无偿献血者抗-HCV与ALT检测结果的分析

目的:调查分析无偿献血者抗-HCV检测结果与ALT值的关系。方法:对邯郸市2009年3月～2010年2月18～55岁20 847名献血者5项检测结果行Epi dat a3.0双录入,导入SPSS13.0,统计抗-HCV阳性者与健康献血者ALT的几何均数,并进行检验,检验水准α=0.05。结果:抗-HCV阳性者与健康献血ALT值的几何均数分别为20.61U/l和17.28 U/l;α=2.012,P=0.046,P<0.05,差异有统计学意义。抗-HCV阳性127例中有23例ALT>40EU/l,不合格率为18.11%;合格率为81.89%。结论:抗-HCV阳性献血人群ALT水平高于健康献血人群;ELI SA方法对于HCV阳性的检出高于ALT对HCV的检出,ALT作为HCV感染窗口期检测的意义不大。     

丙型肝炎基因治疗研究进展

我国丙型肝炎病毒（HCV）感染发生率较高，一般人群抗-HCV阳性率为3．2％，其中相当一部分可发展为慢性丙型肝炎，成为肝硬化和肝癌的高发人群。对HCV感染目前尚无有效疫苗预防，目前临床上最有效的抗HCV治疗方案为聚乙二醇化干扰素联合利巴韦林，但有约50％患者不能产生持续病毒学应答，对我国常见的1型HCV感染有效率更低。     

251例血液透析患者HBsAg与抗-HCV检测结果分析

目的分析血液透析患者乙型肝炎表面抗原（HBsAg）与丙型肝炎抗体（抗-HCV）检测结果，旨在寻求血透患者感染的依据，减少医源性感染。方法应用酶联免疫吸附法（EuSA）检测2006年12月份在我院进行血液透析的251例患者HBsAg与抗-HCV，并对透析1年以上的149例患者的肝炎标志物阳性率与透析年限、输血史、手术史的相关性进行分析。结果透析1年以上的149例患者中，HBsAg阳性者19例，阳性率为12．8％；抗-HCV阳性者29例，阳性率19．5％。HB—sAg、抗-HCV同时为阳性者仅1例（0．4％）。抗-HCV阳性率随透析年限、输血次数、手术次数增加而增高（P〈0．05），多因素非条件多元Logistic回归分析提示，透析年限是抗-HCV阳性率最有统计学意义的因素（OR〉I）；而HBsAg阳性率与透析年限、输血、手术、性别的相关性均无明显统计学意义（P〉0．05）。结论透析年限、输血、手术与抗-HCV阳性率具有显著相关性，随着透析年限的增加抗-HCV阳性率上升，而与HBsAg阳性率无明显相关性。     

维持性血液透析患者HCV检测方法的比较

目的 探讨维持性血液透析(HD)患者丙型肝炎病毒(HCV)的检测方法 .方法 对108例HD患者,采用荧光定量PCR法测定血清HCV RNA,用酶联免疫吸附实验(ELISA)检测血清HCV抗体(抗-HCV)和HCV核心抗原(HCV-cAg),并同时检测丙氨酸转氨酶(ALT)和天冬氨酸转氨酶(AST),计算其变动率. 结果 HD患者荧光定量PCR HCV RNA检出率为33.3%(36/108),抗-HCV阳性率为32.4%(35/108),HCV-cAg阳性率为26.9%(29/108),HCV标志阳性患者中仅4例ALT和AST均升高.在抗-HCV阳性患者中,HCV RNA检出率为82.9%(29/35);在抗-HCV阴性患者中,HCV RNA检出率为9.6%(7/73);在HCV RNA阴性患者中,抗-HCV阳性率为8.3%(6/72),两者符合率为88%[(29+66)/108];在HCV RNA阳性患者中HCV-cAg检出率为80.6%(29/36).结论 ALT不能作为血液透析患者HCV诊断和反映病情的一项敏感指标,荧光定量PCR技术可弥补ELISA检测的不足,在抗-HCV阴性的血液透析患者中检测HCV RNA具有重要意义,对监测无症状的HCV携带者或新发现的感染者,应用ELISA法检测HCV-cAg将是有意义的发展方向.     

