携帯ESRの応用(8)-DNA検査より高感度:ラジカルイムノアッセイ法の英語版
Journal of Hepatology 49 (2008) 17?24。
What can be revealed by extending the sensitivity of HBsAg detection to below the present limit?
Hitoshi Togashi1,*, Chika Hashimoto1, Junji Yokozawa1, Akihiko Suzuki1,
Kazuhiko Sugahara1, Takafumi Saito1, Ichiro Yamaguchi2, Hala Badawi3,
Norikazu Kainuma4, Masaaki Aoyama5, Hiroaki Ohya5, Takao Akatsuka5,
Yasuhito Tanaka6, Masashi Mizokami6, Sumio Kawata,
1Department of Gastroenterology, Course of Internal Medicine and Therapeutics, Yamagata University Faculty of Medicine,
Yamagata University Health Administration Center, 1-4-12 Kojirakawa-machi, Yamagata 990-8560, Japan
2Murayama Public Health Center, Yamagata Prefecture, Japan
3Medical Microbiology, Theodor Bilharz Research Institute, Giza, Egypt
4Tohoku Seiki Industries, Ltd., Yamagata, Japan
5Institute for Life Support Technology, Yamagata Public Corporation for Development of Industry, Yamagata, Japan
6Department of Clinical Molecular Informative Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
Background/Aims:We investigated what can be revealed by extending the sensitivity of HBsAg detection to below the present limit.
Methods:We examined the sensitivity of this immunoassay in comparison with real-time PCR detection of HBV DNA using serially diluted sera from HBV carriers. Low HBsAg was measured in 210 healthy volunteers and 368 patients with non-B chronic liver diseases who were negative for HBsAg by a standard EIA method.
Results: The radical immunoassay was able to detect HBsAg at a concentration of 0.025 ng /ml. Low HBsAg was positive in 6 of 210 normal volunteers (2.86%), 5 of 65 non-B, non-C cirrhosis patients (7.69%), 6 of 62 non-B, non-C hepatocellular carcinoma patients (9.68%: p = 0.04 vs. volunteers), 12 of 134 chronic hepatitis C patients (8.96%: p < 0.02 vs. volunteers), and 11 of 107 hepatocellular carcinoma patients complicated by chronic hepatitis C (10.28%: p < 0.008 vs.volunteers). Although no HBV DNA was positive in healthy volunteers, 9 patients with non-B chronic liver diseases were positive for HBV DNA by real-time PCR analysis.
Conclusions: Increasing the sensitivity of HBsAg detection to below the present limit has revealed that infection with HBV, including occult HBV, is far more endemic than suspected previously.