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中国误诊学杂志 2012年第14期12卷 3565-3566页

作者：顾丽萍江苏省江阴市人民医院检验科 214400

乙型肝炎病毒（HBV）是一种嗜肝细胞病毒，其广泛传播已成为一个危害广大人民身体健康的社会问题。血清乙肝病毒抗原抗体五项指标（HBVM）是临床诊断乙型肝炎的常用指标，其血清学模式是评价疾病状态的重要指标，有其独特的临床意义。... 详细信息

乙型肝炎病毒（HBV）是一种嗜肝细胞病毒，其广泛传播已成为一个危害广大人民身体健康的社会问题。血清乙肝病毒抗原抗体五项指标（HBVM）是临床诊断乙型肝炎的常用指标，其血清学模式是评价疾病状态的重要指标，有其独特的临床意义。近年来，临床出现愈来愈多的HBVM特殊模式，对特殊模式的研究，有助于我们加深对HBV感染发病机制的认识，提高对HBV感染的诊断和防治水平。本文就HBV特殊模式的产生原因、临床意义总结如下。

关键词：肝炎病毒乙型/分离和提纯肝炎乙型/诊断人类

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Process options in hepatitis B surface antigen extraction from transgenic potato

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BIOTECHNOLOGY PROGRESS 2000年第3期16卷 435-441页

作者： Dogan, B Mason, HS Richter, L Hunter, JB Shuler, ML Cornell Univ Sch Chem Engn Ithaca NY 14853 USA Cornell Univ Dept Food Sci Boyce Thompson Inst Dept Agr & Biol Engn Ithaca NY 14853 USA

The process conditions for recombinant hepatitis B surface antigen (HBsAg) extraction from transgenic potato were examined. The effects of temperature, the reducing agent P-mercaptoethanol (BME), and proteinase inhibitors on the level of antigenic activity of recovered HBsAg were determined. Sedimentation profiles were performed to characterize HBsAg assembly into virus-like particles. Increasing the temperature of the sample for about 1 min increased the measured HBsAg antigenic activity. The optimum temperature was around 50 degrees C. A 3-fold enhancement of the antigenic activity was obtained in extract from transgenic potato expressing HBsAg, when monoclonal antibodies were used to assay for HBsAg. When antigenic activity was determined by polyclonal antibodies, no enhancement in the antigenic activity was obtained. Temperature may affect the conformation of the a epitope to which the monoclonal antibodies bind or alter the fluidity of surface lipid regions. BME increased the antigenic activity of HBsAg up to 4-fold when monoclonal antibodies directed against the a determinant were used, but there was no increase with polyclonal antibodies. This observation suggests that BME affects the structure or presentation of the a epitope. In the presence of BME and leupeptin, a proteinase inhibitor, higher antigenic activity was obtained. Leupeptin might protect the antigen, which might become more susceptible to proteolytic degradation after reduction, as a result of stimulation of sulfhydryl proteases. Although both temperature and BME increased the antigenic activity of HBsAg individually, when combined their interaction was antagonistic, resulting in reduced antigenic activity. Different proteinase inhibitors, including leupeptin, aprotinin, E-64, pefabloc, and pepstatin, had no significant effect on HBsAg from potato extract in a 2 h period in the absence of BME. The sedimentation profile of potato-produced HBsAg was determined in 5-30% sucrose gradients. Yeast-der

关键词：肝炎表面抗原乙型/生物合成肝炎表面抗原乙型/分离和提纯植物基因修饰/遗传学植物基因修饰/免疫学蛋白酶抑制药/药理学重组遗传还原剂/药理学马铃薯/遗传学马铃薯/免疫学蔗糖温度

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Full-genome sequence analyses of hepatitis B virus (HBV) strains recovered from chimpanzees infected in the wild: Implications for an origin of HBV

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VIROLOGY 2000年第1期267卷 58-64页

作者： Takahashi, K Brotman, B Usuda, S Mishiro, S Prince, AM Toshiba Gen Hosp Dept Med Sci Shinagawa Ku Tokyo 1408522 Japan New York Blood Ctr Lindsley F Kimball Res Inst New York NY 10021 USA

