陕西、青海、新疆三省(区)部分人群庚型肝炎病毒血清学调查

目的：调查陕西、青海、新疆三省（区）部分人群庚型肝炎病毒（HGV／GBV）血清学特征。方法：采用ELISA方法，共调查三省（区）1469份血清中GBV－IgG抗体。结果：少数民族血清GBV－IgG抗体的阳性率（藏族4．11％，蒙古族5．36％，维吾尔族4．55％，回族4．00％）略高于汉族（1．36％－1．73％），但差异无显著性（P＞0．05）；吸毒人群GBV－IgG阳性率（11．30％，34／301）明显高于正常人群（2．44％，18／736），（P＜0．01）；献血员GBV－IgG阳性率为1．02％－7．68％。结论：三省区民族间GBV－IgG抗体阳性差异无显著性，血源性传播是其重要途径，应加强对献血员及吸毒人员的监管。     

慢性乙型肝炎患者血清和肝组织中HBV DNA含量与庚型肝炎病毒感染的关系

目的：观察慢性乙型肝炎（CH－B）患者血清、肝组织中HBV DNA含量与庚型肝炎病毒（HGV）感染的关系，探讨HGV感染对CH－B患者乙型肝炎病毒（HBV）复制的影响。方法：应用逆转录－聚合酶链反应（RT－PCR）、免疫组织化学法、荧光定量PCR（FQ－PCR）技术方法对56份CH－B患者血清HGV RNA、肝组织HGV Ag、血清及肝组织中HBV DNA含量分别进行了检测，并将血清HGV RNA与肝组织HGV Ag的表达、HGV RNA、HGV Ag阳性与阴性患者HBV DNA含量分别进行了对比研究。结果：血清HGV RNA、肝组织HGV Ag阳性分别为10份（17．9％）、8份（14．3％）。血清HGV RNA阳性与肝组织HGV Ag表达显著相关（P＜0．01），但部分肝组织HGV Ag阴性患者亦有血清HGV RNA表达。血清HGV RNA、肝组织HGV Ag阳性与阴性患者血清及肝组织中HBV DNA含量差异无显著性（P＞0．05）。结论：HGV感染对CH－B患者HBV复制无影响。HGV可在肝脏中复制，但致病性可能较微弱。     

原位杂交法检测非甲～庚型肝炎患者肝组织中TT病毒DNA

目的 证实在非甲－庚型病毒性肝炎患者肝组织中TT病毒（transfusion-transmitted virus,TTV)的存在。方法 采用地高辛素标记TTV DNA探针以原位杂交技术对51例血清学病毒标记非甲－戊型、免疫组化检测肝组织中HBsAg、HCV NS3Ag及HGV N55Aag阴性的病毒性肝炎患者石蜡包埋肝组织进行了检测。结果 各型病毒性肝炎肝组织中TTV基因的总检出率为27．5％,其中急性轻型肝炎的检出率为30．8％（4 ／13）,急性重型肝炎为1／8,亚急性重型肝炎为3／7,慢性肝炎为2／6,活动性肝硬化为2／9,慢性重肝肝炎为1／4,原发性肝癌为1／4。TTV DNA表达于肝细胞核或胞质内,以核型多见。在急性肝炎,TTV阳性细胞弥漫分布于肝小叶内,慢性肝炎于汇管区附近较为密集,而在肝硬化病例,阳性细胞在假小叶内多呈片族状不规则分布。结论 在不明原因病毒性肝炎患者血清及肝组织中TTV DNA的检出表明TTV为一种新型的肝炎病毒,TTV为一种嗜肝性病毒。     

