隐匿性乙肝病毒感染的肝门诊抗-HBc阳性患者的调查

StephenW

PLoS One. 2015 Mar 12;10(3):e0117275. doi: 10.1371/journal.pone.0117275. eCollection 2015.
Investigation of occult hepatitis B virus infection in anti-hbc positive patients from a liver clinic.
Martinez MC 1, Kok CC 2, Baleriola C 2, Robertson P 2, Rawlinson WD 3.
Author information
    1Virology Division, Prince of Wales Hospital, Sydney, Australia; School of Medical Sciences, University of New South Wales, Sydney, Australia.
    2SEALS Microbiology, Prince of Wales Hospital, Sydney, Australia.
    3Virology Division, Prince of Wales Hospital, Sydney, Australia; SEALS Microbiology, Prince of Wales Hospital, Sydney, Australia; School of Medical Sciences, University of New South Wales, Sydney, Australia.
Abstract

Occult hepatitis B infection (OBI) is manifested by presence of very low levels (<200IU/mL) of Hepatitis B viral DNA (HBV DNA) in the blood and the liver while exhibiting undetectable HBV surface antigen (HBsAg). The molecular mechanisms underlying this occurrence are still not completely understood. This study investigated the prevalence of OBI in a high-risk Australian population and compared the HBV S gene sequences of our cohort with reference sequences. Serum from HBV DNA positive, HBsAg negative, and hepatitis B core antibody (anti-HBc) positive patients (study cohort) were obtained from samples tested at SEALS Serology Laboratory using the Abbott Architect, as part of screening and diagnostic testing. From a total of 228,108 samples reviewed, 1,451 patients were tested for all three OBI markers. Only 10 patients (0.69%) out of the 1,451 patients were found to fit the selection criteria for OBI. Sequence analysis of the HBV S gene from 5 suspected OBI infected patients showed increased sequence variability in the 'a' epitope of the major hydrophilic region compared to reference sequences. In addition, a total of eight consistent nucleotide substitutions resulting in seven amino acid changes were observed, and three patients had truncated S gene sequence. These mutations appeared to be stable and may result in alterations in HBsAg conformation. These may negatively impact the affinity of hepatitis B surface antibody (anti-HBs) and may explain the false negative results in serological HBV diagnosis. These changes may also enable the virus to persist in the liver by evading immune surveillance. Further studies on a bigger cohort are required to determine whether these amino acid variations have been acquired in the process of immune escape and serve as markers of OBI.

PMID:
    25763579
    [PubMed - in process]

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StephenW

公共科学图书馆之一。 2015年3月12日; 10（3）：e0117275。 DOI：10.1371 / journal.pone.0117275。 eCollection 2015年。
隐匿性乙肝病毒感染的肝门诊抗-HBc阳性患者的调查。
马丁内斯MC 1，角CC 2，Baleriola C 2，罗伯逊P 2，罗林森WD 3。
作者信息
    1Virology司，威尔斯亲王医院，悉尼，澳大利亚;学校医学科学院，新南威尔士大学，悉尼，澳大利亚。
    2SEALS微生物，威尔斯亲王医院，悉尼，澳大利亚。
    3Virology司，威尔斯亲王医院，悉尼，澳大利亚; SEALS微生物，威尔斯亲王医院，悉尼，澳大利亚;学校医学科学院，新南威尔士大学，悉尼，澳大利亚。
抽象

隐匿乙型肝炎感染（OBI）由非常低的水平的存在下表现（<200IU /毫升）的B型肝炎病毒DNA（HBV DNA）在血液和肝脏同时表现出不可检测HBV表面抗原（HBsAg）。这种情况的发生的分子机制仍然不完全了解。这项研究调查了欧倍德的患病率在高危澳大利亚人口相比我们的队列中的参考序列的HBV S基因序列。从使用雅培架构师密封圈血清学实验室测试样品获得自HBV DNA阳性，HBsAg阴性，和乙型肝炎核心抗体（抗-HBc）阳性患者（研究队列）血清，筛查和诊断测试的一部分。共有228108样品审查，1451例患者进行了测试这三个OBI标志。只有10例（0.69％）出了1451例患者被发现符合选择标准OBI。相比于参考序列的HBV■从5 OBI疑似感染者基因序列分析表明，增加序列变异的主要亲水区的'一'表位。此外，共产生7个氨基酸改变8一致核苷酸取代进行观察，3名患者已截短S基因序列。这些突变似乎是稳定的，并可能导致在HBsAg的构象的改变。这些可以乙型肝炎表面抗体（抗​​-HBs）的亲和力有负面影响，并可能解释在血清学诊断乙型肝炎的假阴性结果。这些变化也可能使病毒通过逃避免疫监视坚持肝脏。在更大的人群需要进一步的研究，以确定是否这些氨基酸的变化已在免疫逃逸的过程中被取得，并作为OBI的标志。

结论：
    25763579
    [考研 - 过程]

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