目的探讨血清ＨＢｅＡｇ阴性（双抗体夹心法）与ＨＢｅＡｇ／ＩＣ形成及ＨＢＶ变异株Ａ１８９６的关系，评价ＨＢｅＡｇ／ＩＣ检测的临床意义．方法单克隆抗ＨＢｅ固相ＥＬＩＳＡ检测血清中ＨＢｅＡｇ／ＩＣ；套式多聚酶链反应检测ＨＢＶＤＮＡ；３＇碱基特异多聚酶链反应判断Ａ１８９６变异；ＥＬＩＳＡ检测ＨＢｅＡｇ、抗ＨＢｅ，研究对象为１１７例慢性ＨＢＶ感染者，２０例健康对照统计处理采用卡方检验．结果ＨＢｅＡｇ／ＩＣ阳性血清中ＨＢＶＤＮＡ检出率明显高于ＨＢｅＡｇ／ＩＣ阴性血清，Ｐ＜０００１（９１３％ｖｓ３６２％）；２９份ＨＢｅＡｇ阴性、ＨＢＶＤＮＡ阳性血清中仅５例（１７２％）检出Ａ１８９６，而且其中２例与野毒株（Ｇ１８９６）混合感染并伴ＨＢｅＡｇ／ＩＣ阳性．２９份中１７份（５８７％）为ＨＢｅＡｇ／ＩＣ阳性的Ｇ１８９６感染；血清抗ＨＢｅ阳性组Ａ１８９６检出率高于抗ＨＢｅ阴性组，Ｐ＜００５（２５％ｖｓ３２％）．结论ＨＢｅＡｇ／ＩＣ为ＨＢＶ活跃复制指标；临床ＨＢｅＡｇ阴性、ＨＢＶＤＮＡ阳性患者仍多数为Ｇ１８９６感染，ＨＢｅＡｇ／ＩＣ形致双抗体夹心法不能检出ＨＢｅＡｇ；抗ＨＢｅ应答可能为促使前Ｃ变异的重要因素 Objective To investigate the relationship between serum HBeAg negative (double antibody sandwich method) and HBeAg / IC formation and HBV variant A1896 and to evaluate the clinical significance of HBeAg / IC detection. Methods Monoclonal anti- HBe ELISA was used to detect serum HBeAg / IC, nested polymerase chain reaction (PCR) was used to detect HBVDNA, 3¡¯-base specific polymerase chain reaction was used to determine the mutation of A1896. ELISA was used to detect HBeAg and antiHBe in 117 chronic patients HBV infection, 20 healthy controls statistical treatment using chi-square test. Results The positive rate of HBVDNA in HBeAg / IC positive sera was significantly higher than that in HBeAg / IC negative sera (P <0001, 913% vs 362%). In 29 HBeAg negative and HBVDNA positive sera, only 5 (17  2%) detected A1896, and 2 of them were mixed with wild-type strain (G1896) and had positive HBeAg / IC. The detection rate of A1896 in serum anti- HBe positive group was higher than that in anti  BeBe negative group, P <005 (25% vs32%), and 17 of 17 (587%) were HBeAg / IC positive G1896. ). Conclusions HBeAg / IC is an index of active replication of HBV. Clinically positive patients with HBeAg-negative and HBVDNA-positive are still mostly G1896 infection, and HBeAg / IC induced by double antibody sandwich method can not detect HBeAg. Anti- HBe response may be an important factor in promoting pre-C mutation