Hepatitis B virus (HBV) belongs to the genus Orthohepadnavirus of the family Hepadnaviridae. Having been found in various animals (duck, heron, woodchuck, ground squirrel, and primates), hepadnaviruses must have undergone a long history of evolution and may comprise more members than currently recognized. Chimpanzees may also have their own hepadnavirus, even if it might be very close to HBV. We analyzed HBV-like sequences from three chimpanzees (Pan troglodytes) that were most likely infected during their life in Africa in the wild. Two chimpanzees (Ch256 and Ch258) possessed a viral genome of 3182 nt in length with a 33-nt deletion in the preS1 region;which could not be classified into any of the six genotypes (A-F) of human HBV but was very homologous to a previously reported isolate from a London Zoo chimpanzee. Phylogenetically distinct from the HBV-like sequences from gibbons, orangutans, and a gorilla so far reported, the Ch256 and Ch258 isolates would represent an indigenous chimpanzee HBV (tentatively ChHBV). A third chimpanzee (Ch195) had a 3212-nt genome, classifiable into the genotype E of HBV. Because HBV-E has been found mostly in Africans, Ch195 may have been Infected from a human source in Africa. However, an inverse scenario is also possible: a spread of HBV-E might have occurred from chimpanzees to humans a long time ago in Africa. Analysis of the arginine-rich C-terminal region of the core protein, which is well conserved among mammalian hepadnaviruses, indicated that HBV-E/F and nonhuman primate hepadnaviruses are much closer than HBV-A/B/C/D to the hepadnaviruses of woodchuck and ground squirrel. Our results support an "ex-nonhuman primate" hypothesis for the origin of HBV. (C) 2000 Academic Press.

关键词：非洲氨基酸序列动物野生/病毒学碱基序列 DNA 病毒/遗传学进化分子基因组病毒肝炎表面抗原乙型/遗传学肝炎病毒乙型/分类肝炎病毒乙型/遗传学肝炎病毒乙型/分离和提纯分子序列数据黑猩猩属/病毒学种系发生蛋白质前体/遗传学序列同源性氨基酸序列同源性核酸血清分型病毒核心蛋白质类/遗传学动物人类

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Estimation of the risk of bloodborne pathogens to health care workers after a needlestick injury in Taiwan

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AMERICAN JOURNAL OF INFECTION CONTROL 2002年第1期30卷 15-20页

作者： Shiao, J Guo, L McLaws, ML Univ New S Wales Sch Publ Hlth & Community Med Fac Med NSW Hosp Infect Epidemiol & Surveillance Unit Sydney NSW Australia Natl Yang Ming Univ Dept Nursing Taipei 112 Taiwan Natl Cheng Kung Univ Coll Med Dept Environm & Occupat Hlth Tainan 70101 Taiwan

Objectives: To estimate the number of health care workers (HCWs) in Taiwan at risk, annually for contracting hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV after a needlestick and sharps injury (NSI) with a used hollow-bore needle. Methods: All patients hospitalized in I tertiary hospital between September 1997 and June 1993 had routine pathological work-ups. On the first day of the months of September 1997, December 1997, March 1998, and June 1998, 1805 samples of deidentified residual sera randomly sampled from 18,474 inpatients older than 6 years were serologically tested for antigens to HBV (HBsAg and HBeAg) and antibodies to HCV anti-HCV) and HIV (anti-HIV) with enzyme-linked immunosorbent assay reagents. The frequency of NSIs with contaminated devices in HCWs from 16 public teaching hospitals between July 1996 and June 199 7 and the serologic results were used to extrapolate the estimated annual rate of seroconversion in HCWs after an NSI. Results: Of the 1805 samples tested, 16.7% were seropositive for HBsAg (of which 1.7% were positive For HBeAg), 12.7% were positive for anti-HCV, and 0.8% were positive for anti-HIV, Of the 7550 NSIs reported by 8645 HCWs, 66.7% involved a contaminated hollow-bore needle. From these data, 308 to 924 HCWs were estimated to be at risk for contracting HBV 334 to 836 were a[ risk for contracting HCV;and, at the most, 2 were at risk for contracting HIV The estimated annual number of contaminated NSIs sustained by 4 categories of HCWs ranged from 0.3 to 0.7, resulting in 543 nurses, 113 technicians, 80 physicians, and 66 supporting staff to be at risk annually of acquiring HBV infection, The numbers of HCWs estimated to be at risk of acquiring HCV were 596 nurses, 90 physicians, 84 technicians, and 30 supporting staff. The risk of acquiring HIV was low, with I nurse and possibly I other staff potentially exposed annually. Conclusions: Our estimates of the rise for seroconversion after an NSI have demonstrated that an oc

