831名健康青年庚型肝炎病毒和人免疫缺陷病毒感染？…

目的 了解我国健康青年中庚型肝炎病毒（ＨＧＶ）和人免疫缺陷病毒的感染情况。方法 采用酶联免疫法（ＥＩＡ）检测６省８３１名健康青年血清中的ＨＧＶ和ＨＩＶ抗体，对抗－ＨＧＶＩｇＧ阳性的血清再用逆转录－巢式聚合酶链反应（ＲＴ－ＰＣＲ）检测ＨＧＶＲＮＡ。结果 发现抗－ＨＧＶ ＩｇＧ阳性率为２．５３％（２１／８３１），２１例阳性者中ＨＧＶ ＲＮＡ阳性８例，两者符合率为３８．１％；抗－ＨＩＶ均阴性。结论 我     

831名健康青年庚型肝炎病毒和人免疫缺陷病毒感染的调查

目的了解我国健康青年中庚型肝炎病毒（ＨＧＶ）和人免疫缺陷病毒的感染情况。方法采用酶联免疫法（ＥＩＡ）检测６省８３１名健康青年血清中的ＨＧＶ和ＨＩＶ抗体，对抗－ＨＧＶＩｇＧ阳性的血清再用逆转录－巢式聚合酶链反应（ＲＴ－ＰＣＲ）检测ＨＧＶＲＮＡ。结果发现抗－ＨＣＶＩｇＧ阳性率为２５３％（２１／８３１），２１例阳性者中ＨＧＶＲＮＡ阳性８例，两者符合率为３８１％；抗－ＨＩＶ均阴性。结论我国健康青年人群中确实存在ＨＧＶ感染。     

献血员、丙型肝炎患者血中庚型肝炎检测分析

庚型肝炎病毒（ＨＧＶ） ,主要是经血液传播的一种新型肝炎病毒 ,对献血员进行ＨＧＶ筛查 ,是避免和减少与ＨＧＶ相关的输血性肝炎发生的有效方法。本文通过对献血员及丙型肝炎患者血清中抗ＨＧＶ -ＩｇＧ及庚型肝炎病毒核酸（ＨＧＶ -ＲＮＡ）的检测 ,对其感染状况进行分析 ,现将结果报告如下。对象和方法一、对象 :健康对照组８５例 ,用ＲＩＡ作血ＨＢｓＡｇ、ＨＣＶ -ＩｇＧ检测均为阴性 ,ＡＬＴ正常 ,年龄２１～３８岁。献血员１２６例 ,年龄２３～４２岁。丙型肝炎患者８６例（发病前均有输血史 ,根据１９９５年第五次全国病毒性肝炎诊…     

丙型肝炎患者血清抗丙型肝炎病毒抗体IgM及HCVRNA检测结果的比较

用酶联免疫吸附试验（ＥＬＩＳＡ）对住院病人抗丙型肝炎病毒抗体（抗－ＨＣＶ）阳性血清标本进行抗－ＨＣＶＩｇＭ的检测，并与ＨＣＶＲＮＡ检测结果比较。结果表明，ＨＣＶＲＮＡ阳性、抗－ＨＣＶ阳性，ＨＣＶＲＮＡ阳性、抗－ＨＣＶ阴性及ＨＣＶＲＮＡ阴性、抗－ＨＣＶ阳性三种类型中均有抗－ＨＣＶＩｇＭ阳性者。结果还表明ＨＣＶＲＮＡ阳性病例的抗－ＨＣＶＩｇＭ阳性率明显高于ＨＣＶＲＮＡ阴性的病例（Ｐ＜０．０５），在临床诊断上ＨＣＶＲＮＡ阳性与阴性病例的肝病大多数为急性肝炎（ＡＨ）和慢性活动性肝炎（ＣＡＨ），ＨＣＶＲＮＡ阳性与阴性比较，各类肝病的病例数无明显差别。     

