Buffet C
Service des maladies du foie et de l'appareil digestif, Centre hospitalier de Bicêtre, Le Kremlin-Bicêtre.
Rev Prat. 1995 Jan 15;45(2):168-73.
The diagnosis of hepatitis A is based on IgM anti-HAV positivity. IgG anti-HAV indicates immunity from further infections of hepatitis A. In acute hepatitis B, HBs Ag is the first marker to appear in the serum, followed by HBe Ag and anti-HBc. After recovery, HBs Ag disappears, anti-HBs appears with anti-HBe and anti-HBc and persists for many years. Anti-HBs is indicative of recovery and immunity. Chronic hepatitis B infection is defined as the persistence of HBs Ag for more than 6 months. The presence of HBeAg and HBV DNA in the serum of HBsAg positive carriers has been considered as indication of active viral replication. After a variable period, often several years, viral replication disappears. The patient displays serum anti-HBe antibodies and HBV DNA is not detected in the serum. This state is the most frequently observed and has been classified as wild type. Mutations have been described. The delta virus is not able to replicate on its own, but is capable of infection when activated by the presence of hepatitis B virus. The appearance of serum IgG anti-delta is the simplest method of diagnosing delta infection. Serological tests for HCV detect antibodies to viral antigens (Elisa assay). Each positive anti-HCV assay must be followed by a complementary confirmation test. The most widely used method for supplementary testing is the recombinant immunoblot assay in which antibodies are sought for recombinant antigens of HCV coated on nitrocellulose strips.(ABSTRACT TRUNCATED AT 250 WORDS)
甲型肝炎的诊断基于IgM抗-HAV阳性。IgG抗-HAV表明对甲型肝炎进一步感染具有免疫力。在急性乙型肝炎中,HBs Ag是血清中最早出现的标志物,其次是HBe Ag和抗-HBc。恢复后,HBs Ag消失,抗-HBs与抗-HBe和抗-HBc一同出现并持续多年。抗-HBs表明恢复和免疫。慢性乙型肝炎感染定义为HBs Ag持续存在超过6个月。HBsAg阳性携带者血清中HBeAg和HBV DNA的存在被视为病毒活跃复制的指标。经过一段可变的时间,通常是数年,病毒复制消失。患者血清中出现抗-HBe抗体,血清中未检测到HBV DNA。这种状态最为常见,已被归类为野生型。已描述了突变情况。丁型病毒不能自行复制,但在乙型肝炎病毒存在时被激活时能够感染。血清IgG抗-丁型的出现是诊断丁型感染的最简单方法。丙型肝炎病毒的血清学检测检测针对病毒抗原的抗体(酶联免疫吸附测定)。每次抗-HCV检测呈阳性后都必须进行补充确认试验。补充检测最广泛使用的方法是重组免疫印迹试验,其中寻找涂覆在硝酸纤维素条上的丙型肝炎病毒重组抗原的抗体。(摘要截断于250字)