关键词：血传病原体/分离和提纯 HIV感染/预防和控制 HIV感染/传播卫生人员/统计学和数值数据肝炎病毒属/分离和提纯肝炎乙型/预防和控制肝炎乙型/传播肝炎病毒乙型/分离和提纯肝炎丙型/预防和控制肝炎丙型/传播医院教学针刺伤/并发症危险性评估台湾青少年成年人老年人老年人 80以上儿童女(雌)性人类男(雄)性中年人

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TT virus infection in hemodialysis patients

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AMERICAN JOURNAL OF GASTROENTEROLOGY 1999年第12期94卷 3567-3570页

作者： Utsunomiya, S Yoshioka, K Wakita, T Seno, H Takagi, K Ishigami, M Yano, M Watanabe, K Kobayashi, M Watanabe, K Kishimoto, H Kakumu, S Nagoya Univ Sch Med Dept Internal Med 3 Showa Ku Nagoya Aichi 4668550 Japan Tokyo Metropolitan Inst Neurosci Dept Microbiol & Immunol Tokyo Japan Nagoya Kyoritsu Hosp Nagoya Aichi Japan Aichi Med Sch Dept Internal Med 1 Aichi Japan

OBJECTIVE: Recently, TT virus (TTV), associated with post transfusion hepatitis, was discovered. Prevalence of TTV infection in maintenance hemodialysis (HD) units and its pathogenicity to liver was investigated. METHODS: A total of 115 patients on HD were assessed for presence of serum TTV. DNA was purified from sera, and nested polymerase chain reaction was done for the detection of TTV DNA. RESULTS: TTV was detected in 59 patients on HD (51.3%), as compared with healthy blood donors (15 of 91 [16.5%], p < 0.0001). Serum HCV RNA and HBs antigen were positive in 16 and three patients, respectively. The prevalence rate of TTV was already 58.3% in the patients on HD for only 1 yr, and did not change according to the duration of HD until 15 yr on HD. TTV was positive in 51.2% (43 of 84) of the patients with history of blood transfusion, and in 51.6% (16 of 31) of those without it. In HCV-negative patients, alanine aminotransferase (ALT) levels of TTV-positive patients were similar to those of TTV-negative patients. Contrarily, in HCV-positive patients, ALT levels were more frequently greater than or equal to 15 IU/L in TTV-positive patients (14 of 18) than in TTV-negative patients (five of 15) (p < 0.05). CONCLUSIONS: TTV infection is remarkably prevalent in patients on HD and in healthy blood donors. It is suggested that TTV generally does not cause liver disease by itself, but there remains the possibility that TTV may aggravate liver disease caused by HCV. (Am J Gastroenterol 1999;94:3567-3570. (C) 1999 by Am. Coll. of Gastroenterology).

关键词：供血者/统计学和数值数据横断面研究肝炎病毒属/分离和提纯肝炎乙型/流行病学肝炎乙型/传播肝炎乙型/病毒学肝炎病毒乙型/分离和提纯肝炎丙型/流行病学肝炎丙型/传播肝炎丙型/病毒学肝炎病毒/致病力肝炎病毒性人/流行病学肝炎病毒性人/传播肝炎病毒性人/病毒学发病率日本/流行病学肝功能试验肾透析危险因素毒力老年人女(雌)性人类男(雄)性中年人

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Hepatitis G virus (HGV) infection in voluntary and commercial blood donors in India

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DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE 2000年第1期38卷 7-10页

作者： Kar, P Bedi, P Berry, N Chakravorty, A Gupta, RK Saha, R Das, BC Maulana Azad Med Coll ICMR Dept Med New Delhi 110002 India Maulana Azad Med Coll ICMR Dept Microbiol New Delhi 110002 India Maulana Azad Med Coll ICMR Dept Prevent & Social Med New Delhi 110002 India Maulana Azad Med Coll ICMR Inst Cytol & Prevent Oncol Div Mol Oncol New Delhi 110002 India Associated Lok Nayak Hosp New Delhi 110002 India

The prevalence of hepatitis G virus (HGV) has been determined in commercial as well as voluntary blood donors from India by detecting viral RNA genome using reverse transcription polymerase chain reaction (RT-PCR) assay. 45 professional blood donors from private blood banks and 50 healthy controls who opted for voluntary blood donation were recruited for the study. Both the groups were also screened serologically for HBV and HCV infection. The prevalence of HGV in the general population in India was found to be 4% but significantly a higher frequency (46.6%;p < 0.001) of HGV was observed in commercial blood donors. (C) 2000 Elsevier Science Inc. All rights reserved.

