丁型肝炎病毒感染病原学检测技术的临床应用及研究进展

刘慧敏; 陈文婷; 毛青

doi:10.12449/JCH260203

丁型肝炎病毒感染病原学检测技术的临床应用及研究进展

DOI: 10.12449/JCH260203

刘慧敏^{1, 2},
陈文婷^{1, 2},
毛青^{1, 2, , ,}

1.
陆军军医大学第一附属医院感染病科，重庆 400038
2.
病毒传染病精准防治重庆市重点实验室，重庆 400038

利益冲突声明：本文不存在任何利益冲突。

作者贡献声明：刘慧敏负责查阅文献，起草并撰写论文；陈文婷负责制图、文献查阅；毛青负责拟定写作思路、观点及提纲，修改文章并最后定稿。

详细信息

通信作者:
毛青， qingmao@tmmu.edu.cn（ORCID： 0000-0001-9499-8470）

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出版历程
- 收稿日期: 2025-12-01
- 录用日期: 2026-02-14
- 出版日期: 2026-02-25

Etiological detection techniques for hepatitis D virus infection： Clinical application and research advances

Huimin LIU^{1, 2},
Wenting CHEN^{1, 2},
Qing MAO^{1, 2
, ,
,}

1.
Department of Infectious Diseases，The First Affiliated Hospital of Army Medical University，Chongqing 400038，China
2.
Chongqing Key Laboratory of Infectious Disease Research，Chongqing 400038，China

More Information

Corresponding author: MAO Qing， qingmao@tmmu.edu.cn （ORCID： 0000-0001-9499-8470）

摘要

摘要: 丁型肝炎是由丁型肝炎病毒（HDV）感染引起的严重感染性疾病，其临床表现与转归因感染方式（同时感染和重叠感染）的不同存在差异。本文系统阐述了HDV病原学标志物、HDV感染的筛查策略、临床诊断及治疗管理原则；同时，从病毒结构的特点、基因型及检测技术等角度，探讨了HDV感染病原学检测所面临的挑战，并对该领域的新技术进行了综述，以期为HDV感染者的临床诊疗实践提供参考，并为推动病原学检测技术的标准化与国产化研发提供思路。
- δ肝炎病毒 /
- 病原学 /
- 检测技术
Abstract: Hepatitis D is a severe infectious disease caused by hepatitis D virus （HDV）， and its clinical manifestation and outcome vary depending on the mode of infection （co-infection and super-infection）. This article systematically elaborates on the etiological markers for HDV， screening strategies for HDV infection， clinical diagnosis， and principles for treatment and management. In addition， it also discusses the challenges in etiological detection of HDV infection from the perspectives of the unique structure of the virus， genotypes， and detection techniques and reviews the new techniques in this field， in order to provide a reference for the clinical diagnosis and treatment of patients with HDV and offer new ideas for the standardization and domestication of etiological detection techniques.
- Hepatitis Delta Virus /
- Etiological /
- Detection Technologies

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注： a，HDV/HBV同时感染（co-infection）通常表现为急性肝炎。血清中HDAg可能出现较早，但持续时间短且难以检测；HDV-Ab出现时间较晚；在无法进行HDV RNA检测时，HDV-Ab可能是HDV急性感染的唯一标志物，需通过后续检测记录血清中抗体转换情况。b，HDV的重叠感染（super-infection）可能表现为慢性HBV感染急性恶化。HBsAg阳性且HDV RNA及HDV-Ab检测阳性，可判断为HDV重叠感染，通常伴随HBsAg及HBV DNA水平下降，但HBV和HDV感染持续存在，因此，患者体内仍保持HBsAg、HBV DNA、HDV-Ab以及HDV RNA持续阳性状态^{［ 8］}。HBsAg，乙型肝炎表面抗原；HBV，乙型肝炎病毒；抗-HBs，乙型肝炎表面抗体；HDV，丁型肝炎病毒；HDAg，丁型肝炎病毒抗原；HDV-Ab，丁型肝炎病毒抗体；IgM，免疫球蛋白M；IgG，免疫球蛋白G。

图 1 HDV感染病原学标志物的临床变化

Figure 1. Clinical changes of etiological markers in HDV infection

下载: 全尺寸图片幻灯片

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