出入境人员丙型肝炎病毒感染者miRNA-122表达变化研究

目的探讨珠海口岸出入境人员丙型肝炎病毒(HCV RNA)感染者外周血miRNA-122表达的变化及其对丙型肝炎患者的临床意义。方法收集96例丙型肝炎IgG抗体初筛阳性患者外周血,定量检测HCV RNA水平。对HCV RNA阳性患者检测miRNA-122、丙氨酸氨基转移酶(ALT)及检查肝脏超声影像学改变,并进行相关性分析。结果 96例HCV IgG阳性患者检测出49例HCV RNA阳性,占60.9%;两组患者miRNA-122表达水平差异有统计学意义(P0.01);与ALT呈正相关,与HCV RNA无相关性。B超检查发现11例合并轻度脂肪肝,合并脂肪肝患者miRNA-122表达水平高于无脂肪肝患者。结论 HCV阳性患者循环miRNA-122表达可能与病毒复制无关,而是反映肝脏组织活动性损害和病变严重性的指标。     

街头献血者丙氨酸氨基转移酶与隐匿性丙型肝炎病毒感染的关系分析

目的观察街头献血者丙氨酸氨基转移酶(ALT)与隐匿性丙型肝炎病毒感染(OCI)的关系,旨在提高街头献血的安全性。方法回顾性分析2018年6月至2019年6月榆林市865例街头献血者的检查资料,检测入组患者丙型肝炎病毒抗体(抗-HCV)、外周血HCV RNA、血ALT水平,分析865例街头献血者检测结果,并对ALT异常献血者OCI筛查结果进行分析,采用Spearman相关分析ALT水平与外周血HCV RNA的相关性。结果 865例献血者中,ALT正常献血者686例,占79.31%,ALT异常者179例,占20.69%,ALT异常者HCV RNA阳性率明显高于ALT正常献血者(P<0.05);179例ALT异常献血者中共68例外周血HCV RNA阳性,其中外周血HCV RNA阳性者ALT水平明显高于HCV RNA阴性者(P<0.05);ALT水平与外周血HCV RNA载量呈正相关(r=0.346,P<0.05)。结论街头献血者不仅需常规检测ALT水平,且需重视对OCI筛查以及外周血HCV RNA的检测,以提高街头献血的安全性。     

丙型肝炎患者外周血HCV RNA载量与DARC rs12075多态性的相关性

目的探讨丙型肝炎患者外周血HCV RNA病毒载量与DARC rs12075的相关性。方法以196例大连地区汉族HCV感染者为研究对象,使用TaqMan探针Real-timePCR技术对DARC rs12075进行分型。HCVRNA病毒载量测定采用Roche公司全自动核酸分离纯化检测系统COBAS AmpliPrep/COBAS TaqMan及其配套试剂。用豆形图展示HCVRNA病毒载量。结果 DARCrs12075分型结果显示,FY~*A/FY~*A基因型患者171例,其余为FY~*A/FY~*B基因型,未发现FY~*B/FY~*B基因型。对FY~*A/FY~*A基因型与FY~*A/FY~*B基因型患者间HCV RNA病毒载量进行比较,差异无统计学意义。进一步根据患者HCV RNA病毒载量不同将其分为4组,分别对各组不同基因型患者间HCV RNA病毒载量进行比较,差异均无统计学意义。结论丙肝患者外周血HCV RNA载量与DARC rs12075多态性无关。     

丙型肝炎患者血清HCV—RNA载量与抗-HCV及丙氨酸氨基转移酶联合检测的意义

目的：探讨丙型肝炎患者血清HCV—RNA载量与抗-HCV及丙氨酸氨基转移酶（ALT）浓度的关系。方法：采用实时荧光定量PCR法检测HCV—RNA载量,酶联免疫吸附法（ELISA）检测抗-HCV,全自动生化分析仪连续监测法测定ALT活性浓度。结果：289例丙型肝炎患者的血清标本中,抗-HCV均为阳性,282份标本HCV—RNA均高于检测上限（1000IU／mL）,两种检测方法的符合率为97．6％。ALT异常率随着HCV—RNA载量的增高而升高。HCVRNA载量与ALT异常率呈正相关（r=0．968,P％0．05）。而ALT浓度变化与HCV—RNA载量并无相关性（r=0．028,P〉0．05）。结论：HCV—RNA载量与抗-HCV检测是诊断HCV感染的重要指标,HCV—RNA载量是反映HCV复制的可靠指标,结合丙氨酸氨基转移酶测定,可以帮助临床了解HCV在体内复制的状况及肝脏的损伤情况,为临床诊断HCV感染和评价抗HCV治疗效果提供可靠依据。     

