血液病患者HBV和HCV感染现况调查

对１４４例血液病患者ＨＢＶ和ＨＣＶ感染状况进行调查，ＨＢｓＡｇ、抗－ＨＢｃ和抗－ＨＣＶ检出率分别为９．７２％、３６．８１％及２４．３１％，而健康对照组分别为１２．０３％、４６．３０％和０．９３％。ＨＣＶ感染率与年龄、性别无关，但与受血史，受血次数密切相关。抗－ＨＣＶ阳性者血清ＡＬＴ水平明显高于抗－ＨＣＶ阴性者，ＨＢＶ／ＨＣＶ重叠感染时ＡＬＴ升高尤为明显，本组调查提示输血及应用血液制品是血液病患者感     

河北省固安县北斜村HCV感染者三年随访研究

笔者对４２例抗０ＨＣＶ阳性者进行了三年随访研究，发现血清ＡＬＴ异常者占１８．１％￣２６．２％，ＨＣＶ ＲＮＡ阳性率为８０％。三年间抗－ＨＣＶ年阴转率仅０．９５％，抗－ＨＣＶ抗体几何平均滴度１６０左右，１９９１年１９９４年检测结果表明抗－ＨＣＶ ＧＭＴ值无明显差异，抗体滴度与血清ＡＴＬ水平以及ＨＣＶ ＲＮＡ无关。     

广西百色地区肝病患者及受血者HCV感染现状调查

笔者应用ＥＬＩＳＡ法对广西百色地区１７９例各类肝病患者及４１例受血者血清进行了抗－ＨＣＶ检测。结果各类肝病抗－ＨＣＶ阳性率为１７．９％，受血者抗－ＨＣＶ阳性率为３１．７％。在急性肝炎（急肝）、慢性肝炎（慢肝）、肝硬化和肝癌中，抗－ＨＣＶ阳性率各为４．３％（１／２３）、１２．８％（１０／７８）、２８．６％（１２／４２）和２５．０％（９／３６）。抗－ＨＣＶ阳性率有随肝病慢性比而增高的趋势，肝硬化的抗－ＨＣＶ阳性率明显高于急肝或慢肝（Ｐ＜０．０５），而肝癌的抗－ＨＣＶ阳性率与急肝或慢肝相差不显著（Ｐ＞０．０５或０．１），且发现ＨＢｓＡｇ阴性肝病者的抗－ＨＣＶ阳性率明显高于ＨＢｓＡｇ阳性患者（Ｐ＜０．５），肝病患者抗－ＨＣＶ的检出率与ＡＬＴ活性无关（Ｐ＞０．０５）。在受血者中，抗－ＨＣＶ的检出率与受血次数、ＡＬＴ活性关系非常密切。因此，加强对ＨＣＶ的检测是当前预防输血后肝炎的紧迫任务。     

丙型肝炎病毒再感染与初次感染对比研究

用套式ＰＣＲ法检测ＨＣＶＲＮＡ，对比研究了ＨＣＶ再感染与初次感染。１０例初次感染ＨＣＶ者，９例为临床型肝炎，１例亚临床型，首次ＡＩ／Ｔ升高距输血的时间为１５～６０天（平均３７．９±１３．９）；抗－ＨＣＶ和ＨＣＶ－ＲＮＡ阳性１年以上分别为１０／１０和７／１０。５例再感染者，４例为临床型肝炎，１例亚临床型，ＡＬＴ首次升高距输血时间为３０～４６天（平均３４．８±６．ｈ），抗－ＨＣＶ和ＨＣＶＲＮＡ阳性１年以上分别为５／５和３／５。结果表明，ＨＣＶ再感染与初次感染在临床表现、ＡＬＴ异常。抗－ＨＣＶ和ＨＣＶＲＮＡ阳性持续时间等均无明显差异，提示ＨＣＶ感染后诱发的免疫力较差，再感染仍可发病。     

