was tested with nested polymerase chain reaction (n PCR) using nested primers induced from S region of HBV genome. A 1896 mutant was determined by 3' base specific PCR (3' BS PCR). In this study, 117 patients with chronic HBV infection were investigated. Statistical analysis of data was conducted with X test. RESULTS The detection rate of serum HBV DNA was greatly higher in sera with positive HBeAg/IC than that in sera with negative HBeAg/IC, P <0 001 (91 3% vs 36 2%). Twenty nine patients with positive HBV DNA had no HBeAg in serum, only 5 of them (17 2%) were infected with A 1896 mutant, but 2 of the 5 patients also had wild type HBV (G 1896 ) and HBeAg/IC in sera, 17 patients (58 7%) were infected with G 1896 and had HBeAg/IC in serum. The prevalence of A 1896 was much higher in sera with positive anti HBe than that in sera with negative anti HBe. CONCLUSION HBeAg/IC is one of the markers indicating HBV active replication. Most patients with negative HBeAg and positive HBV DNA in serum are infected with wild type HBV (G 1896 ), the formation of HBeAg/IC results in undetection of HBeAg with “Sandwich” ELISA: Anti HBe response may be one of the factors that promote the mutation of pre C gene of HBV.