丙型肝炎病毒诱导肝细胞脂肪变的研究进展

全世界有1.7亿人感染丙型肝炎病毒(HCV),我国普通人群抗-HCV的阳性率为3.2%.国内外大量的实验室与临床资料研究显示,慢性HCV感染者容易发生肝细胞脂肪变,文献[1-6]报道成人慢性HCV感染者约有50%(30%～82%)合并肝细胞脂肪变;儿童慢性HCV感染者亦有较高的脂肪肝检出率,约25%[7].     

粪便 SDC2基因甲基化检测在东莞市石排镇居民结直肠癌早期筛查的应用价值研究

目的探讨粪便SDC2基因甲基化(mSDC2)检测在东莞市石排镇居民结直肠癌早期筛查的应用价值。方法本研究采用横断面研究方法。2021年5月至2022年2月期间, 东莞市石排镇政府采用整群抽样方法确定东莞市石排镇18个村的筛查范围, 对符合初筛标准的居民由东莞市石排医院开展粪便mSDC2检测, 确定高危人群, 初筛阳性者建议其接受肠镜复查。观察mSDC2检测初筛的阳性率、肠镜依从率、肠镜检出率以及筛查成本-效益。结果有效筛查人数共计10 708人, 筛查参与率54.99%(10 708/19 474), 合格率97.87%(10 708/10 941)。筛查对象中, 男性4 713例(44.01%), 女性5 995例(55.99%), 年龄为(54.52±9.64)岁;以年龄段分组, 40～49岁组3 770人(35.21%), 50～59岁组3 882人(36.25%), 60～69岁组2 017人(18.84%), 70～74岁组1 039人(9.70%)。通过初筛检出mSDC2阳性结果的居民共计821人, 初筛阳性率为7.67%(821/10 708), 521人接受了肠镜检查,...     

血透患者中丙型肝炎病毒感染的流行病学研究

目的：了解血透患者中丙型肝炎病毒的感染情况,并探讨相关的危险因素。方法：对150例维持性血透患者应用逆转录聚合酶链反应及酶联免疫吸附法检测血清中HCV－RNA及抗HCV－IgG的水平。结果：HCV－RNA的阳性率为26．7％（40／150）;抗HCV－IgG的阳性率为24％（36／150例）;HCV感染率（总阳性率）为35．3％（52／150例）。结论：提示血液患者中HCV感染率明显高于普遍人群。输血及血制品是其第一位的危险因素,而透析器及管路的交叉使用也是不容忽视的危险因素之一。     

哈尔滨某三甲医院丙型肝炎病毒基因分型研究

目的分析哈尔滨某三甲医院丙型病毒性肝炎患者的HCV基因分型情况,为地区性丙型肝炎的防治提供理论依据。方法收集50例抗-HCV阳性患者血清标本,提取HCV RNA进行核心(core)片段扩增和DNA测序。根据测序结果,采用进化树方法对所得基因序列进行基因分型,获得入组丙型肝炎患者的基因分型情况。结果本研究中中42例患者的血清样本成功扩增出HCV core基因部分片段(+328 nt~+726 nt),其中各种HCV基因分型分布如下:基因分型结果1b型12份(28.57%),2a型29份(69.05%),3a型1份(2.38%)。结论哈尔滨某三甲医院丙型肝炎患者HCV的基因型最常见为HCV 2a型,其次为HCV 1b型,偶见HCV 3a型。     

维持性血液透析患者感染丙型病毒性肝炎150个月随访研究

目的:评价血液透析患者感染丙型肝炎病毒(HCV)的阳转率和危险因素。方法:随访1998年6月～2010年6月在本院透析的血透患者,共纳入2 465例血透患者,采用ELISA法每隔6月在同一实验室检测抗-HCV。结果:1998年6月的抗HCV阳性率为54.7%,每隔半年的阳性率分别为54.7%,53.8%,52.6%,53.0%,51.2%,45.9%,45.5%,48.2%,35.6%,33.7%,33.7%,31.7%,30.4%,28.4%,27.2%,24.5%,20.8%,19.4%,16.6%,14.4%,15.3%,15.2%,12.5%,11.9%和10.0%。在1～150个月随访期间,总计238例患者阳转,随访1～12月者阳转率为4.5%,13～24月者为6.9%,25～48月者为11.9%,49～60月者28.1%,61～72月者35.1%,73～84月者38.6%,85～96月者阳转率46.9%,97～108月者56.3%,109～126月者63.6%,随访至139～150月时,阳转率已高达75%。结论:提示透析环境对HCV传播有影响,可能一方面通过共用透析机,一方面是由于未隔离阳性患者;严格的消毒隔离措施对降低HCV感染和阳转有重要作用。     