太原市健康人群和血液制品抗－HCV调查

１９９２年随机抽取３２９名健康人进行流行病学调查，抽血检测ＡＬＴ和抗－ＨＣＶ。结果抗－ＨＣＶ阳性８人，标化阳性率为４．６４％，均无输血史。男性抗－ＨＣＶ标化阳性率为２．４３％，女性标化阳性率为４．１６％，差异无显著性意义。检测１０岁以前儿童８３人，无１人抗－ＨＣＶ阳性；以后随年龄增长抗－ＨＣＶ阳性率升高，提示ＨＣＶ感染主要发生在成长过程中，垂直传播的意义较小。ＡＬＴ均正常。检测丙种球蛋白８批、白蛋白１０批和血浆１批，抗－ＨＣＶ阳性率分别为１００％、２７．２７％和１／１，流行病学意义值得重视。     

输血后肝炎的随访研究

１９８９～１９９０年对太原地区的输血者及其对照进行随访，在输血前或对照入院一周内采血。输血或对照采首份血后２周、４周、１２周、和２４周采血，检测血清ＡＬＴ、ＨＢＶ感染标志和抗－ＨＣＶ。结果，发生输血后肝炎９例，发病率为１０．４６％，输血后乙型和丙型肝炎的发病率各为６．９７％和２．３２％，未定型为１．１６％；对照组无病发生。ＨＢＶ、ＨＣＶ感染以及ＡＬＴ异常与输血量有关。１０份ＨＢｓＡｇ阳性血输给１０名受血者，仅１例输入ＨＢｓＡｇ和ＨＢｅＡｇ双阳性血后ＨＢｓＡｇ阳转、ＡＬＴ异常。６份抗－ＨＢｃ阳性血的受血者，无异常反应，仅１例输入抗－ＨＢｃ和和ＨＢｅＡｇ双阳性血后，ＡＬＴ升高至５７单位，现有结果显示抗－ＨＢｃ阳性血未引起发病。３例抗－ＨＣＶ阳性血的受血者中，１例－ＨＣＶ阳转，但ＡＬＴ正常。     

丙型肝炎流行地区不同人群的HCV感染状况研究

对发生丙型肝炎流行的固安县不同人群的ＨＣＶ感染状况进行了调查和随访。１９８６年献浆血员、全血血员和非献血成人的肝炎现患率分别为１７．４％、１．５％和１．１％；ＡＬＴ异常率分别为３１．９％、７．８％和５．０％；抗－ＨＣＶ阳性率分别为７９．７％、１２．４％和７．２％。１９９０年随访以上三类人群，抗－ＨＣＶ阳性率分别为４３．９％、６．７％和１．０％；调查献浆为主村、献全血为主村和基本不献血村全人群，抗Ｈ     

新乡铁路辖区不同人群HCV感染现状调查

作者应用ＥＬＩＳＡ法对新乡铁路管辖地区６２０例不同人群进行了丙型肝炎病毒抗－ＨＣＶ检测，平均阳性率为２７％，其中正常人群抗－ＨＣＶ阳性率为２．８％（１３／４５６），门诊肝病患者抗－ＨＣＶ阳性率为４．８％（４／８４），献血员阳性率为０（０／８０），结果表明新乡铁路管辖地区正常人群丙型肝炎感染率低于全国３．２％［１］，门诊肝病患者ＨＣＶ感染率高于正常人群，门诊肝病患者中ＡＬＴ异常者抗－ＨＣＶ阳性率明显高于ＡＬＴ正常者（Ｐ＜０．０１）。管辖区三家医院血源来自各地中心血库，因对献血员采取了严格体检，有效阻止了丙型肝炎在输血过程中的传播。     

各型病毒性肝炎、肝癌抗－HCV检测及HCV感染与输血的关系

本文对各型病毒性肝炎、肝癌２００例进行血清抗－ＨＣＶ检测，阳性率为２０．５％，以重型肝炎和肝硬化检出率为高，分别为４２．８６％、４６．１５％，二者与其他型肝炎相比，有显著性差异（Ｐ＜０．０５）。输血后肝炎抗－ＨＣＶ阳性率为６７．５％，健康献血员抗－ＨＣＶ阳性率为２０．４７％，而输血后己型肝炎仅占２．５％。说明输血是造成丙型肝炎传播的重要途径，因此，对献血员应进行严格筛选。观察表明，ＨＢＶ与ＨＣＶ双重感染，可能是形成慢性肝炎，肝硬化以及促使肝炎向重型发展的重要原因之一。抗－ＨＣＶ阳性的慢性肝炎，血清ＡＬＴ５０％在正常范围内，余者仅轻度升高，说明ＨＣＶ感染所致的肝损伤可能是一个较慢的过程     

