肝胆相照论坛

标题: 通过免疫球蛋白产品乙肝核心抗体和半乳甘露聚糖酶免疫阳 [打印本页]

作者: StephenW    时间: 2016-4-15 18:23     标题: 通过免疫球蛋白产品乙肝核心抗体和半乳甘露聚糖酶免疫阳

Transmission of Hepatitis B core Antibody and Galactomannan Enzyme Immunoassay positivity via immunoglobulin products: a comprehensive analysis

    Isobel Ramsay1,2, Rebecca L. Gorton3, Mauli Patel4, Sarita Workman5, Andrew Symes5, Tanzina Haque1, Dianne Irish1, Suranjith L. Seneviratne5,6, Siobhan O. Burns5,6, Emmanuel Wey7, and David M. Lowe5,6

    1Department of Virology, Royal Free London NHS Foundation Trust, London, UK
    2Department of Microbiology, Addenbrooke's Hospital NHS Foundation Trust, Cambridge, UK
    3Department of Microbiology, Health Services Laboratory (HSL), Royal Free Hospital, London, UK
    4Department of Virology, Health Services Laboratory (HSL), Royal Free Hospital, London, UK
    5Department of Clinical Immunology, Royal Free London NHS Foundation Trust, London, UK
    6Institute of Immunity and Transplantation, University College London, Royal Free Campus, London, UK
    7Department of Microbiology, Royal Free London NHS Foundation Trust, London, UK

    Corresponding author: Dr David Lowe, Institute of Immunity and Transplantation, University College London, Royal Free Campus, London, NW3 2QG, UK. d.lowe{at}ucl.ac.uk

Abstract

Background. Therapeutic immunoglobulins are used as replacement or immunomodulatory therapy, but can transmit clinically important molecules. We investigated Hepatitis B virus (HBV) antibodies and galactomannan enzyme immunoassay (GM-EIA) positivity. Detection of HBV core antibody may prompt antiviral prophylaxis when commencing therapy such as rituximab; a positive GM-EIA result prompts investigation or treatment for invasive fungal disease.

Methods. Cross-sectional analysis of HBV serology in 80 patients established (>6 months) on immunoglobulin therapy; prospective analysis of HBV serology in 16 patients commencing intravenous immunoglobulin (IVIG); pre- and post-infusion analysis of GM-EIA in 37 patients receiving IVIG.

Results. Pre-IVIG, 9/80 patients tested positive for HBV surface antibody and 1/80 tested equivocal for HBV core antibody. On IVIG, 79/79 tested positive for surface antibody, 37/80 tested positive for core antibody and 10/80 tested equivocal for core antibody. There were significant differences by product, but among patients receiving products which appear to transmit core antibody, negative results correlated with lower surface antibody titres and longer time since infusion suggesting a simple concentration effect. There was a progressive increase with each infusion in the percentage of patients testing positive for HBV core antibody among patients newly commencing IVIG. Some patients ‘sero-reverted’ to negative during therapy. Certain IVIG products tested positive for GM-EIA and there were rises in index values in corresponding patient samples from pre- to post-infusion. Overall, 5/37 patient samples pre-infusion and 15/37 samples post-infusion tested positive for GM-EIA.

Conclusions. HBV antibodies and GM-EIA positivity are common in patients receiving IVIG and confound diagnostic results.

    © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions{at}oup.com.



作者: StephenW    时间: 2016-4-15 18:24

通过免疫球蛋白产品乙肝核心抗体和半乳甘露聚糖酶免疫阳性传输:综合分析

    伊泽贝尔Ramsay1,2,丽贝卡L. Gorton3,Mauli Patel4,萨里塔Workman5,安德鲁Symes5,Tanzina Haque1,戴安娜Irish1,Suranjith L. Seneviratne5,6,西沃恩O. Burns5,6,灵光Wey7和David M. Lowe5​​,6

    病毒学,皇家自由伦敦NHS信托基金会,伦敦,英国教研室
    微生物学,Addenbrooke医院NHS信托基金会,英国剑桥教研室
    微生物学,健康服务实验室(HSL),皇家自由医院,伦敦,英国3Department
    病毒学,健康服务实验室(HSL),皇家自由医院,伦敦,英国4Department
    临床免疫5Department,皇家自由伦敦NHS信托基金会,伦敦,英国
    免疫6Institute和移植,伦敦大学学院,皇家自由校园,伦敦,英国
    微生物学,皇家自由伦敦NHS信托基金会,伦敦,英国7Department

    通讯作者:大卫·罗伊博士,免疫研究所和移植,伦敦大学学院,皇家自由校园,伦敦,NW3 2QG,英国。 d.lowe {}在ucl.ac.uk

抽象

背景。治疗性免疫球蛋白被用作替换或免疫疗法,但可以传输临床上重要的分子。我们研究了乙型肝炎病毒(HBV)的抗体和半乳甘露聚糖酶免疫测定(GM-EIA)阳性。 HBV核心抗体检测可以提示开始治疗,如利妥昔单抗时,抗病毒药物预防;积极GM-EIA结果提示检查或治疗侵袭性真菌病。

方法。在免疫球蛋白治疗80建立患者(> 6个月)HBV血清学的横断面分析;在16例患者开始静脉注射免疫球蛋白(IVIG)HBV血清学的前瞻性分析;在37例患者接受IVIG GM-EIA前和输注后分析。

结果。预IVIG,八十零分之九患者检测呈阳性乙肝表面抗体和1/80测试模棱两可的乙肝病毒核心抗体。在IVIG,七十九分之七十九表面抗体呈阳性,八十零分之三十七核心抗体呈阳性和10/80测试模棱两可核心抗体。有按产品显著差异,但收到这似乎传递核心抗体产品的患者中,阴性结果和下表面抗体滴度,并因为输液表明一个简单的集中效应较长时间相关。有一个与患者的乙肝病毒核心抗体检测呈阳性的患者新开始IVIG之间的百分比每次输注逐步增加。有些病人的血清回复“治疗期间至负面。某些IVIG产品GM-EIA检测呈阳性,并从前期到后期注入相应的患者样本有上涨的指数值。总体而言,5/37患者样本预先灌输和三十七分之十五样品输注后的GM-EIA检测呈阳性。

结论。乙肝病毒抗体和GM-EIA阳性在接受IVIG患者中常见,混淆诊断结果​​。

    ©的美国传染病学会出版由牛津大学出版社的作者2016年。版权所有。对于权限,电子邮件journals.permissions {}在oup.com。

作者: 零度沙漠    时间: 2016-4-15 20:51

看不懂啊
作者: zgct    时间: 2016-4-15 22:24

谢谢
作者: 齐欢畅2    时间: 2016-4-15 22:40

马克。
作者: StephenW    时间: 2016-4-15 22:54

回复 零度沙漠 的帖子

当正在接受IVIG(静脉注射免疫球蛋白)治疗, 非乙肝患者可以有假HBsAg阳性测试结果




欢迎光临 肝胆相照论坛 (http://hbvhbv.info/forum/) Powered by Discuz! X1.5