日本普外病人中丙型肝炎感染率

外科医师在手术时最容易通过血液接触感染血源性疾病.已证实在出血及长时间手术中,血液接触是常见的方式.血液传播的疾病包括人类免疫缺陷性疾病(HIV),乙型肝炎病毒(HBV)和其他一些引起肝炎的病源体.由于最近对病源体的克隆以及特殊检验的开展,已认识到丙型肝炎病毒(HCV)感染是引起输血后或血源性肝炎的主要原因.此型肝炎常导致肝硬化和肝细胞癌.目前.对这一血源性病源体的预防措施尚在研究中.尽管HCV抗体阳性率在自愿献血中为0.42～1.4%,但在外科病人中的感染率仍不清楚.本研究的目的是了解外科病人中HCV的感染率以及确定与HCV抗体阳性的相关因素.作者自1991年4月至1992年5月,共检查了789例病人,平均年龄58.1±14.2岁,男性469例,其中胃肠道疾病202例,肝胆道疾病141例,门脉高压65例,血管疾患188例,肺疾患107例,其他疾病29例.应用Ortho ELISA方法进行检测.结果显示789例被检测的病人中HCV抗体阳性者为129例(16.3%),其阳性率比一般日本人高得多;肝胆道疾病及门脉高压者较其他疾患阳性率高,前者阳性率为94/206,即45.6%,而其它疾患的阳性率为35/583,即6%;两者P<0.0001.50岁以上者较年轻者发病率高,前者阳性率为118/578, 即20.4%,后者阳性率为11/211,即5.3%;两者P<0.0001.作者把有输血史,外科手术史,肝功     

Infection of hepatitis C virus in patients with chronic renal failure undergoing hemodialysis therapy and staff members]

The prevalence of antibody to hepatitis C virus (anti-HCV) was determined in 564 patients and 145 staff members of nine hemodialysis (HD) units in Nagano Prefecture using an enzyme-linked immunosorbent assay based on the C 100 HCV antigen (the first generation anti-HCV assay). And also serum HBV markers were tested in these subjects. One hundred patients (18%) were anti-C100 HCV positive, indicating that this figure represents a much higher prevalence than that (0.9%) among general population in the same geographical area. Out of 141 patients without history of blood transfusion, 17 (12%) were positive for anti-C 100 HCV, suggesting that blood-transfusions-unrelated acquisition of HCV infection can occur. Anti-HCV prevalence correlated with both the blood units transfused and the duration of HD treatment. There was a significant difference in the prevalence of anti-C 100 HCV in individual dialysis units ranging from 0% to 53%. In the dialysis unit with prevalence of 53%, approximately half of the anti-HCV positive patients were found to have chronic liver disease. The prevalence of hepatitis B virus (HBV) markers among HD patients, on the other hand, was 36% (202/564). Fifty one (51%) of 100 anti-C 100 HCV positive patients and 151 (33%) of 464 anti-C 100 HCV negative patients were positive for HBV markers, with significant difference in HBV infection rate between the 2 groups. The prevalence of chronic liver disease, defined as abnormal serum transaminase levels for more than 6 months was significantly higher in anti-HCV positive patients than in anti-HCV negative ones (39% vs 10%, p less than 0.05), suggesting that HCV infection may contribute to chronic liver disease in HD patients. Among 145 staff members, only 3 (2%) were positive for anti-HCV, whereas 25 (17%) were positive for hepatitis B core antibody (anti-HBc), indicating prior HBV infection. With applying the second generation anti-HCV assay, which can detect antibodies to both capsid and nonstructural products of HCV gene, anti-HCV prevalence increased by two times in HD patients, but didn't change in HD staff members.(ABSTRACT TRUNCATED AT 400 WORDS)     

