HBeAg特异免疫复合物检测及临床意义

DETECTION OF HBeAgSPECIFIC IMMUNE COMPLEXAND ITS CLINICAL SIGNIFICANCE

采用单克隆抗－ＨＢｅ固相ＥＬＩＳＡ法检测１１８例ＨＢＶ感染者血清中ＨＢｅＡｇ特异免疫复合物（ＨＢｅＡｇ／ＩＣ），结果表明∶ＨＢｅＡｇ／ＩＣ与ＨＢＶ复制相关，可作为ＨＢＶ复制的一种血清学标志，ＨＢｅＡｇ阴性、ＨＢＶＤＮＡ阳性者中，６２．２％患者ＨＢｅＡｇ／ＩＣ阳性，提示ＨＢｅＡｇ／ＩＣ的形成致使夹心法不能检出ＨＢｅＡｇ，这类患者仍可以是ＨＢＶ野毒株感染，并非均为ＨＢｅＡｇ缺陷变异株感染；ＨＢｅＡｇ／ＩＣ阳性血清ＡＬＴ异常率明显高于ＨＢｅＡｇ／ＩＣ阴性血清（Ｐ＜０．０１），提示ＨＢｅＡｇ／ＩＣ存在与肝损伤有关。

A method (ELISA) for detection of HBeAgspecific immune complex (HBeAg/IC) using monoclonal antibody was developed and 118 patients with HBV infection were investigated.The results showed that HBeAg/IC was related to HBV active replication, could serve as a marker of HBV replication;Of 37 patients with HBeAgnegative and HBV DNA positive,23(62.2%) had HBeAg/IC in their sera, suggesting that HBeAg/IC formation prevents the detection of HBeAg by 'Sandwich 'ELISA and this kind of patients could be still infected with wild type HBV.It is not ture that all patients with HBeAgnegative and HBV DNApositive are infected with HBeAgdefect mutant;The rate of abnormal ALT level is much higher in patients with HBeAg/IC in serum than that in patients without HBeAg/IC, P<0.01(90.63% vs 51.85%),indicating that the existence of HBeAg/IC is related to liver damage.