AP-HP, Pitié-Salpêtrière Hospital, Virology Department, Paris, France.
AP-HP, Pitié-Salpêtrière Hospital, Service d'Hépato-Gastro-Entérologie, Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMR 8149, F-75005 Paris, France.
J Clin Virol. 2015 Jan;62:32-7. doi: 10.1016/j.jcv.2014.11.015. Epub 2014 Nov 18.
Presence at the same time of HBsAg and anti-HBs antibodies (HBsAg/Ab) is an entity sometimes encountered in chronic hepatitis B (CHB) carriers.
This study was designed to characterize such serological profiles and to assess the reliability of serological marker quantification by three commercially available assays in this setting.
Among 2578 CHB identified patients, 129 (5%) had an HBsAg/Ab profile as determined by Abbott Architect. After exclusion of co-infections (HIV, HCV, HDV), HBV reactivation or HBIg treatment, 101 samples from 62 patients were tested for HBsAg and anti-HBs quantification using Architect, DiaSorin Liaison-XL and Roche Modular-Cobas. Influence of genotype and HBsAg variants was studied in 31 samples with HBV replication.
HBsAg detection was confirmed with the 3 techniques for 98% (n = 99) of the samples while the HBsAg/Ab profile was concordant between all techniques for 65% of them. The overall correlation between the 3 HBsAg quantification techniques was good (R(2): 0.94-0.97). The median HBsAg concentration was comparable for the 99 samples whatever the used technique but a bias of -0.11 and 0.02 log IU/mL were noticed for DiaSorin and Roche compared to Abbott, respectively. Anti-HBs quantifications were poorly correlated between techniques with major discrepancies observed. Genotype and substitutions within the "a" determinant showed an impact on HBsAg quantification.
The double HBsAg/Ab profile is not an analytical artifact and is confirmed on all commercially available techniques. While such profile does not influence HBsAg quantification, differences of HBsAg quantification were noticed according to HBV genotype or HBsAg variant.
乙型肝炎表面抗原（HBsAg）和抗-HBs 抗体（抗-HBs）同时存在于慢性乙型肝炎（CHB）患者中，这种情况并不少见。
本研究旨在描述这种血清学特征，并评估三种市售检测方法在这种情况下对血清标志物定量的可靠性。
在 2578 例 CHB 患者中，Abbott Architect 检测到 129 例（5%）存在 HBsAg/Ab 模式。排除合并感染（HIV、HCV、HDV）、HBV 再激活或 HBIg 治疗后，对 62 例患者的 101 份样本进行 HBsAg 和抗-HBs 定量检测，使用 Architect、DiaSorin Liaison-XL 和 Roche Modular-Cobas。在 31 份有 HBV 复制的样本中研究了基因型和 HBsAg 变异体的影响。
98%（n=99）的样本使用三种技术均能确认 HBsAg 的检测，其中 65%的样本三种技术的 HBsAg/Ab 模式一致。三种 HBsAg 定量技术之间的总体相关性良好（R²：0.94-0.97）。无论使用何种技术，99 份样本的 HBsAg 浓度中位数均相似，但与 Abbott 相比，DiaSorin 和 Roche 的检测结果分别有 -0.11 和 0.02 log IU/mL 的偏差。不同技术之间的抗-HBs 定量相关性较差，观察到主要差异。基因型和“a”决定簇内的替代物对 HBsAg 定量有影响。
双重 HBsAg/Ab 模式不是分析性假象，在所有市售技术上均得到证实。虽然这种模式不影响 HBsAg 定量，但根据 HBV 基因型或 HBsAg 变异体，HBsAg 定量存在差异。
