【摘要】戊型肝炎(Hepatitis E,HE)是由戊型肝炎病毒(Hepatitis E virus,HEV)引起的经消化道传播的急性传染病,发病率逐年升高,目前尚无特效治疗方法,也无特异性被动和主动免疫制剂可供预防。在急性戊型肝炎患者中,血液或粪便中HEV RNA持续时间较短,操作复杂、成本高,不能在临床广泛开展。HE的诊断主要依靠血清HEV抗体检测,抗-HEV IgM是HE急性感染的诊断指标之一,类风湿因子等的存在会影响血清IgM的检测,造成假阳性。抗-HEV IgG一般在发病2周后可检测到,可持续1年甚至数年,因此抗-HEV IgG不能鉴别患者为HEV急性感染还是既往感染。有研究表明抗-HEV IgA是HE的急性指标,可代替或辅助现有IgM诊断试剂用于HE诊断,既增加了检测特异性,又能有效减少漏诊。

    【关键词】戊型肝炎;戊型肝炎病毒;抗-HEV IgM;抗-HEV IgA;抗-HEV IgG

    【Abstract】 Hepatitis E(HE),as the spread of acute gastrointestinal disease,is caused byhepatitis E virus(HEV).Its morbidity is increasing year and year.However,there is neitherspecific treatment nor specific passive and active immunity drug to prevent against the disease at present.HEV RNA in blood or stool of patients with acute Hepatitis E can not be widely used due to its short existed time,complicated operation and high cost.Diagnosis of Hepatitis E is made by detection of serum anti-HEV antibody.Anti-HEV IgM is a diagnosis index of acute Hepatitis E,which may be influenced by rheumatoid factor,resulting in false positive.Anti-HEV IgG can generally be detected two weeks after the onset of disease and for at least 1 year.Therefor ,it can not be used to distinguish acute infection from previous infection.Study has showed that anti-HEV IgA is a valuable index for diagnosing acute HEV infections,which is an alternative or supplementary antibody of IgM for detecting HEV infection,increasing high specificity and reducing missed diagnosis. ......