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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-HEVIgA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。
Hepatitis E (HE) is an acute infectious disease transmitted by the digestive tract caused by Hepatitis E virus (HEV). The incidence is increasing year by year. There is no specific treatment and no specificity Passive and active immune agents are preventable. In patients with acute hepatitis E, HEV RNA in blood or stools has a short duration, complicated operation and high cost, and can not be widely applied clinically. HE diagnosis mainly relies on serum HEV antibody detection, anti-HEV IgM is one of the diagnostic indicators of HE acute infection, the presence of rheumatoid factor can affect serum IgM detection, resulting in false positive. Anti-HEV IgG is usually detectable 2 weeks after onset and can last for 1 year or even several years. Therefore, anti-HEV IgG can not identify patients with acute or previous HEV infection. Studies have shown that anti-HEVIgA is an acute indicator of HE, can replace or assist the existing IgM diagnostic reagents for HE diagnosis, both to increase the specificity of the test, but also effectively reduce the missed diagnosis.