广州地区肝炎患者血清中庚型肝炎病毒核酸检测和病毒核苷酸测序

目的 了解广州地区肝炎患者中庚型肝炎病毒（HGV）的感染情况及基因型特点。方法 采用逆转录－套式聚合酶链反应（RT－nested PCR)方法检测出肝炎患者血清中HGV RNA,引物位于HGV基因组的非编码区,并对扩增产物进行直接测序。结果 251例急慢性肝炎血清中共检出25例HGV RNA阳性,总阳性率为9．96％,其中56例非甲－戊型肝炎中要出4例阳性（7．14％）,77例乙型肝炎（HB）中检出8例阳性（10．39％）,118例丙型肝炎（HC）中检出13例阳性（11．17％）;2株HGV广州核苷酸之间的同源性为98．0％,与非洲洲的同源性分别为81．7％和84．2％,与美国株的同源性均为91．1％。结论 广州地区肝炎患者中存在HGV感染,2株HGV广州株可能为同一基因型,且与HGV美国株具有较高的同源性。     

庚型肝炎病毒NS5区优势抗原表位的表达及其抗原性的初步评价

目的 表达庚型肝炎病毒（HGV）基因且NS5区部分基因重组抗原，分析其抗原性。方法 分别亚克隆了HGV NS5a、NS5b以及NS5b与C区嵌和的基因至pThoiC表达载体上，构建成3个重组表达质粒，分别大肠埃希菌JM109（DE3），用IPTG诱导表达重组蛋白。表达产物经纯化后采用Western blot和间接ELISA方法分析3个重组蛋白的抗原性。结果 经酶切和序列分析鉴定正确，3种表达蛋白均高效表达且相对分子质量与预期大小相符。Western blot分析和间接ELISA试验表明，3种表达蛋白均能与抗－HGV阳性血清发生特异性反应。将应用重组蛋白检测的抗－HGV抗体与混合重组抗原（包括C区合成肽、NS5a合成肽、NS3区基因重组抗原）的检测结果进行了比较，在混合重组抗原阳性的22份血清中，P5a检出率为68％（15／22），P5b检出率为91％（20／22），Pc-5b检出率为73％（16／22）。在70份阴性标本中，3种抗原的检出率分别为P5a:7%(5/70);P5b:1%(1/70);Pc-5b:6%(4/70)。3个重组抗原单独检出阳性的标本，其中有一部分经RT－PCR检测亦为阳性。结论 原核表达的NS5区蛋白所检测的抗－HGV抗体不能完全被其他区段的抗原所覆盖，是免疫诊断HGV感染所必需的抗原表位之一。     

从MT2、HeTa细胞DNA及人和黑猩猩PBMC DNA中扩增GBV—C核苷酸同源序列的研究

目的 检测MT2和LeLa细胞DNA、6例人和1例黑猩猩PBMC DNA中是否存在与GBV－C同源的核苷酸序列。方法 直接以上述DNA为模板、采用GBV－C 5′－NCR和NS53区引物的直接套式PCR（dPCR)、核苷酸序列分析、引物介导原位扩增（PRINS）DNA序列特异荧光标记技术。结果 从MT2和HeLa细胞DNA、4例人PBMC DNA标本中获得5′－NCR引物扩增片段,从MT2和HeLa细胞DNA、5例人和黑猩猩PBMC DNA标本中获得NS3区引物扩增片段。这些扩增产物的核苷酸序列与GBV－C同源性分别为74．29％－77．14％和73．80％－79．15％。PRINS检测结果显示,dPCR阳性的PBMC及其染色体上有荧光着色。结论 MT2和HeLa细胞DNA、人和黑猩猩PBMC DNA中存在与PBMC及其染色体上有荧光着色。结论 MT2和HeLa细胞DNA、人和黑猩猩PBMC DNA中存在与GBV－C 5′－NCR和／或NS3区同源性较高的核苷酸序列,这些序列可能位于dPCR阳性的PBMC染色体上。     