河北省某农村丙型肝炎病毒感染的随访研究

对河北省某农村的全体人群进行了丙型肝炎病毒（ＨＣＶ）感染的半年随访调查，随访率为８３．４２％。在随访期间，该人群抗－ＨＣＶ阴性者的阳转率为０．４５％（２／４４１），抗－ＨＣＶ阳性者的阴转率为４．２６％（２／４７），表明抗－ＨＣＶ阴性人群处于ＨＣＶ低危感染状态。抗－ＨＣＶ阳性者持续阳性率高（９５．７４％，４５／４７），且在随访期间ＡＬＴ异常率显著高于抗－ＨＣＶ阴性人群。２名抗－ＨＣＶ阳转者的妻子均为抗－ＨＣＶ阳性，无近期献血及其它经血暴露史，提示可能为性传播。     

单采浆还输血球献血员中丙型肝炎病毒感染的流行病学和血清学研究

本文报告单采浆献血员中丙型肝炎病毒(HCV)感染的流行病学和血清学研究结果。通过对5个自然村3 496人流行病学调查表明,单采浆献血员肝炎现患率和单项ALT异常率分别为17.10%和23.23%,二者均显著高于全血献血员和非献血员成人。经排除法证明,上述肝炎患者绝大多数为肠道外传播的非甲非乙型肝炎。后将部分单采浆献血员肝炎病例和单项ALT异常者的血清标本,送美国疾病控制中心检测,抗-HCV阳性率分别为97.06%和100%。证实为HCV感染。流行病学调查表明,单采浆献血员HC流行是由单采浆还输血球过程中交叉感染引起的。     

Antibodies to hepatitis C virus in blood donors

Recently a recombinant polypeptide of hepatitis C virus (HCV) has been developed by the Chiron Corporation in California. This antigen has been used to develop an ELISA test (Ortho Diagnostic Systems) for serum anti-HCV antibodies. Preliminary data have shown that this virus is the major cause of NANB hepatitis in the world. We examined differences in anti-HCV prevalence among subgroups of blood donors (total sera examined 639) classified for past or present exposure to HBV or not, and for ALT levels. The anti-HCV prevalence found in regular blood donors with normal ALT levels and no antibody to HBcAg was 1.2%. No significant difference in the anti-HCV prevalence was found among other subgroups of blood donors except that a higher prevalence (10%) was found in a group with both elevated ALT and HBV markers.These preliminary findings suggest that the policy of blood supply should take into account the advent of HCV antibody test.     

献血感染丙型肝炎人群转归分析

目的研究献血感染丙型肝炎病毒（HCV）人群16年后的转归。方法对该人群问卷收集一般情况,肝脏B超检查;采集5ml静脉血,进行丙型肝炎病毒抗体、RNA、谷丙转氨酶（ALT）和血清生化指标（透明质酸、Ⅲ型前胶原肽、Ⅳ型胶原）检测。结果162名研究对象尚未出现晚期肝病患者。抗-HCV阳性率95.68%,RNA阳性率77.78%,ALT异常率20.37%。不同急性期症状感染者,16年后抗-HCV阳性率、ALT异常率和RNA阳性率差异无统计学意义。经性别分层分析,女性感染年龄〉40岁抗体较易阴转（χMH^2=8.26,P=0.04）。结论HCV感染16年后,不同急性期症状感染者转归无差异,病毒清除与性别和初始感染年龄有关。     

Sexual transmission of hepatitis C virus among female prostitutes and patients with sexually transmitted diseases in Fukuoka, Kyushu, Japan.

