Chongsrisawat Voranush, Thawornsuk Nutchanart, Theamboonlers Apiradee, Louisirirotchanakul Suda, Poovorawan Yong
Center of Excellence in Viral Hepatitis Research, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Viral Immunol. 2006 Winter;19(4):623-9. doi: 10.1089/vim.2006.19.623.
On the basis of a seroepidemiological survey of hepatitis B virus (HBV) infection conducted on 6208 random serum samples from four provinces of Thailand, we found 19 of 246 (7.7%) hepatitis B surface antigen (HBsAg)-positive samples with unusual serological constellations of HBV infection. Ten samples tested positive for HBsAg, anti-HBc (anti-hepatitis B core antibody), and anti-HBs (anti-hepatitis B surface antibody) markers (group I), 3 specimens were HBsAg and anti-HBs positive without detectable anti-HBc (group II), and the remaining 6 specimens showed only HBsAg (group III). In group I, 7 of 10 HBsAg-positive sera could be confirmed by HBsAg neutralization, yielding positive results for all samples. None of the group II sera were available in sufficient amounts for confirmation. In group III, five of six sera were confirmed by HBsAg neutralization, with four showing a positive reaction. HBV DNA was detected in 7 of 10 (70%) specimens in group I, in 1 of 3 (33.3%) specimens in group II, and in 3 of 6 (50%) specimens in group III. On the basis of HBsAg neutralization, HBV DNA was found in five of seven (71.4%) HBsAg-positive samples in group I and in three of four (75%) HBsAg-positive samples in group III, whereas the one confirmed HBsAg-negative sample in group III also remained negative for HBV DNA. Amino acid sequences were compared with those specifying the "a" determinant of the wild-type virus, particularly focusing on HBV-S protein variations between positions 110 and 160. Among 11 HBV DNA-positive sera, G145A was detected in 2 samples in group I, with the remaining samples identical to the wild-type virus. These unusual serological profiles may be due to the altered immune response of the host or to HBV variants.
基于对泰国四个省份随机抽取的6208份血清样本进行的乙肝病毒（HBV）感染血清流行病学调查，我们在246份乙肝表面抗原（HBsAg）阳性样本中发现19份（7.7%）存在不寻常的HBV感染血清学特征。10份样本的HBsAg、抗-HBc（抗乙肝核心抗体）和抗-HBs（抗乙肝表面抗体）标志物检测呈阳性（第一组），3份样本HBsAg和抗-HBs阳性但未检测到抗-HBc（第二组），其余6份样本仅显示HBsAg阳性（第三组）。在第一组中，10份HBsAg阳性血清中有7份可通过HBsAg中和试验得到确认，所有样本结果均为阳性。第二组血清均无足够量用于确认。在第三组中，6份血清中有5份通过HBsAg中和试验得到确认，4份呈阳性反应。第一组10份样本中有7份（70%）检测到HBV DNA，第二组3份样本中有1份（33.3%）检测到HBV DNA，第三组6份样本中有3份（50%）检测到HBV DNA。基于HBsAg中和试验，第一组7份HBsAg阳性样本中有5份（71.4%）检测到HBV DNA，第三组4份HBsAg阳性样本中有3份（75%）检测到HBV DNA，而第三组中1份经确认的HBsAg阴性样本HBV DNA检测仍为阴性。将氨基酸序列与指定野生型病毒“a”决定簇的序列进行比较，特别关注HBV-S蛋白110至160位之间的变异。在11份HBV DNA阳性血清中，第一组2份样本检测到G145A，其余样本与野生型病毒相同。这些不寻常的血清学特征可能是由于宿主免疫反应改变或HBV变异所致。
