Fujita Y K, Kamata K, Kameda H, Isselbacher K J, Wands J R
Gastroenterology. 1986 Dec;91(6):1357-63. doi: 10.1016/0016-5085(86)90187-3.
We studied 375 chronic hemodialysis patients for evidence of hepatitis B virus infection using first- and second-generation monoclonal radioimmunoassays. These assays employ high-affinity monoclonal antibodies produced against antigenic determinants that reside on hepatitis B surface antigen. Such assays have a lower limit of detection for hepatitis B surface antigen-associated determinants in serum of approximately 55 and 15 pg/ml, respectively. We found that 14 of 375 chronic hemodialysis patients were positive for hepatitis B surface antigen by both polyclonal and monoclonal radioimmunoassay. However, an additional 17, some of whom had chronic hepatitis and hepatocellular carcinoma, were identified as harboring hepatitis B virus infection only by the monoclonal radioimmunoassays. Thus the monoclonal radioimmunoassays improved the hepatitis B virus detection rate by 120% (3.7% vs. 8.3%). More importantly, 6 of the 17 monoclonal radioimmunoassay-reactive patients had no serologic evidence of recent or past hepatitis B virus exposure as shown by the absence of antibodies to the hepatitis B core and surface antigens in the blood. We conclude that there are hemodialysis patients with hepatitis B virus infection undetectable by conventional polyclonal radioimmunoassays.
我们使用第一代和第二代单克隆放射免疫测定法，对375名慢性血液透析患者进行了乙型肝炎病毒感染证据的研究。这些测定法采用针对乙型肝炎表面抗原上抗原决定簇产生的高亲和力单克隆抗体。此类测定法对血清中乙型肝炎表面抗原相关决定簇的检测下限分别约为55和15 pg/ml。我们发现，375名慢性血液透析患者中有14名通过多克隆和单克隆放射免疫测定法检测乙型肝炎表面抗原均呈阳性。然而，另外17名患者，其中一些患有慢性肝炎和肝细胞癌，仅通过单克隆放射免疫测定法被确定为感染了乙型肝炎病毒。因此，单克隆放射免疫测定法将乙型肝炎病毒的检测率提高了120%（3.7%对8.3%）。更重要的是，17名单克隆放射免疫测定法呈反应性的患者中有6名没有近期或既往接触乙型肝炎病毒的血清学证据，血液中缺乏乙型肝炎核心抗原和表面抗原抗体即可证明。我们得出结论，存在一些慢性血液透析患者感染了乙型肝炎病毒，但用传统的多克隆放射免疫测定法无法检测到。
