一例H7N9禽流感感染病例病毒载量、耐药性与抗体水平变化分析

石伟先; 潘阳; 赵佳琛; 崔淑娟; 彭晓旻; 卢桂兰; 张代涛; 刘医萌; 吴双胜; 杨鹏; 陈丽娟; 王全意

doi:10.3784/j.issn.1003-9961.201.06.011

一例H7N9禽流感感染病例病毒载量、耐药性与抗体水平变化分析

Analysis on viral load, drug resistance and specific antibody level of a human case infected with influenza A (H7N9) virus in Beijing

摘要

摘要: 目的通过对北京市1例人感染H7N9禽流感病例连续检测H7N9病毒及血清抗体，掌握H7N9病毒载量、抗体、耐药性在病程发展中的变化。方法以24 h为间隔，共收集病例的下呼吸道盥洗液样本25份，血清样本23份。采用实时荧光定量反转录聚合酶链反应（real-time RT-PCR）法监测病程发展中下呼吸道盥洗液样本中的H7N9病毒载量变化、神经氨酸酶（NA）基因上R294K耐药位点变化；采用血凝抑制实验监测病例病程发展中血清样本中H7N9抗体水平变化。结果随着病程进展和临床抗病毒治疗的进行，病例H7N9禽流感病毒载量逐渐降低，抗体水平逐渐升高。病程后期部分样本中发现少量NA基因R294K耐药突变。结论 real-time RT-PCR和血凝抑制试验可用于人感染H7N9禽流感患者的病毒载量、耐药性变化和抗体水平变化监测，为临床救治提供依据。

Abstract: Objective To understand the changes of the viral load, antibody level and drug resistance during illness of human infection with influenza A (H7N9). Methods A total of 25 bronchoalveolar lavage fluids and 23 blood samples were collected from 1 case of infection with influenza A (H7N9) virus in Beijing at interval of 24 hours. Real-time RT-PCR was performed to evaluate the viral load of H7N9 virus and determine the R294K mutation in NA protein. Hemagglutination inhibition test was conducted to evaluate the H7N9 virus specific antibody level. Results Along with the disease progress and antiviral therapy, the viral loads of H7N9 virus decreased gradually, meanwhile the titer of H7N9 virus specific antibody increased. Mild R294K mutation occurred in NA protein in some samples in late phase. Conclusion Quantitative real-time RT-PCR assay and hemagglutination-inhibition test can be used to monitor the changes of viral load, drug resistance and the specific antibody level of H7N9 virus infected persons in clinical treatment.

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