基于超高敏感性乙型肝炎表面抗原测定的乙型肝炎重新激活

StephenW

Novel monitoring of hepatitis B reactivation based on ultra-high sensitive hepatitis B surface antigen assay
Authors

    First published: 29 January 2017Full publication history
    DOI: 10.1111/liv.13349  View/save citation
    Cited by (CrossRef): 0 articles Check for updates

   
    Funding information

    This work was supported in part by a grant-in-aid from the Research Program on Hepatitis from Japan Agency for Medical Research and Development (AMED) and a grant-in-aid from the Ministry of Education, Culture, Sports, Science and Technology (Scientific Research (C) no. 90423855 to S.K.)
    Handling Editor: Francesco Negro

Abstract
Background & Aims

Occult hepatitis B virus (HBV) infection should be evaluated before systemic chemotherapy to prevent HBV reactivation-related hepatitis. We investigated HBV reactivation using high sensitivity HB surface antigen (HBsAg) chemiluminescent enzyme immunoassay (HBsAg-HQ) and ultra-high sensitive HBsAg assay employing a semi-automated immune complex transfer chemiluminescence enzyme technique (ICT-CLEIA).
Methods

Of 120 HBV-resolved patients with haematological malignancy receiving systemic chemotherapy from 2012 to 2015 in our hospital, 13 patients had HBV DNA reactivation (in 12/13 patients HBV DNA became quantifiable) according to HBV DNA monitoring. These patients were applied for Architect HBsAg-QT (detection limit:50 mIU/mL), HBsAg-HQ (5 mIU/mL) and ICT-CLEIA (0.5 mIU/mL) using stored samples.
Results

When HBV DNA was firstly quantifiable by regular HBV DNA monitoring, HBsAg-QT was detected in 1/12 patients (8%), HBsAg-HQ was detected in 4/12 patients (33%) and ICT-CLEIA was detected in all 12 patients (100%), suggesting that the sensitivity of ICT-CLEIA was comparable to that of HBV DNA quantification. Interestingly, two patients were HBsAg positive by ICT-CLEIA before HBV DNA became detectable. Median difference of detectable point between HBV DNA and ICT-CLEIA was zero (range from −28 to 56 days), while median delay by HBsAg-QT or HBsAg-HQ was 52.5 days after HBV DNA became detectable. Although anti-HBs titres were high (131.9 mIU, 80.4 mIU) in two patients with escape mutations (Saa126V, Saa145R), HBsAg by ICT-CLEIA and HBV DNA were detectable concurrently.
Conclusions

ICT-CLEIA is a novel assay for HBV monitoring to prevent hepatitis caused by HBV reactivation.

StephenW

基于超高敏感性乙型肝炎表面抗原测定的乙型肝炎重新激活的新型监测
作者

    首次发表：2017年1月29日全文出版历史
    DOI：10.1111 / liv.13349查看/保存引用
    引用（CrossRef）：0篇文章检查更新

    资金信息

    资金信息

    这项工作部分得到了日本医学研究与发展机构（AMED）的肝炎研究计划的赠款援助和教育，文化，体育和科技部的赠款援助（科研（C）编号90423855给SK）
    处理编辑：Francesco Negro

抽象
背景与目标

在全身化疗前应评估隐匿性乙型肝炎病毒（HBV）感染，以预防HBV再激活相关性肝炎。我们使用半自动免疫复合物转移化学发光酶技术（ICT-CLEIA），使用高灵敏度HB表面抗原（HBsAg）化学发光酶免疫测定（HBsAg-HQ）和超高灵敏度HBsAg测定来研究HBV再激活。
方法

根据HBV DNA监测，2012年至2015年在我院接受全身化疗的120例乙型肝炎病毒治疗患者中，13例HBV DNA再激活（12/13例HBV DNA可量化）。使用存储的样品将这些患者应用于建筑师HBsAg-QT（检测限：50mIU / mL），HBsAg-HQ（5mIU / mL）和ICT-CLEIA（0.5mIU / mL）。
结果

当HBV DNA首次通过常规HBV DNA监测进行量化时，在1/12例患者（8％）检测到HBsAg-QT，4/12例（33％）检测到HBsAg-HQ，所有12例检测到ICT-CLEIA患者（100％），表明ICT-CLEIA的敏感性与HBV DNA定量相当。有意思的是，两名患者在HBV DNA变为可检测之前，被ICT-CLEIA阳性者HBsAg阳性。 HBV DNA和ICT-CLEIA之间的可检测点的中位差为零（范围从-28到56天），而HBsAg-QT或HBsAg-HQ的中位延迟在HBV DNA可检测后为52.5天。尽管两名逃逸突变患者（Saa126V，Saa145R）的抗HBs滴度较高（131.9 mIU，80.4 mIU），ICT-CLEIA的HBsAg和HBV DNA同时检出。
结论

ICT-CLEIA是一种用于HBV监测以预防HBV再激活引起的肝炎的新型检测方法。