丙型肝炎病毒感染的血清学检测

目的了解丙型肝炎病毒（ＨＣＶ）感染及病毒血症存在情况。方法用酶联免疫吸附试验（ＥＬＩＳＡ）和聚合酶链反应（ＰＣＲ）对不同人群的血清标本做了抗－ＨＣＶ、抗－ＨＣＶＩｇＭ和ＨＣＶＲＮＡ的检测，并对三项指标间的关系进行了对比分析。结果抗－ＨＣＶ在普通成年人、献血员、急性肝炎和肝硬化患者中的检出率分别是３５７％，８５８％，６２５％和４８３８％；与ＨＣＶＲＮＡ的符合率分别是１１４３％，６１１１％，８００％和７３３３％。相同人群抗－ＨＣＶＩｇＭ与ＨＣＶＲＮＡ的符合率分别是７５％，９０９％，８１８１％和１００％。结论抗－ＨＣＶＩｇＭ比抗－ＨＣＶ能更客观地反映ＨＣＶ病毒血症的情况，个别抗－ＨＣＶ阴性血清检测到了抗－ＨＣＶＩｇＭ和ＨＣＶＲＮＡ。     

不同人群庚型肝炎病毒感染状况分析

为了解不同人群庚型肝炎病毒（ＨＧＶ）感染状况，采用优化的ＨＧＶＮＳ５区两条合成肽为抗原，建立间接酶联免疫吸附试验（ＥＬＩＳＡ），检测了１２０９例不同人群血清中抗－ＨＧＶＩｇＧ，总阳性率为３．８％，其中非Ａ～Ｅ型肝炎患者抗－ＨＧＶＩｇＧ阳性率最高，为２０．５％，明显高于自然人群的０．８％和其它肝炎患者（Ａ～Ｅ型）的３．３％，丙型肝炎患者中抗－ＨＧＶＩｇＧ阳性率亦较高，为８．０％。职业献血员抗－ＨＧＶＩｇＧ阳性率３．４％高于义务献血员０．０％。性病患者阳性率为３．６％，有静脉吸毒史的ＨＩＶ感染者阳性率亦较高，为８．０％。结果表明，ＨＧＶ在我国有较高的感染率；ＨＧＶ可能为非Ａ～Ｅ型肝炎的重要致病因子；职业献血员和有血液接触史者ＨＧＶ感染率较高，提示血源应严格筛选     

丙型肝炎患者血清抗丙型肝炎病毒性抗IgM及HCVRN…

用酶联免疫吸附试验对住院病人抗丙型肝炎病毒抗体阳性血清标本进行抗－ＨＣＶＩｇＭ的检测，并与ＨＣＶＲＮＡ检测结果比较。结果表明，ＨＣＶＲＮＡ阳性、抗－ＨＣＶ阳性，ＨＣＶＲＮＡ阳性，抗－ＨＣＶ阴性及ＨＣＶＲＮＡ阴性，抗－ＨＣＶ阳性三类型中均有抗－ＨＣＶＩｇＭ阳性者。     

丙型肝炎病毒感染者中抗病毒IgM检测的意义

建立了抗ＨＣＶＩｇＭ间接ＥＬＩＳＡ方法，并用之检测ＨＣＶ不同感染人群。抗ＨＣＶＩｇＭ在不同感染人群中的检出率变化很大。急性输血后丙型肝炎患者检出率可高达９３．８％，而正常献血员中可低至０．６８％。比较抗ＨＣＶＩｇＭ和抗ＬｇＧ阳性中ＨＣＶＲＮＡ的检测结果发现，抗ＩｇＭ阳性者中，不同ＨＣＶ感染人群的ＨＣＶＲＮＡ检出率很高（９３．０％～１００％）；而ＩｇＧ阳性者中ＨＣＶＲＮＡ的检出率变化很大（３７．５％～９３．８％）。在４３例血液透析者中抗ＩｇＭ与ＨＣＶＲＮＡ检测的一致性为８３．７％；抗ＩｇＭ与抗ＩｇＧ检测的一致性为８８．４％，结果提示：（１）抗ＨＣＶＩｇＭ与ＨＣＶ活跃复制有关，（２）抗ＨＣＶＩｇＭ与抗ＨＣＶＩｇＧ检出不完全一致。因此，临床检测抗ＨＣＶＩｇＭ有其特殊意义。     