The authors investigated the prevalence of antibody to hepatitis C virus (anti-HCV) in 404 female prostitutes, 428 clinic patients with a history of at least one episode of sexually transmitted disease, and 8,944 blood donors who served as the controls. All subjects were Japanese, and all studies were carried out in Fukuoka, Kyushu, Japan, in 1989. The prevalence of anti-HCV was significantly higher in the prostitutes (6.2%), in the female patients with sexually transmitted diseases (6.1%), and in the male patients with sexually transmitted diseases (2.9%) than in the controls (1.5%). Prevalence of anti-HCV increased with age in prostitutes and in the controls. The prevalence of anti-HCV in those who had been involved in prostitution for 1 year or more (8.1%) was higher than in those who had been involved in prostitution for less than 1 year (1.4%), but the difference was not statistically significant. One of the 152 anti-HCV negative prostitutes seroconverted between 1 and 2 years later. Among the subjects with sexually transmitted diseases, patients with a history of at least one episode of syphilis had a significantly higher prevalence of anti-HCV (4.4%) than the controls. Patients with acute urethritis and cervicitis also showed a high prevalence of anti-HCV (3.6% and 6.7%, respectively). These data support the possibility of sexual transmission of hepatitis C virus.     

The prevalence of hepatitis C virus antibodies among the voluntary blood donors of New Delhi,India

Infection with hepatitis C virus (HCV) is a major cause of transfusion-associated hepatitis, cirrhosis and hepatocellular carcinoma. The present study was conducted with an objective to evaluate the prevalence of anti-HCV antibody in New Delhi, India using a large number of healthy voluntary blood donors. A total of 15,898 healthy voluntary blood donors were subjected to anti-HCV testing (using a commercially available third generation anti-HCV ELISA kit) and 249 were found to be reactive for anti-HCV antibody, yielding an overall prevalence of 1.57%. No significant difference was found between the HCV positivity rate of male (1.57%; 238/15,152) vs. female (1.47%; 11/746) donors, family (1.58%; 213/13,521) vs. altruistic (1.51%; 36/2377) donors and first-time (1.55%; 180/11,605) vs. repeat (1.61%; 69/4293) donors. The age distribution of anti-HCV reactivity showed a maximum prevalence rate of 1.8% in the age group of 20–29 years. In addition, there was a clear trend of decreasing positivity for anti-HCV with increasing age and this trend was statistically significant. The results of the present study show that the prevalence of anti-HCV antibodies in the healthy voluntary blood donors of New Delhi, India is considerably higher than the reported seroprevalence of HCV in majority of the industrialized nations and this represents a large reservoir of infection capable of inflicting significant disease burden on the society. In addition, donors of New Delhi, India showed a trend of decreasing seroprevalence with increasing age, possibly implying a higher exposure rate to HCV in younger subjects.     

Incidence of hepatitis C virus antibodies in blood donors, high risk patient groups, liver diseases and health professionals. Multicenter study of the ABBOT ELISA method, comparison with the ORTHO test

Serum samples from 1185 individuals (blood donors, health care workers, patients on haemodialysis or from other high risk groups or with non-A, non-B [NANB] hepatitis and other liver diseases) were examined for antibody to a recombinant antigen of hepatitis c virus (anti-HCV). A new ABBOTT HCV EIA system was used and a parallel study with ORTHO HCV ELISA was also done for 380 samples to compare the two anti-HCV tests. A confirmatory neutralizing ABBOTT ELISA probe was also performed in 45 cases. Anti-HCV seropositivity was found in 1.60% of accepted healthy blood donors, while among subjects excluded from donation for elevated aminotransferase the rate was 8.95%. In patients on haemodialysis 47.15% anti-HCV prevalence was found, in other high risk group subjects 32.5%. Patients with acute post-transfusion (PT) NANB hepatitis showed 40% prevalence, this rate in chronic PT-NANB was 77.8%. The two ELISA tests revealed 95% agreement in the parallel determinations. Serial dilution studies of anti-HCV positive sera showed that ABBOTT test was of superior sensitivity. The results of the confirmatory test suggest that reactive (positive) samples of low optical density near to the cut-off value require a confirmation with the neutralization test. In conclusion HCV infection in Hungary seems to be a common aetiologic factor in PT-NANB hepatitis and the screening of blood donors for anti-HCV may be useful. However, because of financial difficulties, cost/benefit calculations are recommended before the introduction of this preventive measure.     

