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[IgM抗-HBc在乙肝和丁肝病毒重叠感染鉴别诊断中的作用]

[IgM anti-HBc in the differential diagnosis of co- and HDV superinfection].

作者信息

Fedorchenko S V, Vozianova S V

出版信息

Ter Arkh. 1991;63(11):55-8.

PMID:1810065
Abstract

EIA was used to study the titers of IgM anti-HBc in 38 patients with chronic hepatitis B, 10 with acute viral hepatitis B and 18 patients with D-infection (6 with coinfection and 12 with D-superinfection) depending on the presence of HBe/anti-HBe. Chronic active hepatitis (CAH) was diagnosed in 18 patients, chronic persistent hepatitis (CPH) in 15, and the "healthy" HBsAg carriership in 5. The titers of IgM anti-HBc 1:100 were detectable in 14 out of the 18 patients with CAH and in 3 out of the 15 patients with CPH and correlated with the clinico-biochemical activity of the process and the presence of HBeAg in serum. In coinfection, the antibody titers were determined in the range of the antibody titers were determined in the range of 1:3200 to 1:25600 for the first two weeks of the disease and did not depend on the presence of HBe/anti-HBe. Anti-D were identified only on the 3d week since the first disease manifestations. In the presence of the replicative form of CAH, HDV-superinfection was diagnosed in 3 patients with HBeAg in serum and the titers of IgM anti-HBc 1:100 and higher. The follow-up studies demonstrated inhibition of HBV replication shown up by HBeAg elimination from serum and a decrease in the titers of IgM anti-HBc. Therefore, the titers 1:100 cannot serve as a diagnostic criterion for coinfection, for in the replicative form of CAH, their concentration may be higher.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

采用酶免疫分析法(EIA),根据HBe/抗-HBe的存在情况,研究了38例慢性乙型肝炎患者、10例急性乙型病毒性肝炎患者和18例丁型肝炎感染患者(6例合并感染,12例重叠感染)的抗-HBc IgM滴度。诊断为慢性活动性肝炎(CAH)的患者18例,慢性持续性肝炎(CPH)患者15例,“健康”HBsAg携带者5例。18例CAH患者中有14例、15例CPH患者中有3例可检测到抗-HBc IgM滴度为1:100,且与疾病的临床生化活性及血清中HBeAg的存在相关。在合并感染时,疾病前两周抗体滴度在1:3200至1:25600范围内,且不依赖于HBe/抗-HBe的存在。仅在疾病首次出现症状后的第3周检测到抗-D。在CAH复制型存在的情况下,3例血清中HBeAg阳性且抗-HBc IgM滴度为1:100及更高的患者被诊断为HDV重叠感染。随访研究表明,血清中HBeAg消失及抗-HBc IgM滴度降低显示HBV复制受到抑制。因此,1:100的滴度不能作为合并感染的诊断标准,因为在CAH复制型中,其浓度可能更高。(摘要截短于250字)

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