关键词：供血者/统计学和数值数据 DNA引物/化学 DNA 病毒/化学电泳琼脂凝胶酶联免疫吸附测定黄病毒科/遗传学黄病毒科/分离和提纯肝炎病毒属/分离和提纯肝炎乙型/血液肝炎病毒乙型/分离和提纯肝炎丙型/血液肝炎病毒性人/血液肝炎病毒性人/流行病学印度/流行病学患病率 RNA 病毒/化学 RNA 病毒/分离和提纯逆转录聚合酶链反应人类男(雄)性

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Sequence variations of hepatitis B virus promoter regions in persistently infected patients

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ARCHIVES OF VIROLOGY 2001年第2期146卷 279-292页

作者： Ha-Lee, YM Lee, J Pyun, H Kim, Y Sohn, J Cho, YJ Kim, Y Korea Univ Korea Nutr Res Inst Seoul 136701 South Korea Korea Univ Coll Med Dept Pediat Seoul 136701 South Korea Korea Univ Coll Med Dept Biochem Seoul 136701 South Korea Soonchunhyang Univ Coll Med Inst Digest Res Div Gastroenterol Hepatol Seoul South Korea Korea Univ Coll Med Dept Clin Pathol Seoul 136701 South Korea

The HBV in the sera of two chronic active hepatitis patients were analyzed for the promoter sequence heterogeneity. In most cases, the proportion of any particular clone in the total viral populations was less than 50%, showing high mutation rates. In contrast, promoter sequences of HBV from asymptomatic carriers revealed only a few point mutations with no deletions. HBV in chronic patient harbored variants with multiple mutations throughout promoters including 1762 (A-to-T), 1764 (G-to-A) double mutation in C promoter and deletions near CCAAT site in S promoter. Unlike other three promoter regions, C, pre-S1 and S, of HBV which revealed a high level of sequence heterogeneity, the X promoter region (from nt 985 to 1430) showed little sequence heterogeneity within a patient. However, the predominant viral clones in two patients were quite different from each other. In addition to mutations in promoter regions, a deletion mutation in the translation start codon was also found in pre-S1 gene. The results in this report indicate that the mutation rates are not the same in all four promoters and that one of the strategies for maintaining persistent infection could be through mutations in viral promoters which then impair the balance of viral gene expressions.

关键词：碱基序列克隆分子 DNA 病毒/遗传学肝炎病毒乙型/遗传学肝炎病毒乙型/分离和提纯肝炎乙型慢性/血液肝炎乙型慢性/病毒学分子序列数据突变突变误义聚合酶链反应启动区(遗传学) 序列缺失变异(遗传学) 成年人女(雌)性人类男(雄)性中年人

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Hepatitis B core antigen antibody as an indicator of a low grade carrier state for hepatitis B virus in a Saudi Arabian blood donor population

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TRANSFUSION SCIENCE 1997年第1期18卷 49-53页

作者： Bernvil, SS Andrews, V Kuhns, MC McNamara, AL Department of Pathology and Laboratory Medicine King Faisal Specialist Hospital and Research Centre Riyadh Saudi Arabia.

Blood donor screening for anti-hepatitis B score antigen (anti-HBc) was introduced as a surrogate marker of non-A, non-B hepatitis prior to the availability of a specific test for hepatitis C. In areas endemic for hepatitis B virus (HBV), such as Saudi Arabia, earlier studies indicated that up to 30% of blood donors might disqualify if screened for anti-HBc. The issue was readdressed in a study of 6035 consecutive first-time Saudi national blood donors in an attempt to identify a subgroup of anti-HBc positive donors who might be at high risk of being low grade carriers of HBV. An isolated anti-HBc of high titer in a donor with a low or absent anti-hepatitis B surface antigen (anti-HBsAg) was taken as an indicator of increased risk of a low grade carrier state. Using this algorithm, an additional 125 (2%) donors would disqualify. HBsAg immune complex assays and polymerase chain reaction of donor samples with an isolated anti-HBc identified two donors with immune complexes and two donors with HBV DNA. All four donor samples expressed over 90% neutralization in the anti-HBc supplementary testing, indicating high titer anti-HBc. These findings seem to support the suggested policy of donor exclusion based on the anti-HBc and anti-HBsAg serology as a means to eliminate low grade carriers of HBV in endemic areas without jeopardizing the blood supply. (C) 1997 Elsevier Science Ltd.

