增强免疫力-诊断慢性乙型肝炎病毒感染。

StephenW

J Infect Dev Ctries. 2019 Mar 31;13(3):255-260. doi: 10.3855/jidc.9929.
Booster immunity - diagnosis of chronic hepatitis B viral infection.
Komitova RT1, Kevorkyan AK2, Atanasova MV3, Ivanova AV4, Golkocheva-Markova E5.
Author information

1
    Department of Infectious diseases, Parasitology and Tropical medicine, Faculty of Medicine, Medical University, Plovdiv, Bulgaria. [email protected].
2
    Department of Epidemiology and Disaster Medicine, Faculty of Public Health, Medical University, Plovdiv, Bulgaria. [email protected].
3
    Department of Microbiology and Immunology, Faculty of Pharmacy, Medical University, Plovdiv, Bulgaria. [email protected].
4
    Laboratory of Porphyrias and Molecular Diagnostics of Liver Diseases. Clinic of Gastroenterology, Saint Ivan Rilski University Hospital, Sofia, Bulgaria. [email protected].
5
    National Reference Laboratory "Hepatitis viruses", National Center for Infectious and Parasitic Diseases, Sofia, Bulgaria. [email protected].

Abstract
INTRODUCTION:

Diagnosis of chronic hepatitis B virus (HBV) infection particularly its occult form requires monitoring and repeat serological and molecular studies. The aim of the study was to investigate the possible relation between the case of a family outbreak of hepatitis A and the finding that a member of this family was diagnosed with chronic hepatitis B.
METHODOLOGY:

A mother and her two sons, one previously diagnosed with chronic HBV infection, were hospitalized due to suspected acute hepatitis. Serological markers for hepatitis A, hepatitis B and hepatitis C were assessed. Additionally, HBV DNA was tested with a sensitive PCR. Hepatitis B vaccine was administered to the mother to differentiate resolved from occult HBV infection.
RESULTS:

A family outbreak of hepatitis A was confirmed, alongside a focus of chronic HBV infection. The serological profile for two brothers was HBsAg(+), anti-HBcIgM(-), anti-HBc(+), HBcAg(-)/anti-HBe(+). The mother was negative for all HBV markers except anti-HBc. HBV DNA was detected at a level of 461 IU/mL in the elder brother, 3647 IU/mL in the younger brother and was negative in the mother on two occasions. Her anti-HBc alone, having two sons with chronic HBV infection, and her lack of antibody response to hepatitis B vaccine despite being negative for HBV DNA, led to the diagnosis of probable occult HBV infection.
CONCLUSION:

Our results confirmed that a vaccination approach could facilitate diagnosis of chronic HBV infection in the presence of isolated anti-HBc. If it were not for a family outbreak of hepatitis A, this unexpected family HBV focus would not have been revealed.

Copyright (c) 2019 Radka T Komitova, Ani Kevorkyan, Maria Atanasova, Aneta Ivanova, Elica Golkocheva.
KEYWORDS:

anti-HBc alone; hepatitis B vaccine; hepatitis B virus; occult HBV infection

PMID:
    32040457
DOI:
    10.3855/jidc.9929

StephenW

J感染开发人员。 2019三月31; 13（3）：255-260。 doi：10.3855 / jidc.9929。
增强免疫力-诊断慢性乙型肝炎病毒感染。
Komitova RT1，Kevorkyan AK2，Atanasova MV3，Ivanova AV4，Golkocheva-Markova E5。
作者信息

1
    保加利亚普罗夫迪夫医科大学医学院传染病，寄生虫学和热带医学系。 [email protected]。
2
    保加利亚普罗夫迪夫，医科大学公共卫生学院流行病学和灾难医学系。 [email protected]。
3
    保加利亚普罗夫迪夫，医科大学药学院微生物学和免疫学系。 [email protected]。
4
    卟啉症和肝病分子诊断实验室。保加利亚索非亚圣伊万·里尔斯基大学医院消化内科。 [email protected]。
5
    国家参考实验室“肝炎病毒”，保加利亚索非亚国家传染和寄生虫病中心。 [email protected]。

抽象
介绍：

诊断慢性乙型肝炎病毒（HBV）感染，尤其是其隐匿性形式，需要进行监测并重复进行血清学和分子学研究。该研究的目的是调查甲型肝炎家庭暴发病例与该家庭成员被诊断出患有慢性乙型肝炎的发现之间的可能关系。
方法：

一名母亲和她的两个儿子（先前被诊断出患有慢性HBV感染）因怀疑患有急性肝炎而住院。评估了甲型，乙型和丙型肝炎的血清学指标。另外，HBV DNA用灵敏的PCR检测。母亲接种了乙型肝炎疫苗，以区别于隐匿性HBV感染。
结果：

确认了家族性甲型肝炎暴发，以及慢性乙肝病毒感染的重点。两兄弟的血清学特征为HBsAg（+），抗HBcIgM（-），抗HBc（+），HBcAg（-）/抗HBe（+）。母亲对除抗HBc以外的所有HBV标记均为阴性。哥哥的HBV DNA水平为461 IU / mL，弟弟的水平为3647 IU / mL，母亲两次均呈阴性。她只有两个儿子患有慢性HBV感染，她仅抗HBc，尽管HBV DNA阴性，但她对乙型肝炎疫苗缺乏抗体反应，因此导致了可能的隐匿性HBV感染的诊断。
结论：

我们的结果证实，在存在分离的抗HBc的情况下，疫苗接种方法可以促进慢性HBV感染的诊断。如果不是因为甲型肝炎的家庭暴发，这种意外的家庭HBV重点将不会被发现。

版权所有（c）2019 Radka T Komitova，Ani Kevorkyan，Maria Atanasova，Aneta Ivanova，Elica Golkocheva。
关键字：

单独抗HBc；乙肝疫苗；乙型肝炎病毒；隐匿性HBV感染

PMID：
    32040457
DOI：
    10.3855 / jidc.9929

StephenW

https://www.jidc.org/index.php/journal/article/download/9929/2031