丙型肝炎病毒E1抗体检测及临床应用

目的：研究丙型肝炎患者血清中HCV E1抗体，确定HCV E1抗原在抗体检测中的应用价值。方法：应用酶联免疫吸附测定（ELISA）方法检测80份卫生部第3代HCV血清参比品，821例职业献血员血清和720例临床肝炎患者血清中E1抗体。结果：用E1抗原单包板检查80份卫生部血清参比品的阳性符合率为70％、阴性符合率为100％；从821例职业献血员血清样品中检出E1抗体阳性率为1．9％；从720例临床肝炎患者血清中检出E1抗体阳性率为68％。大部分E1抗体阳性血清，同时也能和HCV的Core、NS3抗原及NS5A抗原呈阳性反应，但有个别血清只对E1抗原呈阳性反应。用市购HCV抗ELISA检测试剂盒检测为阴性的218例肝炎科门诊患者、813例献血员和848例一般人群血清，用E1抗原单包板复检，检出的阴性率分别为1．4％、1．1％和0．9％。在3例患者血清学转变的追踪研究中，HCV E1抗体都同现最早。结论：用E1工程蛋白检测E1抗体具有较高的灵敏度和特异性。E1抗体在HCV感染患者中普遍存在而且早出现，在临床诊断上是有意义的。     

乙型肝炎病毒E抗原抗体系统的变化与慢性肝病预后的关系

为了探索乙型肝炎病毒（HBV）E抗原抗体系统的变化与慢性肝病的肝损程度及肝癌发生是否有关系，本文采用Elisa法对243例不同慢性肝病患者进行乙型肝炎病毒E抗原抗体系统检测，同时采用PCR法进行HBVDNA的检测．其结果提示：180例抗-HBe阳性的血清检出101例HBVDNA阳性，其阳性率为56％（101／180）；同时发现抗-HBe的检出率在肝细胞癌（HCC）组、肝炎后肝硬化（LC）组、慢性肝炎（中、重度CH）组中分别为83％（57／69）、78％（54／69）、75％（54／72），明显高于慢性肝炎（轻度CH）组，其检出率为45％（15／33）．结果说明：HBeAg阴转和／或抗-HBe阳转并不意味着病毒复制水平明显降低，临床不具传染性；而且抗-HBe的出现与加重肝细胞损害程度或肝细胞癌变可能有一定的关系，不能忽视对病程的随访与监测。     

庚型肝炎病毒（HGV）的分子生物学及免疫学研究进展

庚型肝炎病毒（HGV／GBV－C）为单股正链RNA病毒（SSRNA＋），同丙型肝炎病毒（HCV）具有相似的基因结构，但两者有许多不同之处。本文仅就庚型肝炎病毒的分子生物学及免疫学作了综述。     

病毒性肝炎肝细胞凋亡及与肝纤维化的关系

目的 研究病毒性肝炎肝细胞凋亡及与肝纤维化的关系。方法 以原位末端标记及免疫组化检测４０例慢性病毒性肝炎（ＣＨ）肝组织细胞调亡相关线状断裂ＤＮＡ以及Ｆａｓ抗原、转化生长因子β１（ＴＧＦ－β１）、Ⅲ型前胶原肽（ＰⅢＰ）在肝组织中的表达;以酶联免疫吸附测定（ＥＬＩＳＡ）检测血清可溶性Ｆａｓ（ｓＦａｓ）及ＴＧＦ－β１。结果 ＣＨ肝细胞ＤＮＡ损伤与肝组织Ｆａｓ抗原、ＴＧＦ－β１表达及血清ｓＦａｓ、ＴＧＦ－     