散发性急性戊型肝炎血清抗体动态变化和肝脏超微…

为探讨散发性戊型肝为血清抗体动态变化，应用酶联免疫法（ＥＩＡ）检测了７例急性戊型肝炎抗戊型肝炎病毒（ＨＥＶ）ＩｇＧ和ＩｇＭ抗体、并对１例２进行了肝超微结构病理检测，结果表明，发病１０天至４５天内抗ＨＥＶ－ＩｇＧ和ＩｇＭ滴度最高，发病第４０天仍有肝细胞肿胀，胞浆空化和线粒体固缩等病理变化。患者轿清抗－ＨＥＶＩｇＭ滴度在４５天后逐渐下降，２个月内全中消失，抗－ＨＥＶＩｇＭ滴度在４５天后逐渐下降，２个月     

散发性急性戊型肝炎血清抗体动态变化和肝脏超微结构的病理观察

为探讨散发性戊型肝炎血清抗体动态变化，应用酶联免疫法（ＥＩＡ）检测了７例急性戊型肝炎患者抗戊型肝炎病毒（ＨＥＶ）ＩｇＧ和ＩｇＭ抗体，并对１例患者进行了肝超微结构病理检测。结果表明，发病后１０天至４５天内抗ＨＥＶ－ＩｇＧ和ＩｇＭ滴度最高，发病第４０天仍有肝细胞肿胀，胞浆空化和线粒体固缩等病理变化。患者血清抗－ＨＥＶＩｇＭ滴度在４５天后逐渐下降，２个月内全部消失，抗－ＨＥＶＩｇＧ消长情况与ＩｇＭ相似，但在７个月时仍有３例（４３％）抗体阳性。     

庚型肝炎病毒IgM抗体检测方法的建立及其临床意义

目的建立一种早期、快速诊断庚型肝炎的血清学检测方法。方法以辣根过氧化物酶标记庚型肝炎病毒（ＨＧＶ）多肽ＮＳ３,ＮＳ５区段抗原,建立了捕获酶联免疫吸附试验（ＥＬＩＳＡ）,用于检测血清中ＨＧＶＩｇＭ抗体。结果本法不受特异性ＩｇＧ的竞争和类风湿因子的干扰;与其它致肝炎的病毒（ＨＡＶ、ＨＢＶ、ＨＣＶ、ＨＥＶ、ＣＭＶ、ＥＢＶ）无交叉反应。检测４６例非甲、乙、丙、戊型肝炎患者血清,抗－ＨＧＶＩｇＭ阳性１４例,阳性率３０．４３％,其中,６例同时为ＨＧＶＲＮＡ阳性,阳性符合率为４２．８６％（６／１４）,检测１２例庚型肝炎病人双份血清,其中,急性期血ＨＧＶＩｇＭ抗体均为阳性。结论该法检测ＨＧＶＩｇＭ抗体特异性强,敏感性高,且简便快速,适用于临床对庚型肝炎新近感染的早期诊断,有推广应用价值。     

Prevalence of hepatitis G virus in Pakistani children with transfusion dependent beta- thalassemia major

