2.Definition, Diagnosis, and Prevalence of Occult Hepatitis B Virus Infection.
The Korean Journal of Gastroenterology 2013;62(3):143-147
Occult HBV infection is characterized by the absence of serum HBsAg with persistence of low level of intrahepatic HBV DNA. Several suggested mechanisms for the origin of occult HBV infection include strong suppression of viral replication and gene expression, mutation in the regulatory regions of HBV genome, formation of immunoglobulin-bound HBsAg, viral interference, and blockage of HBsAg secretion from infected hepatocytes. Standardized assays are not yet available, and sensitive HBV DNA amplification assay is necessary for the diagnosis of cryptic infection. Detection rate of HBV DNA is highest in IgG anti-HBc positive population. However, neither anti-HBc nor anti-HBs can be detected in a significant proportion of infected persons. Occult HBV infection occurs in a number of clinical settings and is highly prevalent in HCV-infected patients as well as in patients with cryptogenic chronic liver disease including hepatocellular carcinoma.
DNA, Viral/analysis
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Hepatitis B/*diagnosis/*epidemiology/metabolism
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Hepatitis B Antibodies/blood
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Hepatitis B Core Antigens/immunology
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Hepatitis B Surface Antigens/blood
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Humans
3.Analysis of the hepatitis B report data on pilot surveillance in 200 counties in China, 2013.
Ning MIAO ; Guomin ZHANG ; Hui ZHENG ; Zhenhua WU ; Xiaojin SUN ; Feng WANG ; Fuzhen WANG ; Fuqiang CUI ; Li LI
Chinese Journal of Preventive Medicine 2015;49(9):766-770
<b>OBJECTIVEb>To analyze the information of the supplementary card for hepatitis B and the laboratory confirmed result of immunoglobulin M antibody to hepatitis B virus (HBV) Core Antigen (anti-HBc IgM) for the suspected acute hepatitis B to evaluate the hepatitis B report data on pilot surveillance.
<b>METHODSb>200 counties were established in China for hepatitis B pilot surveillance and 63 641 cases were reported. We added a supplementary card in National Notificable Disease Reporting System (NNDRS) and all the reported hepatitis B cases in NNDRS were required to fill the supplementary card. Venous blood 5 ml was collected and a confirmed test of anti-HBc IgM was made for suspected acute hepatitis B. We made confirmed diagnosis for the suspected acute hepatitis B according to the supplementary card information of the reporting card and the confirmed test result of anti-HBc IgM.
<b>RESULTSb>63 641 hepatitis B cases were reported in 200 hepatitis B pilot surveillance counties in 2013. Among 1 723 cases which were filled with the HBsAg positive within six months in supplementary card, 735 cases were reported as chronic hepatitis B, the proportion was 42.66%. Among 4 582 cases which were filled with anti-HBc IgM positive in supplementary card, 2 436 cases were reported as acute hepatitis B, the proportion was 53.16%. 1 829 cases were reported as chronic hepatitis B, the proportion was 39.92%. The validity cases of the information for liver puncture and the HBV surface antigen (HBsAg) transform during the recovery period in supplementary cards for all the reporting cases were 579 and 4 961, and the rate were 0.91% and 7.80%, respectively. 4 302 suspected acute cases were made confirmed diagnosis, and 1 197 cases (27.82%) were confirmed acute and 2 590 cases (60.20%) were confirmed chronic.
<b>CONCLUSIONb>Clinical doctors failed to make full use of the information of supplementary cards to make classification diagnose for hepatitis B. Suspected acute hepatitis B with anti-HBc IgM positive should be pay attention to follow up and further distinguish acute or chronic hepatitis B according to the HBsAg transform.
China ; epidemiology ; Hepatitis B ; epidemiology ; Hepatitis B Antibodies ; blood ; Hepatitis B Core Antigens ; immunology ; Hepatitis B Surface Antigens ; immunology ; Humans ; Immunoglobulin M ; blood ; Sentinel Surveillance
4.Preliminary study on genotype of hepatitis B virus detected from Tibetans in China.
