急性病毒性肝炎的血清学诊断

Serological diagnosis of acute viral hepatitis.

作者信息

Hoofnagle J H, Ponzetto A, Mathiesen L R, Waggoner J G, Bales Z B, Seeff L B

出版信息

Dig Dis Sci. 1985 Nov;30(11):1022-7. doi: 10.1007/BF01315598.

Abstract

Fifty cases of symptomatic acute viral hepatitis presenting at the Washington, D.C., Veterans Administration Medical Center between 1976 and 1978 were tested for serological markers of hepatitis virus infection. The etiology of the acute hepatitis appeared to be hepatitis A virus in 20%, hepatitis B virus in 52%, non-A, non-B agents in 22%, delta hepatitis in 4%, and infectious mononucleosis in 2%. The diagnosis of type B hepatitis was difficult to verify because 10% of cases were seronegative for HBsAg and another 10% were seronegative by conventional testing for IgM antibody to hepatitis B core antigen (a putative marker of acute hepatitis B virus infection). Accurate serodiagnosis of acute viral hepatitis depends upon the correct application of testing for IgM antibody to hepatitis A virus, IgM antibody to hepatitis B core antigen, HBsAg, and tests for syphilis and mononucleosis.

摘要

1976年至1978年间，在华盛顿特区退伍军人管理局医疗中心就诊的50例有症状的急性病毒性肝炎患者接受了肝炎病毒感染血清学标志物检测。急性肝炎的病因似乎为甲型肝炎病毒的占20%，乙型肝炎病毒的占52%，非甲非乙型病原体的占22%，丁型肝炎的占4%，传染性单核细胞增多症的占2%。乙型肝炎的诊断难以核实，因为10%的病例乙肝表面抗原（HBsAg）血清学阴性，另有10%通过常规检测乙肝核心抗原IgM抗体（急性乙型肝炎病毒感染的推定标志物）呈血清学阴性。急性病毒性肝炎的准确血清学诊断取决于对甲型肝炎病毒IgM抗体、乙肝核心抗原IgM抗体、HBsAg检测以及梅毒和单核细胞增多症检测的正确应用。