Effect and elimination methods of neonatal hyperbilirubinemia on the chemiluminescent detection of HBsAg
10.3760/cma.j.issn.1009-9158.2019.01.011
- VernacularTitle:新生儿高胆红素血症对血清乙肝病毒表面抗原化学发光法检测的影响及消除方法初探
- Author:
Xiaomin SHI
1
;
Na REN
;
Yue SUN
;
Yanfeng HOU
;
Zhihui LI
;
Ping LIU
;
Le CHANG
;
Cunling YAN
;
Zhiyan LI
;
Wenqi SONG
Author Information
1. 北京大学第一医院检验科 100034
- Keywords:
Hyperbilirubinemia;
Neonatal;
Hepatitis B surface antigens;
Luminescent measurements
- From:
Chinese Journal of Laboratory Medicine
2019;42(1):51-56
- CountryChina
- Language:Chinese
-
Abstract:
Objective Investigate the effect of neonatal hyperbilirubinemia on the detection of HBsAg by chemiluminescence and its elimination methods.Methods Case control study.The HBsAg in human serum was detected in 200 cases of hyperbilirubinemia neonates who were hospitalized in Beijing Children's Hospital,Capital Medical University from July 2015 to May 2016 and whose serum total bilirubin level exceeded 200 μmol/L.The positive serum was further detected by 16 200×g high-spoed centrifugation or blue light irradiation for 8 hours,and the results of re-assay of HBsAg were recorded.The retest positive serum wastested for HBV DNA load and checked the results of their mother's examination in HBV.136 adult serum samples with total bilirubin levels exceeding 200 μmol/L in the Peking University First Hospital,were taken as reference to compare the influence of hyperbilirubinemia between adults and newborns on the determination of HBsAg.Results The median level of serum total bilirubin in neonates was 259.0 μ mol/L (226.5,312.5);median level of indirect bilirubin 244.1 μmol / L(212.5,295.8).Median level of serum total bilirubin in adults 356.4 μmol/L(295.9,435.1);median level ofindirect bilirubin 137.1 μmol/L (107.8,172.7).The HBsAg test was negative in adults,11 cases (5.5％) were positive in newborns,their" HBV DNA load was less than＜100 IU/ml.Among them,9 have inoculated hepatitis B vaccine and 2 were unknown.10 of 11 mothers of infants were healthy and 1 was positive for HBsAg,HBeAb,HBcAb.2 of the 11 positive specimens turned negative of HBsAg after high-speed centrifugation.In addition to high speed centrifugation,4 cases turned negative after blue light irradiation.5 cases remained positive after high speed centrifugation and blue light irradiation.Conclusions Neonatal hyperbilirubinemia,which is different from that of adults,is mainly caused by indirectly bilirubin increased,which is one of the main reasons for false positive detection of HBsAg by chemiluminescence in neonates.High-speed centrifugation and blue light irradiation can eliminate the influence of serum indirect bilirubin on the detection of HBsAg to the greatest extent.
