1. Hepatitis B virus
ã€Reference】
The hepatitis B indexes were negative by ELISA and negative by RIA.
ã€Clinical Significance】
1. HBsAg positive is seen in the incubation period of acute hepatitis B, which peaks at the time of onset; if it does not turn negative 3 months after onset, it will easily develop into chronic hepatitis B or cirrhosis. Carrier HBsAg was also positive. HBsAg itself is not contagious; but because it often coexists with HBV, it is often used as one of the infectious signs.
2. Anti-HBs is a protective antibody. Positive anti-HBs indicates that the body has a certain degree of immunity to hepatitis B virus. Anti-HBs generally appear only 3 to 6 months after onset, and can last for many years. Those who have been injected with hepatitis B vaccine or anti-HBs immunoglobulin, anti-HBs may show a positive reaction.
3. HBeAg positive indicates that hepatitis B is in the active phase and is highly infectious. Positive pregnancy can cause vertical transmission. HBeAg continued to be positive, indicating that hepatocyte damage is severe and can be converted to chronic hepatitis B or cirrhosis.
4. Anti-HBe positive: those with anti-HBe positive in the acute phase of hepatitis B, easy to progress to chronic hepatitis B; those with chronic active hepatitis who have anti-HBe positive can progress to cirrhosis; HBeAg and anti-HBe are positive, And when ALT increases, it can progress to primary liver cancer. Anti-HBe positive means that most of the hepatitis B virus is eliminated, replication is reduced, and infectivity is reduced, but it is not non-infectious.
5. Anti-HBc as a sensitive indicator of HBsAg negative HBV infection. It is mostly positive among HBsAg carriers. The anti-HBc test can also be used for the safety identification of hepatitis B vaccines and blood products and the selection of blood donors. Anti-HBcIgG has no protective effect on the body, and its positive can last for decades or even lifetime. Medical Education Network
6. HBeAg positive indicates that there is infectious HBV in the patient's serum, and its high content indicates active replication, strong infectivity, and poor prognosis. But it is not easy to detect, so it is usually not included in the five tests of hepatitis B.
HBV marker detection and analysis
HBsAg HBeAg anti-HBc anti-HBe anti-HBs detection results analysis + +----Acute HBV infection early, HBV replication is active + + +--Acute or chronic HB, HBV replication is active +-+---Acute or chronic HB, HBV replication is weakened ＋ ï¼ ï¼‹ ＋ ï¼ Acute or chronic HB, weakened HBV replication ï¼ ï¼‹ ＋ ï¼ ï¼ Previous HBV infection, no anti-HBs produced ï¼ ï¼ ï¼‹ ＋ ï¼ ï¼ Anti-HBs pre-emergence stage, low replication of HBV ï¼ ï¼‹ ＋ ＋ HBV infection Recovery stage ï¼ ï¼‹ ＋ ＋ HBV infection recovery stage ＋ ＋ ＋ — ＋ HBV reinfection of different subtypes (variants) ＋ ï¼ ï¼ ï¼ ï¼ HBV-DNA is in a state of integration ï¼ ï¼ ï¼ ï¼‹ Obtained after getting sick or receiving HB vaccine Sexual immunity ï¼ ï¼‹ ＋ ï¼ ï¼ Results of HBsAg mutation ＋ ï¼ ï¼‹ ＋ Surface antigen, e antigen mutation2. Hepatitis A virus markers
1. Hepatitis A virus antigen (HAVAg) and RNA determination:
[Reference value] ELISA and RIA method: negative
ã€Clinical Significance】
HAVAg positive is seen in patients with hepatitis A, about 70% to 87% of patients are positive. HAV-RNA positive is specific for the early diagnosis of hepatitis A, and can be used to detect fecal detoxification and water and food contamination.
2. Determination of hepatitis A virus antibody (anti-HAV):
ã€Reference】
ELISA method: anti-HAVIgM, anti-HAVIgA are negative; anti-HAVIgG positive can be seen in the population after infection.
ã€Clinical Significance】
Anti-HAVIgM positive specific early diagnosis indicators; anti-HAVIgG positive in the late recovery, and can persist, suggesting that there is a previous infection, is a sign of gaining immunity.
3. Hepatitis C virus (HCV) markers
(1) Determination of hepatitis C virus RNA (HCV-RNA):
[Reference value] Dot hybridization method and RT-PCR method: negative
ã€Clinical Significance】
Positive results: â‘ In the early diagnosis of HCV infection, positive HCV-RNA indicates that HCV replication is active and highly infectious; turning negative indicates HCV replication inhibition and a good prognosis. â‘¡ Dynamically observe the changes of HCV-RNA and anti-HCV, which can be used as prognostic judgment and evaluation indicators of the efficacy of drugs such as interferon.
(2) Detection of hepatitis C virus antibody (anti-HCV):
[Reference value] ELISA and RIA method: negative.
ã€Clinical Significance】
Positive result: â‘ Anti-HCV positive is an infectious sign, not a protective antibody. â‘¡ In chronic hepatitis C, the positive rate of anti-HCV is about 70% to 80%, so negative people cannot rule out the possibility of hepatitis C. â‘¢IgM is mainly used for early diagnosis. Persistent positive can be used as an indicator for the development of chronic hepatitis, or it may indicate that the virus persists and has the ability to replicate. â‘£ Positive IgG indicates HCV infection and cannot be used as an early diagnosis indicator.
4. Hepatitis D virus (HDV) marker
(1) Determination of hepatitis D virus antigen (HDVAg) and antibody (anti-HDV):
[Reference value] IFA, RIA, ELISA method: negative.
ã€Clinical Significance】
Antigen detection: HDVAg appears early, but only lasts 1 to 2 weeks. HDVAg and HBsAg are positive at the same time, indicating that the hepatitis D and B viruses are infected at the same time, and the patient can rapidly develop chronic or acute severe hepatitis.
Antibody test: â‘ IgG positive: can only be measured in HBsAg positive serum, it is a reliable indicator for diagnosis of hepatitis D, even after HDV infection is terminated, it can be maintained for many years; â‘¡ IgM appears earlier, generally lasts 2 to 20 weeks, and can be used for Early diagnosis of hepatitis D. Medical Education Network
(2) Determination of hepatitis D virus RNA (HDV-RNA):
[Reference value] RT-PCR method: negative.
ã€Clinical Significance】
HDV-RNA positive, can be definitely diagnosed as hepatitis D.
5. Hepatitis E virus (HEV) markers
(1) Determination of IgM and IgG of hepatitis E virus antibodies:
[Reference value] RIA, ELISA method: negative
ã€Clinical Significance】
Positive results: â‘ Anti-HEV-IgM positive, it can be diagnosed that the patient is infected with HEV, which is a diagnostic indicator of acute infection; â‘¡ The anti-HEV-IgG titer of the recovery period of hepatitis E is more than or equal to 4 times of the acute phase, suggesting a new infection Have diagnostic significance.
(2) Hepatitis E virus RNA (HEV-RNA) determination:
[Reference value] RT-PCR method: negative.
ã€Clinical Significance】
Positive results: â‘ Early diagnosis of infection; â‘¡ Confirmation of antibody test results; â‘¢ Judgment of patient detoxification period; â‘£ Molecular epidemiological studies.
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