肾移植供者丙型肝炎病毒(HCV)感染状况及移植抗HCV阳性供肾对受者的影响

目的了解肾移植供者丙型肝炎病毒(HCV)的感染率及移植抗HCV阳性供肾对受者的影响.方法采用酶联免疫吸附(ELISA)法检测肾移植供、受者的抗HCV;巢式多聚酶链反应(Nest-PCR)法检测HCVRNA;根据供、受者HCV状态将受者分为4组,对各组受者进行1年以上的随访研究.结果(1)供者HCV的感染率为4.35%;(2)抗HCV阴性的受者,接受抗HCV阳性供肾移植后,有62.5%的抗HCV及HCVRNA转为阳性,术后丙氨酸转氨酶(ALT)水平和肝功能损害发生率明显高于无HCV感染组;(3)将抗HCV阳性的供肾移植给抗HCV阳性的受者,与抗HCV阴性的受者接受抗HCV阳性供肾移植以及与抗HCV阳性的受者接受抗HCV阴性供肾的临床效果相同.结论(1)移植抗HCV阳性供肾能传播HCV,可影响受者的肝脏病变,但这种影响程度较轻;(2)将抗HCV阳性供肾移植给抗HCV阳性的受者,既不增加传播HCV的危险性,又能扩大供肾来源,是解决我国供肾短缺的一项值得考虑的策略.     

血液透析患者丙型肝炎病毒标志检测

研究血透患者的丙型肝炎病毒感染。方法 在60倒尿毒症血透患者中,采用第二代酶联免疫法测定抗丙型肝炎病毒(HCV)抗体,同时采用套式多聚酶联反应(PCR)法测定HCV-RNA。结果 27例抗HCV-HgG阳性,24例抗HCV-IgM阳性,37例HCV-RNA阳性,总阳性率为63.3％;输血组的HCV感染率为69.6％,而非输血组HCV感染率仍高达42.9％;透析时间大于3年者,HCV的感染率达100％。结论 血透患者HCV感染是相当严重的,其中输血为HCV传染的主要途径,但可能还存在经透析装置等其它传播途径。     

Hepatitis C virus infection in chronic haemodialysis patients, a clinicopathologic study.

Fifty-two patients on regular haemodialysis at our institution were evaluated for the presence of HCV infection. Evaluation included detailed history, clinical examination, and monthly screening for anti-HCV antibody, liver enzymes (ALT, AST), serum iron and ferritin. Also, three-monthly screening for other viral markers, HBV (HBsAg, HBsAb, HBcAb), CMV (IgG and IgM), EBV, and HIV. Anti-HCV antibody was found in 21 patients (40.4%). There was a significant (P less than 0.05) relationship between presence of anti-HCV antibody and proportion of patients who received blood transfusion. During a 12-month follow-up, four (11.4%) patients seroconverted to be Anti-HCV positive while one case (4.8%) seroconverted to be anti-HCV negative. The frequency of elevation of liver enzymes was significantly higher in Anti-HCV positive cases (14/18) than in negative cases (11/28, P = 0.01). Evaluation of liver biopsies of 13 patients showed chronic persistent hepatitis in six and chronic active hepatitis in seven cases. We concluded that hepatitis C is a common problem among chronic haemodialysis patients at our institution; HCV infection is documented in 70% of all clinically diagnosed NANB hepatitis. Presence of anti-HCV antibodies cannot differentiate between active and past infection and cases with early HCV infection can be missed when relying on the mere detection of anti-HCV antibodies.     

Prevalence of anti-HCV in patients on long-term hemodialysis

The prevalence of hepatitis C virus (HCV) infection in patients with long-term hemodialysis (HD) in Japan was assessed using an Ortho HCV Antibody ELISA TEST system. Out of 51 patients, 48 of whom had a history of blood transfusions, 15 (29%) were positive for anti-HCV. This figure is much higher than that in other countries (1-20%), and the difference may reflect a select population. Six (33%) of 18 HD patients with chronic hepatic disease were anti-HCV positive. On the other hand, the prevalence of hepatitis B virus (HBV) markers was 39% (20/51), and 7 (35%) of these 20 with HBV markers were also positive for HCV. The prevalence of anti-HCV showed no relation to the duration of HD treatment. Although a correlation between the prevalence and the blood units transfused was not demonstrated, anti-HCV positive patients had received blood transfusions amounting to significantly more units than those given to negative patients. Anti-HCV was detected in approximately one-third of patients with long-term HD, indicating a lower prevalence of HCV infection as compared to that of HBV infection, and patients with hepatitis of type C accounted for about one-third of HD patients with chronic hepatic disease.     