丙型肝炎患者病毒载量与ALT、AST的相关性研究

目的 研究实时荧光定量聚合酶链反应(PCR)检测丙型肝炎病毒(HCV)载量与生化指标[丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)]的相关性.方法 采用实时荧光定量PCR检测56例丙型肝炎患者血清HCV RNA,同时用全自动生化分析仪检测ALT、AST水平.结果 56份样本中HCV RNA阳性率为57.1%(32/56),HCV RNA阳性样本中ALT、AST异常率明显高于HCV RNA阴性样本.HCV RNA含量高、低与ALT、AST异常率呈正相关,但与ALT、AST水平无关.结论 HCV RNA定量检测及结合ALT、AST检测结果分析有助于了解HCV在体内的复制水平和肝脏炎性反应状态,指导临床用药及观察疗效.     

慢性丙型肝炎患者血浆IRF-3水平的变化及临床意义

目的探讨慢性丙型肝炎(CHC)患者干扰素调节因子(IRF)-3水平的变化及其与丙型肝炎病毒(HCV)RNA载量、肝脏损伤程度及干扰素抗病毒疗效的关系。方法检测57例CHC患者抗病毒治疗前及26名体检健康者(正常对照组)血浆IRF-3、β-干扰素(IFN-β)水平,同时检测丙氨酸氨基转移酶(ALT)活性、Ⅳ型胶原(CⅣ)水平及HCV RNA载量。根据ALT、CⅣ和HCV RNA载量分别分组;根据抗病毒疗效分为应答组和无应答组。采用Spearman秩相关分析评估各项目之间的相关性。结果 CHC组血浆IRF-3、IFN-β水平明显低于正常对照组(P0.01)。ALT升高组与ALT正常组之间、CⅣ升高组与CⅣ正常组之间、HCV RNA高载量组与HCV RNA低载量组之间血浆IRF-3水平差异均有统计学意义(P0.05)。Spearman秩相关分析结果显示,CHC患者IRF-3与IFN-β呈正相关(r=0.930,P0.01),与HCV RNA载量、ALT、CⅣ均呈负相关(r值分别为-0.321、-0.290、-0.345,P0.05)。应答组血浆IRF-3水平低于无应答组(P0.05),血浆IFN-β水平2个组之间差异无统计学意义(P0.05)。结论 CHC患者血浆IRF-3水平与HCV RNA载量、肝细胞损伤程度及纤维化程度有关,对干扰素疗效的判断也有一定的价值。     

抗-HCV-IgG抗体及血清HCV RNA在丙型肝炎诊断中的应用价值

目的探讨抗-HCV-IgG抗体与血清HCV RNA应用于丙型肝炎诊断中的临床价值。方法选择2014年10月~2016年10月检验科收集的114例丙型肝炎待查者的血清标本,采用酶联免疫吸附法(ELISA)对抗-HCV-IgG抗体进行检测,同时采用荧光定量聚合酶链反应(PCR)对HCV RNA载量进行检测。统计所有标本抗-HCV-IgG抗体、HCV RNA检测结果。结果采用ELISA检测抗-HCV-IgG抗体阳性率为25.44%(29/114);采用荧光定量PCR检测HCV RNA阳性率为27.19%(31/114)。31例HCV RNA阳性标本中抗-HCV-IgG阳性标本有26例,符合率为83.87%(26/31)。ELISA检测抗-HCV-IgG抗体阳性率与荧光定量PCR检测HCV RNA阳性率的差异无统计学意义(P0.05)。伴随HCV RNA病毒载量的不断增多,抗-HCV-IgG阳性抗体检出率明显提高;不同HCV RNA病毒载量的相邻区间的抗-HCV-IgG阳性抗体检出率比较,差异无统计学意义(P0.05)。结论 ELISA检测抗-HCV-IgG抗体和荧光定量PCR检测HCV RNA应用于丙型肝炎诊断均具有一定的临床价值,血清HCV RNA病毒载量是判断HCV感染的重要依据,能够有效反映病毒活动性及复制程度,然而单一的抗-HCV-IgG抗体、HCV RNA检测尚存在局限性,易出现漏诊,两者联合检测可显著提高丙型肝炎检出率,做到早诊断、早治疗,提高临床疗效。     

