Khakoo S I, Soni P N, Brown D, Dusheiko G M
University Department of Medicine, Royal Free Hospital and School of Medicine, London, England.
J Med Virol. 1996 Oct;50(2):112-6. doi: 10.1002/(SICI)1096-9071(199610)50:2<112::AID-JMV2>3.0.CO;2-D.
Selection of HBsAg-positive patients for antiviral therapy requires an estimation of disease activity and viral replication. Serum transaminases and histological analysis are commonly used to assess disease activity, and viral replication is assessed by serological testing of HBeAg and serum hepatitis B virus (HBV) DNA. Dot blot hybridisation may be insufficiently sensitive to corroborate low-grade replication in patients with active hepatitis, and polymerase chain reaction (PCR) may be testing too sensitive for this role. Theoretically an assay of intermediate sensitivity is therefore required. Our aim was to evaluate whether the branched chain DNA (bDNA) assay would fulfil this function. Seventy-one HBsAg-positive patients were tested for HBV DNA by the bDNA assay; 64 were also tested by dot blot hybridisation and, when appropriate, also by PCR. Thirty-seven (52%) patients were positive for HBV DNA by the bDNA assay. HBV DNA was detected in the majority (21/28; 75%) of HBeAg-positive patients but also in 14 of 36 (39%) anti-HBe-positive patients. HBV DNA was detected by the bDNA assay in 20 of 48 (42%) patients negative for HBV DNA by dot blot hybridisation assay. All patients positive for HBV DNA by dot blot hybridisation were also positive by the bDNA assay. Sixteen of twenty-five (64%) patients negative for HBV DNA by the bDNA assay were positive for HBV DNA by PCR. The bDNA assay is a sensitive and reliable method for the detection of HBV DNA. As nucleoside analogue therapy becomes more widely available, the assay should provide a useful tool for the selection for and monitoring of patients on antiviral therapy.
选择HBsAg阳性患者进行抗病毒治疗需要评估疾病活动度和病毒复制情况。血清转氨酶和组织学分析常用于评估疾病活动度，而病毒复制则通过HBeAg血清学检测和血清乙型肝炎病毒（HBV）DNA进行评估。斑点印迹杂交对于证实活动性肝炎患者的低水平复制可能不够敏感，而聚合酶链反应（PCR）对于此作用可能检测过于敏感。因此，理论上需要一种中等灵敏度的检测方法。我们的目的是评估分支链DNA（bDNA）检测是否能满足这一功能。通过bDNA检测对71例HBsAg阳性患者进行了HBV DNA检测；其中64例还进行了斑点印迹杂交检测，且在适当情况下也进行了PCR检测。通过bDNA检测，37例（52%）患者的HBV DNA呈阳性。大多数（21/28；75%）HBeAg阳性患者检测到HBV DNA，但36例抗-HBe阳性患者中也有14例（39%）检测到HBV DNA。在斑点印迹杂交检测HBV DNA阴性的48例患者中，有20例（42%）通过bDNA检测检测到HBV DNA。所有斑点印迹杂交检测HBV DNA阳性的患者通过bDNA检测也呈阳性。25例bDNA检测HBV DNA阴性的患者中有16例（64%）PCR检测HBV DNA呈阳性。bDNA检测是一种检测HBV DNA的灵敏且可靠的方法。随着核苷类似物治疗的应用越来越广泛，该检测方法应为抗病毒治疗患者的选择和监测提供有用的工具。