Yan-qing XU ; Yong-dong ZHOU ; Sheng-li BI
Chinese Journal of Experimental and Clinical Virology 2005;19(2):118-120
<b>OBJECTIVEb>To determine the main genotype of hepatitis B virus (HBV) detected from Tibetans in China and provide basic data for hepatitis control and prevention.
<b>METHODSb>The S gene and C gene were amplified by PCR from the sera of HBsAg positive Tibetans. After sequencing, the gene sequences were analyzed and the phylogenetic trees were drawn by the software MEGA3.
<b>RESULTSb>In trees based on S gene, the sequences of most samples clustered at genotype D, while in trees based on C gene, the sequences of all samples clustered at genotype C.
<b>CONCLUSIONb>The dominant genotype of HBV detected from Tibetans in China is a C/D hybrid.
Genotype ; Hepatitis B ; blood ; epidemiology ; virology ; Hepatitis B Core Antigens ; genetics ; Hepatitis B Surface Antigens ; blood ; genetics ; Hepatitis B virus ; classification ; genetics ; immunology ; Humans ; Phylogeny ; Tibet ; epidemiology
5.Analysis of the test results of HBV serum markers and HBV DNA of the neonates born to HBsAg-positive mothers.
Miao-Chan WANG ; Ai-Fang XU ; Yong-Le ZHANG ; Dong-Ming XU
Chinese Journal of Experimental and Clinical Virology 2011;25(6):445-447
<b>OBJECTIVEb>To observe the HBV serum markers and HBV DNA expressions of the neonates born to the HBsAg-positive mothers.
<b>METHODSb>By detecting serum immunity markers of hepatitis B virus (5 items) and serum HBV DNA of 283 neonates (a pair of twins) born to 282 HBsAg-positive mothers.
<b>RESULTSb>12 patterns emerge from the study of the hepatitis B serum markers of 283 neonates. Topping the list is the combination of HBeAg and anti-HBc positive accounting for 48.41% (137/283), followed by the combination of anti-HBe and anti-HBc positive accounting for 22.26% (62/283). The third highest combination is that of HBsAg, HBeAg and anti-HBc positive accounting for 12.37% (35/283). There are five combinations accounting for 16.61% (47/283), each with HBsAg-positive. No case is found of the five items all negative or only HBsAb positive. Five cases are detected of serum HBV DNA > or = 1 x 103 IU/ml accounting for 1.77%.
<b>CONCLUSIONSb>Neonates born to HBsAg-positive mothers display complex patterns of serum hepatitis B markers, the dominant pattern being the combination of HBeAg and anti-HBc positive. Cases of serum HBV DNA > or = 1 x 10(3) IU/ml are rare.
Biomarkers ; blood ; DNA, Viral ; analysis ; Female ; Hepatitis B ; transmission ; Hepatitis B Antibodies ; blood ; Hepatitis B Core Antigens ; blood ; Hepatitis B Surface Antigens ; blood ; Hepatitis B e Antigens ; blood ; Humans ; Infant, Newborn ; Infectious Disease Transmission, Vertical ; Male
6.Analysis of relationship of HBV PreS1 antigen, anti-HBc IgM, DNA load and genotypes in hepatitis B patients.
Wang-Sen QIN ; Li-Ping SHEN ; Shuang ZHANG ; Wen-Jiao YIN ; Fing WANG
Chinese Journal of Experimental and Clinical Virology 2012;26(5):328-330
<b>OBJECTIVEb>To explore the relationship of HBV PreS1 antigen, anti-HBc IgM, DNA load and genotypes, and the significance for clinical diagnosis and prognostic.
<b>METHODSb>Enzyme linked immune-sorbent assay was used to test the HBV serum markers of HB patients; HBV-DNA copies was detected by time fluorescence quantitative PCR; using nested PCR to amplify the S fragment of HBV genome, then sequence and make blast with HBV standard sequences to ascertain genotypes. Make comprehensive analysis of these indexes.