Prevalence of anti-HCV antibodies and seroconversion incidence in five haemodialysis units in Morocco

Dialysis patients are among groups at risk for development of hepatitis C infection (HCV). The aim of the study was to evaluate the prevalence and the incidence of seroconversion for HCV in five haemodialysis units in Morocco. The study was conducted during the period from September 2003 to September 2004. We studied 303 patients (148 females), mean age 49+/-16 years; dialysis duration was higher than five years in 64% of the cases. The prevalence of HCV infection was evaluated by using a fourth generation enzyme immunoassays. In the seronegative patients, we performed anti-HCV tests at three and six months intervals and monthly testing of alanine aminotransferase (ALT) activity and assessment of anti-HCV tests if the ALT activity was elevated. Moreover, risk factors, such as blood transfusion, surgery and other invasive procedures were recorded. Seroprevalence of HCV was 68.3%. Among 85 patients who were tested negative for anti-HCV at the entry of the study, four (4.60%) seroconverted in six month (estimated incidence: 9.41 new cases per year). HCV seropositivity was associated with longer duration of dialysis (p=0.000), and previous blood transfusions (p=0.047). The follow-up of the ALT in the seronegative patients did not show any significant variation. In conclusion, the prevalence and incidence of HCV infection in haemodialysis units in Morocco are dramatically elevated. High incidence seropositivity suggested nosocomial transmission of HCV; the dialysis processes itself, and blood transfusions are important risk factors for HCV transmission in these patients.     

Patterns in the prevalence of hepatitis C virus infection at the start of hemodialysis in Japan

Background Although hepatitis C virus (HCV) infection is a persistent public health concern in hemodialysis patients, there seem to have been only a few reports on the prevalence of HCV at the start of hemodialysis. In this study we investigated whether patients starting on hemodialysis therapy are positive for anti-HCV antibody or not. Methods The 400 patients who began regular hemodialysis between February 2003 and June 2007 were enrolled in this study. Clinical data such as age, anti-HCV antibody and primary cause of end-stage kidney disease (ESKD) were examined. As healthy controls we used 70,717 healthy blood donors in 2005 whose data were obtained from Tokyo Metropolitan Red Cross Blood Center. Anti-HCV antibody was used as an indicator of HCV infection. Since the prevalence of HCV infection is affected by age in Japan, we classified the patients by age group. Results The anti-HCV antibody prevalence rate among the patients who were new to hemodialysis was 7.3%, as opposed to 0.15% in the healthy volunteers. The prevalence of HCV in the 31–45-, 46–60-, and 61-year-old groups was significantly higher among the hemodialysis patients than among the healthy volunteers (P = 0.0209, <0.0001, and <0.0001, respectively). The prevalence rate of anti-HCV antibody was higher among men (10.0%) than among women (1.5%, P < 0.0001) in the hemodialysis patients. The anti-HCV-antibody-positive patients were significantly older than the anti-HCV-antibody-negative patients (66.4 ± 14.3 years versus 58.6±16.6 years; P = 0.0152). Diabetic nephropathy was a more frequent cause of ESKD among the anti-HCV-antibody-positive patients (30.4%) than among the anti-HCV-antibody-negative patients (19.9%, P = 0.0122). Among the anti-HCV-antibody-positive patients, 55.2% had received a blood transfusion. The rate was significantly higher than that among the anti-HCV-antibody-negative patients (19.4%, P < 0.0001). Conclusion The results showed a much higher rate of anti-HCV antibody positivity in patients new to hemodialysis than in healthy volunteers. Older age, blood transfusion, male gender, and diabetic nephropathy seemed to be risk factors for anti-HCV antibody positivity in Japan.     

中国北方肝细胞癌与乙肝病毒感染的紧密关联性

目的确立乙肝病毒(hepatitis B virus，HBV)及丙肝病毒(hepatitis C virus，HCV)感染在中国北方肝细胞癌(hepatocellular carcinoma，HCC)发生中的病因学地位。方法采用Abbott AxSym系统检测119例连续系列中国北方地区HCC病例的血清HBV、HCV标志，对血清HBV标志阴性病例，采用免疫组化、巢式PCR和DNA测序等对HBVX基因进行鉴定。结果119例HCC中，血清HBsAg阳性率为82．4％(98／119)；anti-HBc阳性率为94．1％(112／119)；4例血清HBsAg及anti-HBc均阴性病例中，3例HBVX基因阳性，因而HBV感染的阳性率达99．2％(118／119)。本组anti-HCV阳性率11．8％(14／119)，且均伴有HBV感染标志。结论中国北方地区HCC与HBV感染具有紧密关联性，是本地区HCC发生的主导病因。HCV感染是一个HOC发生的重要辅助因素。