【摘要】 目的 探讨临床乙型肝炎表面抗原HBsAg无反应性标本中开展乙型肝炎病毒(HBV)核酸检测的意义。方法 收集2019年10月～2020年6月期间,全国23家医院10 173例标本HBV血清学和核酸检测结果,首次纳入HBsAg无反应性标本,分析血清HBV DNA定性检测结果。从中再次纳入HBV DNA阳性,且进行了乙型肝炎表面抗体(HBsAb)、乙型肝炎e抗原(HBeAg)、乙型肝炎e抗体(HBeAb)和乙型肝炎核心抗体(HBcAb)血清学标志物检测标本,进行Ct值区间总体分布和HBV血清学标志物模式分析。结果 纳入的9 186例HBsAg无反应性标本中,血清HBV DNA阳性例数为254例(2.77%)。再次纳入的HBV DNA阳性且进行HBV血清学标志物检测的168例标本中有8种HBV血清学标志物模式。其中,166例(98.81%)可能是隐匿型乙型肝炎感染(Occult hepatitis B infection,OBI)患者。结论 HBV核酸检测能从HBsAg无反应性标本检出一定比率的乙型肝炎患者,特别对OBI患者具有较好的检出效果。HBV核酸筛查对OBI检出以及防止HBsAg漏检具有重要的意义。更多还原

【Abstract】 Objective To discuss the detection of hepatitis B virus (HBV) nucleic acid testing (NAT) in HBsAg-negative specimens.Methods A total of 10 173 results of HBV serology test and nucleic acid test from 23 hospitals in China between Oct 2019 and Jun 2020 were collected.HBsAg-negative specimens were Firstly included,and results of serum HBV DNA qualitative test were analyzed.Positive HBV DNA specimens were further included,and tested for serological marker HBsAb,HBeAg,HBeAb and HBcAb.The overall distribution of Ct value intervals and serological marker patterns were analyzed.Results 254(2.77%)of 9 186 HBsAg negative cases included were HBV DNA positive.There were eight serological patterns of HBV markers in 168 HBV DNA positive.166(98.81%) of those patients were occult hepatitis B infection(OBI).Conclusion HBV NAT could detect a certain percentage of HBV patients in HBsAg-negative specimens,especially for OBI patients.HBV NAT screening is important to detect OBI to avoid missing cases.更多还原