HCV早期感染者病毒载量与CD4~+CD25~+Foxp3~+调节性T淋巴细胞相关性研究

目的研究丙型肝炎病毒(HCV)早期感染者(抗原阳性、抗体阴性)的HCV病毒载量与CD4+CD25+叉头/翅膀状螺旋转录因子(Foxp3+)调节性T淋巴细胞水平的相关性,分析CD4+CD25+Foxp3+调节性T淋巴细胞在HCV感染中的作用。方法应用实时荧光定量聚合酶链反应(FQ RT-PCR)技术检测22例HCV核心抗原阳性、抗体阴性(即HCV Ag阳性、抗-HCV阴性)的早期感染病例、26例核心抗原阳性、抗体阳性(即HCV Ag阳性、抗-HCV阳性)的慢性HCV感染病例,24例核心抗原阴性、抗体阳性(即HCV Ag阴性、抗-HCV阳性)的既往HCV感染病例及22例健康对照组HCV RNA病毒载量;并用流式细胞技术检测各组外周血有核细胞中的CD4+CD25+Foxp3+调节性T淋巴细胞水平。结果 HCV Ag阳性、抗-HCV阴性组,HCV Ag阳性、抗-HCV阳性组,HCV Ag阴性、抗-HCV阳性组及健康对照组CD4+CD25+Foxp3+调节性T淋巴细胞逐级下降,其中抗原阳性、抗体阴性组[(4.86±2.14)%]高于其他组[分别为(3.74±1.67)%、(2.74±1.27)%、(2.56±1.18)%],差异有统计学意义(t值分别为2.023、4.125、4.402,P0.05);HCV Ag阳性、抗-HCV阴性组CD4+CD25+Foxp3+调节性T淋巴细胞与HCV RNA病毒载量的对数(copy/mL,Ig)呈正相关(r=0.535,P0.05)。结论 HCV早期感染者CD4+CD25+Foxp3+调节性T淋巴细胞水平与高病毒调定点相关,CD4+CD25+Foxp3+调节性T淋巴细胞水平可能是加速HCV早期感染的影响因素之一。     

实时荧光定量聚合酶链反应在丙型肝炎诊断中的临床应用价值

目的探讨丙型肝炎病毒抗体(抗-HCV)和丙型肝炎病毒核酸(HCV RNA)荧光定量检测在丙型肝炎诊断中的临床应用价值。方法采用实时荧光定量聚合酶链反应(FQ-PCR)和酶联免疫吸附试验(ELISA)检测358例血清中HCV RNA载量及抗-HCV。结果 358例慢性丙型肝炎患者抗-HCV和HCV RNA检出率分别为78.8%和54.2%,经χ2检验差异有统计学意义(P<0.05),HCV RNA的平均载量为4.85×105 copies/mL。结论FQ-PCR检测血清中HCV RNA的载量,是判定HCV感染的直接证据,它反映HCV的活动性和复制程度,有利于抗病毒治疗的疗效观察。抗-HCV和HCV RNA联合检测对丙型肝炎病毒的早期诊断有重要临床应用价值。     

丙型肝炎病毒核心抗原检测在丙型肝炎筛检中的应用

目的探讨丙型肝炎病毒核心抗原(HCV-cAg)对丙型肝炎(简称丙肝)筛查的意义。方法收集2014年10月至2015年10月8 000例门诊及住院患者,用酶联免疫吸附试验(ELISA)检测HCV-cAg、丙型肝炎病毒抗体(HCV-Ab),并对HCVcAg或HCV-Ab阳性标本采用聚合酶链反应(PCR)法检测HCV-RNA进行确诊。结果以HCV-cAg或HCV-Ab阳性为标准,从8 000例血清样本中初步筛查出阳性样本82例,经HCV-RNA确证,其中HCV-RNA阳性73例,阴性9例,HCV-cAg的灵敏度及特异度分别为45.83%和99.98%,HCV-Ab的灵敏度及特异度分别为94.44%和99.90%,联合检测HCV-cAg与HCV-Ab的灵敏度及特异度分别为100.00%和99.86%。结论在丙肝筛检工作中,HCV-cAg与HCV-Ab二者有互补性,联合检测HCV-cAg与HCV-Ab有助于提高HCV筛查率。     