关键词：抗体病毒/诊断应用供血者肝炎乙型/诊断肝炎乙型/流行病学肝炎乙型/病因学肝炎乙型/预防和控制肝炎核心抗原乙型/免疫学肝炎病毒乙型/免疫学肝炎病毒乙型/分离和提纯普查沙特阿拉伯/流行病学人类男(雄)性

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Efficacy of lamivudine in patients with hepatitis B virus precore mutant infection before and after liver transplantation

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AMERICAN JOURNAL OF GASTROENTEROLOGY 1999年第3期94卷 663-667页

作者： Ben-Ari, Z Zemel, R Kazetsker, A Fraser, G Tur-Kaspa, R Rabin Med Ctr Dept Med D Liver Inst Felsenstein Med Res Ctr IL-49100 Petah Tiqwa Israel Rabin Med Ctr Dept Gastroenterol IL-49100 Petah Tiqwa Israel Tel Aviv Univ Sackler Fac Med IL-69978 Tel Aviv Israel

OBJECTIVE: Hepatitis B virus (HBV) precore mutant infection is associated with a more severe liver disease and a poorer response to interferon. We evaluated the efficacy and tolerance of lamivudine to induce complete and sustained suppression of viral replication in seven patients infected with HBV precore mutant (HBeAg-/HBeAb+/HBV DNA+) (in three patients mutation at codon 1896 was detected by direct sequencing). METHODS: Of the seven patients, five had decompensated HBV cirrhosis in a replicative phase and were liver transplant candidates (Group A) and two patients underwent orthotopic liver transplantation (OLT) for HBV liver cirrhosis and developed recurrent HBV infection in the grafted liver (Group B). Lamivudine 100 mg daily was administered orally for a period of 6-75 wk. RESULTS: After 6-8 wk lamivudine therapy was well tolerated and successfully suppressed HBV replication to an undetectable serum level of HBV DNA by polymerase chain reaction in six patients. In Group A, two patients underwent successful OLT with no evidence of HBV reinfection 2-14 months later. Lamivudine was continued after OLT with no episodes of rejection. Three patients died before a suitable liver could be found tone remained serum HBV DNA+ after 6 wk of lamivudine therapy). In Group B, 9-14 months after lamivudine therapy both patients developed lamivudine resistance (increased liver enzymes, reappearance of serum HBsAg and HBV DNA [by hybridization]). In both patients liver histology had progressed and in both, mutation at codon 552 of the HBV polymerase gene was detected. CONCLUSIONS: Lamivudine is well tolerated in patients with decompensated liver cirrhosis due to HBV precore mutant infection who are liver transplant candidates. In four patients (80%) potent suppression of viral replication was detected, allowing OLT to be performed. However, post-OLT, a resistant mutant developed under lamivudine therapy. Combination therapy with other antiviral agents should be evaluated to disc

关键词：抗病毒药/治疗应用 DNA 病毒/血液药物评价肝炎乙型/并发症肝炎乙型/药物疗法肝炎乙型/病毒学肝炎表面抗原乙型/血液肝炎病毒乙型/遗传学肝炎病毒乙型/分离和提纯肝炎病毒乙型/生理学拉米夫定/治疗应用肝硬化/病因学肝硬化/外科学肝移植点突变复发病毒复制/药物作用人类

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AN ATTEMPT TO PREPARE HEPATITIS-B VIRUS (HBV)-FREE PLASMA BY ULTRAFILTRATION USING MICROPOROUS REGENERATED CELLULOSE HOLLOW FIBER

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TRANSFUSION SCIENCE 1990年第2期11卷 211-216页

作者： SEKIGUCHI, S ITO, K KOBAYASHI, M IKEDA, H MANABE, S TSURUMI, T ISHIKAWA, G SATANI, M YAMAGUCHI, K Hokkaido Red Cross Blood Center Sapporo Japan

Hepatitis B Virus(HBV) can be effectively removed from HBV-positive plasma by filtration with a Bemberg(R) Microporous Membrane (BMM) with a pore size of 30 nm or less, however considerable amounts of macromolecular IgM and Factor VIII are trapped in the BMM. We report that HBV-free plasma with adequate amounts of all of the plasma proteins can be obtained by double filtration with a BMM with a pore size of 50 nm. Thus, it may be possible to remove HBV or other transfusion-associated viruses from plasma by BMM filtration with good recovery of all of the plasma components.

关键词：血蛋白质类/分析肝炎病毒乙型/分离和提纯肝炎病毒性人/预防和控制肝炎病毒性人/传播微孔过滤器血浆超滤/仪器和设备超滤/方法人类

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