Simultaneous detection of immunoglobulin A (IgA) and IgM antibodies against hepatitis E virus (HEV) is highly specific for diagnosis of acute HEV infection
Simultaneous detection of immunoglobulin A (IgA) and IgM antibodies against hepatitis E virus (HEV) is highly specific for diagnosis of acute HEV infection
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DOI：
10.1128/jcm.43.1.49-56.2005
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发表时间：
2005-01-01
影响因子：
9.4
通讯作者：
Okamoto, H
中科院分区：
文献类型：
--
作者：
Takahashi, M;Kusakai, S;Okamoto, H
从68名患者中采集的血清样本（年龄，平均值+/-标准差[SD]，56.3 +/- 12.8岁），随后被分子诊断为患有戊型肝炎，以及2，781名被认为最近没有感染戊型肝炎病毒的个体（戊型肝炎病毒;阴性对照; 52.9 +/-18.9岁），通过内部固相酶免疫测定法，以家蚕蛹中表达的重组开放阅读框2蛋白作为抗原探针，检测针对戊型肝炎病毒（抗-戊型肝炎病毒）的免疫球蛋白M（IgM）和伊加类抗体。68例戊型肝炎患者同时检测抗-HEVIgM和抗-伊加。在2，781名对照中，16名（0.6%）仅具有抗-HEV IgM，4名（0.1%）仅具有抗-HEV伊加：这些伊加/IgM抗-HEV阳性个体不仅对HEV RNA呈阴性，而且也缺乏IgG抗-HEV抗体（至少在大多数情况下）。对15例戊型肝炎患者的定期血清标本进行了HEV RNA、抗-HEV IgM和抗-HEV伊加检测。尽管在发病后7至40天（21.4 +/- 9.7）血清中可检测到HEV RNA，但在3名患者中，在发病后37、55或62天可检测到IgM和伊加抗HEV抗体，在12名患者中，直至观察期结束（50至144天）。结果表明，抗-伊加单独或沿着抗-HEVIgM检测对戊型肝炎的血清学诊断有重要意义，其特异性和阳性持续时间均比RNA检测高。
Serum samples collected from 68 patients (age, mean +/- the standard deviation [SD], 56.3 +/- 12.8 years) at admission who were subsequently molecularly diagnosed as having hepatitis E and from 2,781 individuals who were assumed not to have been recently infected with hepatitis E virus (HEV; negative controls; 52.9 +/- 18.9 years), were tested for immunoglobulin M (IgM) and IgA classes of antibodies to HEV (anti-HEV) by in-house solid-phase enzyme immunoassay with recombinant open reading frame 2 protein expressed in the pupae of silkworm as the antigen probe. The 68 patients with hepatitis E had both anti-HEV IgM and anti-HEV IgA. Among the 2,781 controls, 16 (0.6%) had anti-HEV IgM alone and 4 (0.1%) had anti-HEV IgA alone: these IgA/IgM anti-HEV-positive individuals were not only negative for HEV RNA but lack IgG anti-HEV antibody as well (at least in most of the cases). Periodic serum samples obtained from 15 patients with hepatitis E were tested for HEV RNA, anti-HEV IgM, and anti-HEV IgA. Although HEV RNA was detectable in the serum until 7 to 40 (21.4 +/- 9.7) days after disease onset, both IgM and IgA anti-HEV antibodies were detectable until 37, 55, or 62 days after disease onset in three patients and up through the end of the observation period (50 to 144 days) in 12 patients. These results indicate that detection of anti-HEV IgA alone or along with anti-HEV IgM is useful for serological diagnosis of hepatitis E with increased specificity and longer duration of positivity than that by RNA detection.