We ought to obtain data on the prevalence of the newly discovered tranfusion transmittable hepatitis G virus in polytransfused b- thalassemia major children. Each individual had received multiple blood transfusions, from 12 to 36 per year. No documentation of prior hepatic infection was available. Serum samples were collected prospectively from the randomly selected subjects and were analyzed for HGV RNA by polymerase chain reaction using primer specific for two different regions of the HGV genome. Among the 100 individuals examined 21 were positive for HGV RNA. Four patients had evidence of dual infection, both HGV RNA and HCV RNA were isolated from their sera. While in one sample presence of both HGV RNA and HBV DNA was established. Only one child was positive for hepatitis E antibodies. The sera of 10 children were reactive for hepatitis B surface antigen whereas 35 individuals were positive for hepatitis C virus antibody. The ALT levels were variable in HGV infected children. Four out of 16 (25%) showed peak ALT levels of 218 IU/I, 8/16 (50%) children demonstrated slightly elevated ALT levels whereas 25% individuals showed normal ALT levels. Alkaline Phosphatase levels were elevated in 90% of the children and 20% patients of this series also had higher GGT levels. The observed AP levels were not statistically different among HGV, HGV/HCV or HGV/HBV groups. Even though the ALT levels were deranged in the children with HGV alone but none of the children had demonstrated symptoms of liver disease, their direct and total bilirubin levels were normal and no complain of jaundice was recorded. In conclusion, our findings suggested that like other blood borne hepatic viruses, HGV is also prevalent in the high risk group of multiple transfused patients in Pakistan but our results support the absence of any causal relationship between HGV and hepatitis.     

Molecular characteristic-based epidemiology of hepatitis B, C, and E viruses and GB virus C/hepatitis G virus in Myanmar

We carried out a molecular characteristic-based epidemiological survey of various hepatitis viruses, including hepatitis B virus (HBV), hepatitis C virus (HCV), hepatitis E virus (HEV), and GB virus C (GBV-C)/hepatitis G virus (HGV), in Myanmar. The study population of 403 subjects consisted of 213 healthy individuals residing in the city of Yangon, Myanmar, and the surrounding suburbs and 190 liver disease patients (155 virus-related liver disease patients and 35 nonviral disease patients). The infection rates of the viruses among the 213 healthy subjects were as follows: 8% for HBV (16 patients), 2% for HCV (4 patients), and 8% for GBV-C/HGV (17 patients). In contrast, for 155 patients with acute hepatitis, chronic hepatitis, liver cirrhosis, or hepatocellular carcinoma, the infection rates were 30% for HBV (46 patients), 27% for HCV (41 patients), and 11% for GBV-C/HGV (17 patients). In the nonviral liver disease group of 35 patients with alcoholic liver disease, fatty liver, liver abscess, and biliary disease, the infection rates were 6% for HBV (2 patients), 20% for HCV (7 patients), and 26% for GBV-C/HGV (9 patients). The most common viral genotypes were type C of HBV (77%), type 3b of HCV (67%), and type 2 of GBV-C/HGV (67%). Moreover, testing for HEV among 371 subjects resulted in the detection of anti-HEV immunoglobulin G (IgG) in 117 patients (32%). The age prevalence of anti-HEV IgG was 3% for patients younger than 20 years and 30% or more for patients 20 years of age or older. Furthermore, a high prevalence of anti-HEV IgG (24%) was also found in swine living together with humans in Yangon. These results suggest that these hepatitis virus infections are widespread in Myanmar and have led to a high incidence of acute and chronic liver disease patients in the region.     

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.     

Novel approach for detection of hepatitis E virus infection in German blood donors

The risk of transfusion-transmitted hepatitis E virus (HEV) infections by contaminated blood products remains unknown. In the present study, we evaluated and compared different nucleic acid amplification technique (NAT) methods for the detection of HEV in blood components. Minipools of a total of 16,125 individual blood donors were screened for the presence of HEV RNA using the highly sensitive RealStar HEV RT-PCR kit, revealing a minimum detection limit of 4.66 IU/ml. Thirteen donors were HEV RNA positive (0.08%), and of these donors, only three already showed reactive IgM antibody titers. The detected HEV strains all belonged to genotype 3 and were most closely related to German HEV strains from wild boars and pigs as well as from human hepatitis E cases. Furthermore, HEV RNA and HEV-specific IgM and IgG titers were determined in 136 blood donors with elevated alanine aminotransferase (ALT) levels and in 200 donors without pathological findings. HEV RNA was not detectable, but 8.08% (elevated ALT) and 0.5% (nonelevated ALT) of donors showed reactive HEV IgM titers. The overall seroprevalence rate of HEV IgG amounted to 5.94% (elevated ALT, 5.88%; nonelevated ALT, 6.0%). The clinical relevance of transfusion-associated hepatitis E infection still requires further investigation. However, in connection with raising concerns regarding blood safety, our NAT method provides a sensitive possibility for HEV testing.     

