Novel monitoring of hepatitis B reactivation based on ultra-high sensitive hepatitis B surface antigen assay
Novel monitoring of hepatitis B reactivation based on ultra-high sensitive hepatitis B surface antigen assay
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DOI：
10.1111/liv.13349
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发表时间：
2017-08-01
影响因子：
6.7
通讯作者：
Tanaka, Yasuhito
中科院分区：
文献类型：
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作者：
Shinkai, Noboru;Kusumoto, Shigeru;Tanaka, Yasuhito
背景和目标：全身化疗前应评估隐匿性B型肝炎病毒（HBV）感染，以预防HBV再激活相关性肝炎。我们用高灵敏度的乙肝表面抗原（HBsAg）荧光酶免疫分析法研究了HBV的再激活半自动免疫复合物转移化学发光酶法检测HBsAg的研究方法：2012年至2015年在我院接受全身化疗的120例HBV消退的血液系统恶性肿瘤患者中，根据HBV DNA监测，13例患者发生HBV DNA再激活（12/13例患者HBV DNA可定量）。这些患者均申请了Architect EQUIPAg-QT（检测限：50 mIU/mL），Ag-HQ（5 mIU/mL）和ICT-CLEIA（0.5 mIU/mL）。结果：当通过定期HBV DNA监测首次定量HBV DNA时，在1/12例患者（8%）中检测到HBsAg-QT，12例患者中4例（33%）检出HBV-Ag-HQ，12例（100%）均检出ICT-CLEIA，表明ICT-CLEIA的敏感性与HBV DNA定量相当。有趣的是，2例患者在HBV DNA可检测之前，通过ICT-CLEIA检测为HBsAg阳性。HBV DNA和ICT-CLEIA检测点的中位差异为0（范围为-28至56天），而HBVDNA可检测后，HBVAg-QT或HBVAg-HQ的中位延迟为52.5天。虽然抗-HBs滴度高（131.9 mIU，80.4 mIU）在两个患者的逃逸突变（Saa 126 V，Saa 145 R），HBsAg的ICT-CLEIA和HBVDNA检测concurrently.Conclusions：ICT-CLEIA是一种新的检测HBV监测，以防止肝炎引起的HBV再激活。
Background & Aims: Occult hepatitis B virus (HBV) infection should be evaluated before systemic chemotherapy to prevent HBV reactivation-related hepatitis. We investigated HBV reactivation using high sensitivity HB surface antigen (HBsAg) chemiluminescent enzyme immunoassay (HBsAg-HQ) and ultra-high sensitive HBsAg assay employing a semi-automated immune complex transfer chemiluminescence enzyme technique (ICT-CLEIA).Methods: Of 120 HBV-resolved patients with haematological malignancy receiving systemic chemotherapy from 2012 to 2015 in our hospital, 13 patients had HBV DNA reactivation (in 12/13 patients HBV DNA became quantifiable) according to HBV DNA monitoring. These patients were applied for Architect HBsAg-QT (detection limit: 50 mIU/mL), HBsAg-HQ (5 mIU/mL) and ICT-CLEIA (0.5 mIU/mL) using stored samples.Results: When HBV DNA was firstly quantifiable by regular HBV DNA monitoring, HBsAg-QT was detected in 1/12 patients (8%), HBsAg-HQ was detected in 4/12 patients (33%) and ICT-CLEIA was detected in all 12 patients (100%), suggesting that the sensitivity of ICT-CLEIA was comparable to that of HBV DNA quantification. Interestingly, two patients were HBsAg positive by ICT-CLEIA before HBV DNA became detectable. Median difference of detectable point between HBV DNA and ICT-CLEIA was zero (range from -28 to 56 days), while median delay by HBsAg-QT or HBsAg-HQ was 52.5 days after HBV DNA became detectable. Although anti-HBs titres were high (131.9 mIU, 80.4 mIU) in two patients with escape mutations (Saa126V, Saa145R), HBsAg by ICT-CLEIA and HBV DNA were detectable concurrently.Conclusions: ICT-CLEIA is a novel assay for HBV monitoring to prevent hepatitis caused by HBV reactivation.