THE SEROLOGY OF CHRONIC HEPATITIS-B INFECTION REVISITED
THE SEROLOGY OF CHRONIC HEPATITIS-B INFECTION REVISITED
复制标题
DOI：
10.1172/jci116497
复制
发表时间：
1993-06-01
影响因子：
15.9
通讯作者：
MILICH, DR
中科院分区：
文献类型：
--
作者：
MARUYAMA, T;MCLACHLAN, A;MILICH, DR
慢性B型肝炎感染的血清学已通过使用商业免疫测定法测定血清中B型肝炎病毒的结构抗原及其各自的抗体而建立。然而，商业测定尚未设计用于在存在过量循环抗原的情况下检测血清抗体。采用新型免疫分析法分析了200例HBeAg阳性、慢性感染的B型肝炎患者的一系列血清样本，这些患者患有不同程度的肝病，这些免疫分析法旨在检测存在循环病毒抗原的抗体。所有患者，无论他们的肝脏疾病，血清阴性的包膜抗原或分泌的核蛋白抗原（HBeAg）的特异性抗体时，使用的商业检测。相比之下，几乎所有慢性感染的肝病患者和约50%的无肝病患者表现出抗-HBe和抗包膜抗体时，血清进行了测试，在更敏感的免疫测定。此外，无症状患者可以根据抗体精细特异性、滴度和IgG亚类从血清学上区分有症状患者。这项研究表明，大多数慢性感染的B型肝炎患者多年来产生各种抗体，并不是免疫学无反应，如目前的检测所示。
The serology of chronic hepatitis B infection has been established through the use of commercial immunoassays to measure the structural antigens of the hepatitis B virus and their respective antibodies in serum. However, the commercial assays have not been designed to detect serum antibodies in the presence of an excess of circulating antigens. A series of serum samples from 200 HBeAg-positive, chronically infected hepatitis B patients with varying degrees of liver disease were analyzed using novel immunoassays designed to detect antibodies in the presence of circulating viral antigens. All patients, regardless of their liver disease, were seronegative for antibodies specific for the envelope antigens or the secreted nucleoprotein antigen (HBeAg) when the commercial assays were used. In contrast, virtually all chronically infected patients with liver disease and approximately 50% of patients without liver disease demonstrated anti-HBe and anti-envelope antibodies when sera were tested in the more sensitive immunoassays. Furthermore, asymptomatic patients could be serologically distinguished from symptomatic patients based on antibody fine specificity, titer, and IgG subclass. This study revealed that the majority of chronically infected hepatitis B patients produce a variety of antibodies for many years, and are not immunologically unresponsive, as suggested by the current assays.