Hepatitis B Surface Antigen Confirmatory Testing for Diagnosis of Hepatitis B Virus Infection in Taiwan
Hepatitis B Surface Antigen Confirmatory Testing for Diagnosis of Hepatitis B Virus Infection in Taiwan
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DOI：
10.1002/jmv.22127
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发表时间：
2011-09-01
影响因子：
12.7
通讯作者：
Chiang, Shuo-Ya
中科院分区：
文献类型：
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作者：
Chu, Fang-Yeh;Su, Fu-Hsiung;Chiang, Shuo-Ya
本研究旨在探讨乙型肝炎表面抗原（HBsAg）确证检测在乙型肝炎感染流行率较低的台湾青少年乙型肝炎感染诊断中的应用。 2008 年，对一所大学的 403 名研究生（平均年龄 22.8 +/- 0.7 岁）和 1,745 名本科生（18.6 +/- 1.0 岁）以及 367 名成人受试者（41.1 +/- 15.8 岁）的 HBsAg 状况、HBsAg 抗体（抗 HBs）的存在和乙型肝炎核心抗原抗体（抗 HBc）的存在进行了比较。所有 HBsAg 阳性受试者均接受 HBsAg 确认测试。仅使用 HBsAg 阳性来确定乙型肝炎感染确诊病例时，对阳性趋势和预测值 (PVP) 的卡方检验在三个队列中进行了比较。受试者中 HBsAg 阳性率从成人的 16.3% 下降到研究生的 5.2%，然后下降到本科生的 2.8%（P = 0.0007）。确定乙型肝炎病例时，HBsAg 检测的 PVP 从成人的 0.97 下降到研究生的 0.81，然后下降到本科生的 0.56（P < 0.0001）。因此，只有在实施乙型肝炎疫苗接种后出生的学生中，仅进行HBsAg检测，才观察到HBsAg真阳性率显着下降。因此，对于台湾新生儿乙型肝炎疫苗接种计划开始后出生的 HBsAg 检测结果呈阳性的人，可能必须进行额外的中和检测。 J. Med。病毒。 83: 1514-1521, 2011。(C) 2011 Wiley-Liss, Inc.
This study aimed to examine the application of hepatitis B surface antigen (HBsAg) confirmatory testing when diagnosing hepatitis B infection among young persons in Taiwan with a low prevalence rate of hepatitis B infection. HBsAg status, the presence of antibodies against HBsAg (anti-HBs), and the presence of antibodies against hepatitis B core antigen (anti-HBc) were compared among 403 graduate students (mean age 22.8 +/- 0.7 years) and 1,745 undergraduate students (18.6 +/- 1.0 years) from one university, and 367 adult subjects (41.1 +/- 15.8 years) in 2008. Any HBsAg-positive subjects were tested with an HBsAg confirmatory test. Chi-square tests for trend and predictive values of positivity (PVP) when using HBsAg-positive only for determining confirmed cases of hepatitis B infection were compared across the three cohorts. The prevalence of HBsAg positivity among subjects decreased from 16.3% in the adults to 5.2% in the graduate students and then to 2.8% for the undergraduate students (P = 0.0007). The PVP of HBsAg testing when determining cases of hepatitis B decreased from 0.97 for the adults to 0.81 for the graduate students and then to 0.56 for the undergraduate students (P < 0.0001). Thus, a significant decrease in the true-positive rate of HBsAg among the students born after the introduction of hepatitis B vaccination was observed only when HBsAg testing was applied. Additional neutralization tests may therefore become mandatory for persons with a positive HBsAg test result who were born after the commencement of the universal neonatal hepatitis B vaccination program in Taiwan. J. Med. Virol. 83: 1514-1521, 2011. (C) 2011 Wiley-Liss, Inc.