<b>RESULTSb>355 serum specimens of acute or chronic HB patients were collected. The positive rates of HBV PreS1-Ag and HBV-DNA in model I (positive for HBeAg) were 80.2% and 73.7% respectively, which both higher than other models. The abnormal rate of ALT and AST were higher in PreS1-Ag positive group than negative, as well as in anti-HBc IgM positive group. There are 4 samples is genotype B (2.9%), 76 genotype C (55.9%) and 56 genotype D (41.2%). Positive rate of HBeAg and HBV-DNA of genotype C samples were both higher than which of genotype B and D.
<b>CONCLUSIONb>PreS1-Ag and Anti-HBe-IgM indexes are of great value to viral hepatitis B early diagnosis, HBV replication surveillance and prognostic evaluation; the major HBV genotypes in Henan province are C and D, and the positive rate of HBeAg and HBV-DNA were both higher in genotype C HBV infection population than genotype B and D.
Adolescent ; Adult ; Aged ; DNA, Viral ; blood ; Female ; Genotype ; Hepatitis B ; immunology ; virology ; Hepatitis B Antibodies ; blood ; Hepatitis B Core Antigens ; immunology ; Hepatitis B Surface Antigens ; blood ; Humans ; Immunoglobulin M ; blood ; Male ; Middle Aged ; Protein Precursors ; blood ; Viral Load ; Virus Replication
7.Development of time-resolved fluoroimmunoassay kit for detection of IgM antibodies against hepatitis B core antigen.
Ni-ya HU ; Zhi-ning DONG ; Zhuo-long ZHOU ; Ming LI ; Ying-song WU
Journal of Southern Medical University 2009;29(1):84-86
<b>OBJECTIVEb>To prepare a time-resolved fluoroimmunoassay (TRFIA) kit for clinical detection of IgM antibodies to hepatitis B core antigen (HBc).
<b>METHODSb>Immunocapture method was used to develop the TRFIA kit for detection of the anti-HBc IgM antibodies, and the precision, cross-reactivity and sensitivity of the kit were tested with the clinical serum samples.
<b>RESULTSb>The intra- and inter-assay coefficients of variation of the TRFIA kit were 4.8%-7.2% and 7.5%-8.6%, respectively, and no cross-reactivity with anti-HBs, anti-HBc-IgG or anti-HBe was found. Comparison of the results of the TRFIA kit and enzyme-linked immunosorbent assay (ELISA) demonstrated greater sensitivity of the kit than ELISA in detecting the anti-HBc IgM antibodies in 584 serum samples. According to the detection results in 300 serum samples from healthy donors, the cutoff value of the TRFIA kit was 4.5 times of the fluorescence value of the negative control.
<b>CONCLUSIONb>This TRFIA kit for detecting anti-HBc IgM antibodies meets the demand for clinical application and can replace the ELISA kits.
Fluoroimmunoassay ; methods ; Hepatitis B ; immunology ; virology ; Hepatitis B Antibodies ; blood ; Hepatitis B Core Antigens ; immunology ; Humans ; Immunoglobulin M ; blood ; Reagent Kits, Diagnostic ; Sensitivity and Specificity
8.Matching study on immune response between single anti-HBc positivity and healthy adults after primary immunization and revaccination of hepatitis B vaccine.
Jiaye LIU ; Jingjing LYU ; Bingyu YAN ; Yi FENG ; Li ZHANG ; Aiqiang XU
Chinese Journal of Epidemiology 2014;35(10):1091-1094
<b>OBJECTIVEb>To compare the antibody response between adults with hepatitis B virus (HBV) core antibody (anti-HBc) single positivity and healthy adults after primary immunization and revaccination of hepatitis B vaccine(HepB).
<b>METHODSb>Adults aged from 18 to 49 who were both negative for HBV surface antigen (HBsAg) and antibody to HBsAg (anti-HBs), but positive for anti-HBc and narrated no history of HepB immunization by themselves, were selected as single anti-HBc positive group ('anti-HBc alone'). Adults who were negative for HBsAg, anti-HBs and anti-HBc, with age differences within 2 years, and same gender under the 1 : 1 matching program, were selected to form the control group. Both groups were vaccinated on 0-1-6 schedule with the same HepB. Those who were non-response to HepB at primary immunization were revaccination on 0-1-6 schedule. Response rates and geometric mean concentrations (GMC) between the two groups were compared.