GBV-C/HGV infection in hepatitis C virus-infected deferred Swedish blood donors

Sera from 62 hepatitis C virus (HCV)-infected Swedish blood donors were tested by a nested polymerase chain reaction using primers targeting the 5′-noncoding region of the GB virus-C/hepatitis G (GBV-C/HGV) genome and an enzyme-linked immunosorbent assay that detects antibodies to the envelope protein E2 of GBV-C/HGV (anti-E2). Fourteen (22%) and 21 (34%) of the 62 blood donors were found to be GBV-C/HGV RNA and anti-E2 positive, respectively. None of the blood donors was positive for both GBV-C/HGV RNA and anti-E2. Thus, 35 of 62 (56%) HCV-infected donors had been exposed to GBV-C/HGV infection. At sequencing of the 14 GBV-C/HGV isolates, 12 were identified as subtype 2a and 2 as subtype 2b. One of 7 (14%) donors with mild liver disease such as steatosis and nonspecific reactive hepatitis had been exposed to GBV-C/HGV vs. 34 of 55 (62%) with chronic hepatitis with or without cirrhosis (P = 0.04). All other differences in histology were small between HCV and dual HCV GBV-C/HGV-infected donors. In conclusion, more than half of HCV-infected Swedish blood donors in this study were positive for either GBV-C/HGV RNA or anti-E2. GBV-C/HGV viremia and seropositivity were mutually exclusive. J. Med. Virol. 54:75–79, 1998. © 1998 Wiley-Liss, Inc.     

GBV-C/hepatitis G virus in acute nonA-E hepatitis and in acute hepatitis of defined aetiology in Italy

The role of GBV-C/HGV in the aetiology of acute non A-E hepatitis and its impact on the course of acute hepatitis of defined aetiology were investigated by detecting viral RNA by RT-PCR and antibody to the E2 protein of GB virus C (anti-E2) by EIA. Ninety-eight patients with acute nonA-E hepatitis, 35 patients with acute hepatitis A, 63 with acute hepatitis B, 29 with acute hepatitis C and 270 controls were enrolled in this study. The prevalence of GBV-C/HGV RNA was similar among patients with acute nonA-E hepatitis (3.1%), with acute hepatitis A (2.9%), and controls (3.7%), but significantly higher (P < 0.05) among those with hepatitis B or C (19.0% and 48.3%, respectively). Similar figures were obtained considering the total rate of GBV-C/HGV exposure (viral RNA or anti-E2 positivity). The majority (24/30 or 80%) of GBV-C/HGV RNA positive patients reported a parenteral source of exposure whereas the remaining 20% denied having known risk factors. The liver function test values and the rate of chronic hepatitis B and C were similar in patients co-infected and in those not co-infected with GBV-C/HGV. This study excludes a significant role of GBV-C/HGV infection in the aetiology of acute nonA-E hepatitis in Italy. Concomitant GBV-C/HGV and HBV or HCV infection does not worsen the clinical course of illness among patients with acute hepatitis.     

Correlation of interferon treatment response with GBV-C/HGV genomic RNA and anti-envelope 2 protein antibody

The clinical significance of GB virus C/hepatitis G virus (GBV-C/HGV) co-infection was studied retrospectively in 100 consecutive patients with hepatitis C virus (HCV) infection. All 100 patients had been treated with interferon-alpha (IFN-alpha). Co-infection with GBV-C/HGV and HCV was detected in 10 of the 100 patients (10%) and anti-envelope 2 region (anti-E2) antibody was detected in 25 patients. None of the patients with GBV-C/HGV RNA had anti-E2 antibody. Co-infected patients were younger (P < .005) and their serum transaminase levels were lower than HCV-only infected patients (P< .01). In 7 of the 10 co-infected patients, HCV RNA was eradicated from serum after IFN-alpha treatment and normal alanine transaminase (ALT) levels continued in 6 of these 7 patients. In one patient who was negative for HCV RNA but positive for GBV-C/HGV RNA, the ALT level relapsed transiently. The rate of clearance of HCV and normalization of the ALT level was significantly higher in co-infected patients than in HCV-only infected patients (P < .05). GBV-C/HGV RNA disappeared from 6 of the 10 co-infected patients (60%) upon cessation of IFN-alpha treatment. However, continuous clearance of GBV-C/HGV was observed in only two patients and anti-E2 antibody could not be detected in the serum of these patients. These results indicate that co-infected patients tend to be younger and more sensitive to IFN-alpha treatment. However, long-term clearance of GBV-C/HGV after IFN-alpha treatment may be difficult. Moreover, anti-E2 antibody may act to neutralize GBV-C/ HGV.     

