[戊型肝炎暴发的血清学抗体比较]

Tan Chun-rong, Bao Zhong-ying, Sun Huan-ying, Hu Mei, Chen Yan, Chen Min, Zhang Man

Department of Clinical Laboratory, Beijing Shi Ji Tan Hospital, Beijing, China.

Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi. 2005 Mar;19(1):35-8.

OBJECTIVE

To compare the serological characters of an outbreak of hepatitis E and evaluate sensitivity and specificity of anti-HEV E2-IgM.

METHODS

The sera collected from the employees of an outbreak unit were detected for anti-HEV E2-IgM and IgG, and the serum samples from a neighboring department were used as control. The results detected with anti-HEV E2-IgM, IgG and Genelab anti-HEV IgM, IgG in some samples were compared.

RESULTS

The positive rate of anti-HEV E2-IgM in the control group was 0.11%. The results between the positive and the negative samples can be distinguished easily. The specificity of anti-HEV E2-IgM is about 99.89%. The positive rate of anti-HEV E2-IgM in outbreak stricken population was 8.66%, significantly higher than that in the control group (P < 0.001). The results from HEV patients' serial samples in the outbreak unit showed that the anti-HEV E2-IgM titer was high 30-60 days after the infected and then declined clearly. The positivity seemed unrelated to neither sex nor age. Among the 115 positive to anti-HEV E2-IgM, 27 were negative to Genelab anti-HEV IgG, the fact indicated a rather high risk of misdiagnosis of about 23.48%. In the 179 randomized samples of the control group, the positive rate of Genelabs anti-HEV IgG was about 11.17%. In 110 samples for the positive anti-HEV E2-IgM, the positive ratio of Genelabs anti-HEV IgG was about 76.36%, and that of Genelabs anti-HEV IgM only 69.09%. There were 16 samples negative for both Genelabs anti-HEV IgG and IgM. The ratio of the difference between the Genelabs anti-HEV IgG and IgM was about 25.45%.

CONCLUSION

The specificity of anti-HEV E2-IgM was about 99%, and false positive rate was low. The sensitivity of anti-HEV E2-IgM in acute hepatitis E infection was 25%-30% higher than that of Genelabs anti-HEV IgM,IgG. The infected persons in the outbreak unit can be preferably distinguished from the non-infected persons by anti-HEV E2-IgM. Anti-HEV E2-IgM can image the characters of the outbreak of HEV and played a great role in the control of outbreak and in the early diagnosis for hepatitis E.

目的

比较戊型肝炎暴发疫情的血清学特征，评估抗戊型肝炎病毒E2-IgM的敏感性和特异性。

方法

检测暴发单位员工血清中的抗戊型肝炎病毒E2-IgM和IgG，以相邻科室的血清样本作为对照。比较部分样本用抗戊型肝炎病毒E2-IgM、IgG及Genelab抗戊型肝炎病毒IgM、IgG检测的结果。

结果

对照组抗戊型肝炎病毒E2-IgM阳性率为0.11%。阳性与阴性样本结果易于区分。抗戊型肝炎病毒E2-IgM的特异性约为99.89%。疫情受灾人群中抗戊型肝炎病毒E2-IgM阳性率为8.66%，显著高于对照组（P<0.001）。暴发单位戊型肝炎患者系列样本结果显示，感染后30-60天抗戊型肝炎病毒E2-IgM滴度较高，随后明显下降。阳性率似乎与性别和年龄均无关。在115例抗戊型肝炎病毒E2-IgM阳性者中，27例Genelab抗戊型肝炎病毒IgG阴性，这一事实表明误诊风险相当高，约为23.48%。对照组179例随机样本中，Genelab抗戊型肝炎病毒IgG阳性率约为11.17%。在110例抗戊型肝炎病毒E2-IgM阳性样本中，Genelab抗戊型肝炎病毒IgG阳性率约为76.36%，Genelab抗戊型肝炎病毒IgM仅为69.09%。有16例样本Genelab抗戊型肝炎病毒IgG和IgM均为阴性。Genelab抗戊型肝炎病毒IgG和IgM之间的差异比例约为25.45%。

结论

抗戊型肝炎病毒E2-IgM特异性约为99%，假阳性率低。抗戊型肝炎病毒E2-IgM在急性戊型肝炎感染中的敏感性比Genelab抗戊型肝炎病毒IgM、IgG高25%-30%。抗戊型肝炎病毒E2-IgM能较好地区分暴发单位的感染者与未感染者。抗戊型肝炎病毒E2-IgM能反映戊型肝炎暴发的特征，在疫情控制和戊型肝炎早期诊断中发挥重要作用。