Objective To understand the characteristics of the superinfection of hepatise B virus (HBV)together with hepatitis D virus(HDV)by comparing the differences of serum markers ALT,HBV DNA,HBVM,etc.In the pure HBV infection and the superinfection of HBV and HDV and to preliminarily invesitigate the pathogenesis of HDV.Methods The results of major bio-chemical indicators and hepatitis virus markers in 95 cases of HBV together with HDV infection and 100 cases of pure HBV infec-tion as the control group were statistically analyzed.Results Among 95 cases in the superinfection group,the incidence rate of chronic HBV was the highest,accounting for 66.32% and followed by liver cirrhosis.There was no statistical difference between the two groups according to the HBV DNA loads(P >0.05).The good positive correlation existed between the ALT abnormal rate of the liver function and HBV DNA in the superinfection group(r=0.90,P <0.05).The HBeAg negative mode was predominant in the superinfection group (P <0.05 ).There was no difference beween the two groups according to HBsAg > 250 IU/mL (P >0.05).According to HBsAg>250 IU/mL and HBeAg > 1 S/CO,the pure HBV infection group was higher than the super infec-tion group (P <0.05).The positive rate of HBcAb-IgM in the super infection group was significantly higher than that in the pure HBV group (P <0.05).Conclusion The superinfection of HBV together with HDV infection has the high occurrence rate in chro-nic hepatitis B.With the HBV DNA level increase,the abnormal rate of the liver function is also increased.HDV infection can inhib-it the HBeAg expression.The high positive rate of HBcAb-IgM in the superinfection patients might be related with chronic hepatitis B aggravation and recurrence.

Objective To establish an anti-hepatitis E virus (HEV) enzyme-linked immunosorbent assay (ELISA) one-step assay based on seven glutathione S-transferase (GST)-fusion recombinant proteins derived from different HEV genotypes and subtypes. Methods Concentration of the coating antigen was optimized by block titration. The cut-off values were determined for anti-HEV IgG and IgM, respectively. Assay sensitivity, specificity and reproducibility were investigated using samples with confirmed anti-HEV positive. Results An optimal concentration of mixture of recombinant proteins (Mix166) was 1.5 mg/L for antigen coating. Coefficient of variations (CV) of anti-HEV within-run and between-run were 8.67% and 10.85%, respectively. CV of anti-HEV IgM within-run and between-run were 4.56% and 5.99%, respectively. Positive rates of anti-HEV IgG and IgM were both 94% for 50 HEV-polymerase chain reaction (PCR) positive sera tested with the one step assay. Using one-step assay to detect 674 serum samples from healthy people, 52 samples were found anti-HEV IgG positive and 3 samples were anti-HEV lgM positive. A series of serum specimens collected at different time points until 76 weeks from a chimpanzee challenged with HEV Mexican strain were anti-HEV IgM positive during week 1--6 and anti-HEV IgG positive during week 2--76 determined by the one step ELISA. However, import ELISA kits were lack of both the IgM and lgG reactivity to all of the serial chimpanzee sera. Conclusions The sensitivity and specificity of anti-HEV ELISA one-step assay based on the Mix166 antigen are high and could be used for the diagnosis of HEV infection.

Objective To investigate whether maternal antibody to hepatitis B surface antigen (anti-HBs)in infants may interfere with the antibody response to hepatitis B vaccine. Methods Infants from singleton pregnant mothers,who delivered at full term at the Affiliated Drum Tower Hospital of Nanjing University Medical School from October 2006 to January 2007,were divided into two groups based on their mothers'status of anti-HBs(43 positive and 29 negative).All infants were vaccinated with hepatitis B vaccine at birth and one month thereafter.Serum anti-HBs were quantitatively determined for the mothers before delivery and for infants in cord blood at delivery and in serum at the age of 1 and 3.5 months. Results Anti-HBs of all 43 newborns in the positive group were positive in cord blood with the coefficiency of 0.98 to the maternal serum anti-HBs level(t=39.05,P<0.01).Forty-two out of the 43 infants remained anti-HBs positive at the age of 1 month.Anti-HBs was negative both at birth and 1 month old in infants of the negative group.However,all infants in both groups were anti-HBs positive at 3.5 months of age,while the average concentration of anti-HBs in infants of the negative group was significantly higher than that of the positive group [(466.9±86.7)mIU/ml vs(151.2±23.1)mIU/ml,t=2.72,P=0.011].Among the 5 infants whose maternal anti-HBs level>1000 mIU/ml,3 did not produce active antibodies against two doses of hepatitis B vaccination. Conclusions Passively acquired maternal anti-HBs in infants can inhibit the active antibody response to hepatitis B vaccine,and the extent of this effect is associated with maternal anti-HBs level.