<b>RESULTSb>In total, the number of anticipants were 228 pairs. Rates on non-response, low-response, normal-response and high-response after the primary immunization were 8.77% , 11.84%, 31.14% and 48.25% in the control group respectively. The corresponding rates were 8.33%, 30.70%, 35.96% and 25.00% in the 'anti-HBc alone'. The rate of low-response in the control group was lower than that in the 'anti-HBc alone' (χ(2) = 22.28, P < 0.01), while the rate of high-response was higher than that in the control group (χ(2) = 24.43, P < 0.01). GMC of anti-HBs in the control group (534.07 mIU/ml) was higher than that in the 'anti-HBc alone' (183.99 mIU/ml) (u = 4.42, P < 0.01). The anti-HBs conversion rates were 82.35% and 41.18% in the control group and in the 'anti-HBc alone' respectively after the first-dose revaccination, but increased to 90.00% and 82.35% after the third-dose revaccination. The anti-HBs conversion rates in the control group were higher than that in the 'anti-HBc alone' after the first-dose revaccination (P < 0.05), while there was no difference seen between the two groups after the third-dose revaccination (P > 0.05).
<b>CONCLUSIONb>Immune response in the anti-HBc positive adults after primary immunization was weaker than that in common adults. However, immune response induced by HepB was enough to prevent them from infecting HBV. The rates of response showed an obvious increase after revaccination, hence the same HepB immunization strategy could be used.
Adolescent ; Adult ; Hepatitis B ; immunology ; prevention & control ; Hepatitis B Antibodies ; blood ; Hepatitis B Core Antigens ; immunology ; Hepatitis B Surface Antigens ; blood ; Hepatitis B Vaccines ; immunology ; Humans ; Immunization, Secondary ; Middle Aged ; Vaccination ; Young Adult
10.Study on the immuno-effects of recombinant hepatitis B vaccination in adults.
Feng-mei ZHANG ; Qing-xin ZHAO ; Jing-hua HAN ; Quan-he ZHOU ; Mao-ci WANG ; Wei MIAO ; Ruo LI
Chinese Journal of Epidemiology 2003;24(8):697-699
<b>OBJECTIVEb>To evaluate the immuno-effects of hepatitis B (HB) vaccination in adults.
<b>METHODSb>Five groups were sampled by means of cluster sampling, and serum HBsAg, anti-HBs and anti-HBc were tested in every group at people aged from 18 to 50. Recombinant HB vaccine was injected to the ones that HBsAg, anti-HBs and anti-HBc were all negative. Concentration of anti-HBs in serum was tested after one year and three years of vaccination. Immuno-effects of recombinant HB vaccination in adults at different ages and between sexes, were then calculated.
<b>RESULTSb>Good immuno-effects of recombinant HB vaccination in adults were noticed. After one year and three years of vaccination with 5 micro g recombinant HB vaccine, the anti-HBs positive rates were 82.76%, 70.77% while the serum concentrations of anti-HBs were 55.91 mIU/ml and 35.41 mIU/ml respectively. When 10 micro g was used, the concentrations were 83.74%, 72.22%, 56.89 mIU/ml and 30.29 mIU/ml respectively. The effects did not show significant differences between different doses on 10 micro g and of 5 micro g. Concentration of anti-HBs reduced when time went by. The factors such as age and sex influenced the effects of immunity on recombinant HB vaccination.
<b>CONCLUSIONb>Good immunity could be obtained when recombinant hepatitis B was vaccinated in vulnerable population aged 18 to 50.
Adolescent ; Adult ; Female ; Hepatitis B ; prevention & control ; Hepatitis B Antibodies ; blood ; Hepatitis B Core Antigens ; immunology ; Hepatitis B Surface Antigens ; immunology ; Hepatitis B Vaccines ; immunology ; Humans ; Male ; Middle Aged ; Vaccination ; Vaccines, Synthetic ; immunology