乌鲁木齐地区无偿献血者HCV感染及合并感染状况研究

目的 了解乌鲁木齐地区无偿献血者HCV感染及合并感染状况及流行病学特点,为减少HCV经血液传播,预防和控制HCV输血风险提供依据。 方法 收集2008年1月1日-2010年12月31日在乌鲁木齐血液中心献血者的一般资料及五项指标ALT、HBsAg、抗-HCV、抗-HIV、抗-TP血液检测结果。 结果 调查自愿无偿献血者共计140 665名,其中男性86 179名(61.27%),女性54 486名(38.73%),年龄范围18~55周岁。在所调查的140 665名无偿献血者中, 5 971名献血者血液检测不合格,不合格检出率为42.45‰,血液五项检测指标不合格率分别为HBsAg(4.55‰)、ALT(26.82‰)、抗-HCV(5.52‰)、抗-HIV(2.34‰)、抗-TP(4.09‰)。抗-HCV阳性率在性别、年度、学历、年龄分布上差异无统计学意义(均P＞0.05)。HCV与ALT、HBV、HIV、TP的合并感染率分别为0.66‰、0.11‰、0.05‰、0.06‰。logistic回归分析显示献血者HCV感染影响因素有职业、性别及重复献血次数等。 结论 在今后献血工作中,要加大对男性、初次以及未婚无偿献血者的筛查力度,建立一支固定、重复的无偿献血者队伍,才能不断提高血液安全。     

Infection by hepatitis B and C virus in non-intravenous drug using female prostitutes in Spain

We have studied the prevalence of hepatitis B (HBV) and hepatitis C virus (HCV) serologic markers in female blood donors and in female prostitutes and the relationship of antibodies to hepatitis B core antigen (anti-HBc) and of antibodies to HCV (anti-HCV) with the presence of treponemal antibodies (FTA-ABS) in non-intravenous drug using female prostitutes. Hepatitis B surface antigen (HBsAg) was found in 1.0% of the female blood donors, anti-HBc in 15.6% and anti-HCV in 0.7%. In the prostitutes, the prevalence of HBsAg was 6.1%, anti-HBc was positive in 29.0% and anti-HCV in 8.8%. No significant statistical association between the prevalence of anti-HBc or anti-HCV and the age of prostitutes (p = 0.9111 and p = 0.8254 respectively) or the length of time as prostitutes (p = 0.3583 and p = 0.5770) was found. FTA-ABS positive prostitutes had a significantly higher prevalence of anti-HCV than FTA-ABS negative prostitutes (p < 0.001). No statistical association was found between anti-HBc antibodies and positive FTA-ABS prostitutes (p = 0.336).Corresponding author.     

Decrease in the prevalence of hepatitis B and a low prevalence of hepatitis C virus infections in the general population of the Seychelles

A serological survey of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections was carried out on a random sex- and age-stratified sample of 1006 individuals aged 25-64 years in the Seychelles islands. Anti-HBc and anti-HCV antibodies were detected using commercially available enzyme-linked immunosorbent assays (ELISA), followed by a Western blot assay in the case of a positive result for anti-HCV. The age-adjusted seroprevalence of anti-HBc antibodies was 8.0% (95% CI: 6.5-9.9%) and the percentage prevalence among males/females increased from 7.0/3.1 to 19.1/13.4 in the age groups 25-34 to 55-64 years, respectively. Two men and three women were positive for anti-HCV antibodies, with an age-adjusted seroprevalence of 0.34% (95% CI: 0.1-0.8%). Two out of these five subjects who were positive for anti-HCV also had anti-HBc antibodies. The seroprevalence of anti-HBc was significantly higher in unskilled workers, persons with low education, and heavy drinkers. The age-specific seroprevalence of anti-HBc in this population-based survey, which was conducted in 1994, was approximately three times lower than in a previous patient-based survey carried out in 1979. Although there are methodological differences between the two surveys, it is likely that the substantial decrease in anti-HBc prevalence during the last 15 years may be due to significant socioeconomic development and the systematic screening of blood donors since 1981. Because hepatitis C virus infections are serious and the cost of treatment is high, the fact that the prevalence of anti-HCV antibodies is at present low should not be an argument for not screening blood donors for anti-HCV and eliminating those who are positive.