GB virus C/hepatitis G virus and TT virus infections among high risk renal transplant recipients in India.

BACKGROUND: GB virus C/hepatitis G virus (GBV-C/HGV) and TT virus (TTV) have been widely reported in patients with high parenteral risk such as haemodialysis and renal transplant recipients. The occurrence of these agents in association with hepatitis B virus (HBV) and hepatitis C virus (HCV), in Indian renal transplant recipients, is yet unreported. STUDY DESIGN: Molecular and serological markers of GBV-C/HGV and TTV were examined in addition to those for HBV, HCV and hepatitis D virus (HDV) in a selected group of seventy renal transplant recipients. HGV RNA detection was achieved using primers specific for the 5'NCR and NS5a regions of the genome. Anti-GBV-C/HGV antibody was detected using the mu plate anti-HG env kit (Roche, Germany). TTV DNA PCR was performed using primers specific for the coding region (method A) of the genome. In 50% of patients, TTV DNA was also tested for using primers specific for the non-coding region (method B). Host related factors such as age, alanine aminotransferase (ALT) levels, number of transfusions, haemodialysis sessions, and months following transplantation were also studied. RESULTS: Exposure rates to GBV-C/HGV, TTV (method A), HBV, HCV and HDV were 58.6, 32.9, 52.9, 54.3 and 2.9%, respectively. 'Active' infection as measured by viraemia and/or virus-specific antigenaemia for GBV-C/HGV, TTV, HBV and HCV was 52.9, 32.9, 15.7 and 52.9%, respectively. The majority of GBV-C/HGV and TTV infections were seen as co-infections with other hepatitis viruses. Single infection with GBV-C/HGV and TTV was seen in ten (14.2%) and eight (11.4%) patients, and was not associated with ALT elevation when compared to uninfected blood donors. Using univariate analysis, GBV-C/HGV RNA was significantly associated with > or =20 haemodialysis sessions. TTV DNA occurrence was not associated with any risk factors. CONCLUSIONS: There is a high occurrence of GBV-C/HGV and TTV in this select group of renal transplant recipients in India. These viruses mostly occurred in the context of co-infections with other hepatitis viruses. Long term effects of multiple hepatotropic viral infections need to be carefully documented in such transplant populations.     

Detection of HEV antigen as a novel marker for the diagnosis of hepatitis E

Infection with hepatitis E virus (HEV) may be diagnosed by the presence of HEV RNA or anti-HEV antibodies. An enzyme immunoassay (EIA) was developed for the detection of antigen. Twenty-four monoclonal antibodies (mAbs) were produced. An indirect sandwich EIA was developed to detect HEV antigen using a combination of three mAbs as coating antibodies. Approximately 44.6% (33/74), 28.6% (50/175), and none (0/27) of sera positive for anti-HEV IgM alone, both anti-HEV IgM and IgG, and anti-HEV IgG alone also were positive for HEV antigen using this EIA. Forty-two HEV antibody-positive sera were tested for HEV RNA and antigen in parallel and the concordance was 81.0% (34/42). All PCR products were found to belong to HEV genotype 4. In order to evaluate the temporal relationship between HEV antigen positivity and HEV RNA, anti-HEV IgG and IgM, and ALT concentrations, macaques were infected with HEV genotypes 1 and 4 and serial samples were collected. The results showed that the antigen EIA can detect the capsid proteins of both genotypes. HEV antigen was detectable prior to ALT elevation and the appearance of anti-HEV antibodies in the infected monkeys and lasted for several weeks in all cases. HEV antigen became detectable in the serum at almost the same time as HEV RNA in feces but persisted for 4 weeks less than HEV RNA. This assay should be valuable for the diagnosis of acute hepatitis E, particularly in the window period prior to seroconversion to anti-HEV.