Prospective follow-up of patients with GBV-C/HGV infection: specific mutational patterns, clinical outcome, and genetic diversity

An association between a specific mutational pattern within the nonstructural (NS)3 region of GB virus-C/hepatitis G virus (GBV-C/HGV) genome and fulminant hepatic failure has been suggested recently. The mutational pattern consists of 3-6 nucleotide mutations of which one is leading to an amino acid exchange. In the present study, patients with GBV-C/HGV mono-infection (n = 24) or GBV-C/HGV and HCV co-infection (n = 20) were investigated prospectively. In 6/44 patients (14%) the mutational pattern within GBV-C/HGV NS3 previously associated with fulminant hepatic failure was identified by direct sequence analysis of the NS3 region. All 44 patients were asymptomatic clinically and had normal liver functions at initial presentation and after a median follow-up of 2.2 years. In 22/24 patients with GBV-C/HGV mono-infection and all patients with GBV-C/HGV and HCV co-infection GBV-C/HGV RNA remained detectable at the end of the study period, whereas two patients infected with GBV-C/HGV alone became negative for GBV-C/HGV RNA and developed GBV-C/HGV anti-E2 antibodies indicating recovery from GBV-C/HGV infection. Aminotransferase levels remained elevated or became normal independent of the persistence of serum GBV-C/HGV RNA. The median rate of nucleotide substitutions in GBV-C/HGV mono-infected and HCV co-infected patients was 3.4 x 10(-3) and 3.2 x 10(-3) per site per year, respectively. In conclusion, the prevalence of the mutational pattern within NS3 region of GBV-C/HGV associated previously with fulminant hepatic failure is about 14% and not associated specifically with severe liver disease. Over a median follow-up of 2.2 years less than 5% of patients cleared spontaneously GBV-C/HGV and no correlation between viraemia and elevated liver enzymes was observed.     

High prevalence of GB virus C/hepatitis G virus infection in different risk groups of HIV-infected patients

Objectives: To investigate the prevalence of GB virus C (GBV-C)/hepatitis G virus (HGV) RNA and anti-E2 antibodies in different risk groups of HIV-infected patients compared to that in healthy blood donors, and to study the effects of possible interactions between HIV and GBV-C/HGV on the carrier state and hepatic changes.
Methods: Sera from 100 consecutive unselected HIV-infected outpatients and from 100 healthy blood donors were screened for GBV-C/HGV viremia and anti-E2 antibodies. Anti-E2 antibodies were detected using an immunoassay developed by Boehringer Mannheim according to the manufacturer's instructions. GBV-C/HGV RNA was extracted from sera and reverse transcribed. The resulting cDNA was amplified with a PCR developed in the laboratory with primers derived from the 5' noncoding region of the viral genome and detected with a specific capture probe. This procedure was validated by a French multicenter quality control group.
Results: Thirty-one of the 100 HIV-infected patients and 8% of the healthy blood donors displayed anti-E2 antibodies. Four HIV-infected patients and one healthy blood donor were found to be GBV-C/HGV viremic. When analyzed by risk factor for the acquisition of HIV, no differences in the prevalence of anti-E2 antibodies were found between intravenous drug users and homosexual and heterosexual patients.
Conclusions: We found a high prevalence of GBV-C/HGV infection in the HIV-infected population, irrespective of the risk group factor for HIV infection, suggesting that the sexual route is as effective as the parenteral route for the acquisition of GBV-C/HGV. No biological alteration could be attributed to GBV-C/HGV, even in the viremic patients. HIV-infected patients were able to clear GBV-C/HGV viremia and to mount a humoral immune response.