福建省慢性丙型肝炎患者丙型肝炎病毒基因分型的分析

目的观察福建省慢性丙型肝炎患者基因型分布特点以及与患者性别、年龄、丙型肝炎病毒（HCV） RNA 之间的关系。方法应用反转录聚合酶链反应（RT-PCR）和 SANGER 测序法对155例慢性丙型肝炎患者的HCV 进行基因分型。结果在155例标本中,HCV 基因1型占55．48％,基因2型占18．71％,基因3型13．51％,基因6型12．26％,未见基因4、5型;男女慢性 HCV 感染均以1型为主要基因型,在其他基因型中,男性3型、6型多于2型,女性则以2型为主,差异有统计学意义（P ＜0．05）;基因2型平均年龄为（49岁）,3型平均年龄为（35岁）,差异有统计学意义（P＜0．05）。结论福建地区 HCV 基因型以1b 型为主,其次是2a 型,未见基因4、5型;基因2型的感染者平均年龄较基因3型大。     

Post-transfusion hepatitis C in Finland

Summary. Six of 11 (55%) non-A, non-B hepatitis (NANBH) patients seroconverted to hepatitis C virus antibody (anti-HCV) positivity 8–16 weeks after transfusions in a prospective post-transfusion hepatitis study on 685 open-heart surgery patients in Finland. Five of them had a seropositive donor, and two of the five non-converted NANBH patients had received an anti-HCV positive unit. Among 36 studied donors who were positive in the anti-HCV ELISA, reactivity of both the antigen bands in a recombinant immunoblot assay (RIBA) for anti-HCV was significantly associated with NANBH ( P < 0·00005) in the recipient. In addition, infective anti-HCV positive donors had raised ALT values more often than seropositive donors which caused no seroconversion or infection in the recipients ( P = 0·0001).     

Battling hepatitis C

Treatment for patients suffering from the hepatitis C virus (HCV) can slow and sometimes stop disease progression. However, about 60% of the nearly 4 million Americans suffering from HCV fail to clear the virus with standard therapy because side effects compel them to drop out. Here's what you can do to help your patient stick with treatment and win the battle against HCV.     

Auto-antibodies in hepatitis C.

Hepatitis C virus (HCV) has been implicated in the development of a variety of autoimmune phenomena, some of which are well documented and include a panel of auto-antibodies shared with autoimmune hepatitis (AIH). Anti-nuclear (ANA) and smooth muscle (SMA) antibodies (markers of AIH type 1 [AIH-1]), have been demonstrated in 9-38% and 5-91% of cases respectively, whereas anti-liver/kidney microsomal type 1 (anti-LKM-1) and anti-liver cytosol type 1 antibodies (anti-LC1) (markers of AIH type 2 [AIH-2]), are definitely rarer, especially in adults. The presence of these auto-reactivities in chronic hepatitis C generates clinical overlaps and dilemmas in the correct classification and treatment of such patients. The immunopathological characterization of the auto-antibodies, anti-nuclear and smooth muscle antibodies in particular, combined with internationally defined criteria for the diagnosis of AIH is helpful in this clinical process. Thyroid auto-antibodies and cryoprecitable rheumatoid factors are also commonly detected in hepatitis C, while the occurrence of other auto-antibodies still awaits confirmation.     

丙型肝炎患者精液中丙型肝炎病毒检出报告

目的通过研究慢性丙型肝炎患者精液中丙型肝炎病毒感染,探讨丙型肝炎病毒是否经夫妻性生活途径传播。方法用酶联免疫吸附法和荧光定量PCR法,检测56例男性慢性丙型肝炎患者血清、精液及其54例配偶血清抗-HCV、HCVRNA,健康对照组为23对体检健康者夫妇。结果男性慢性丙型肝炎患者血清中抗-HCV、HCVRNA的阳性率分别为91.07%(51/56)、85.71%(48/56),精液中抗-HCV、HCVRNA的阳性率分别为39.28%(22/56)、62.50%(35/56),结果与健康对照组比较均有统计学意义,P<0.05;男性慢性丙型肝炎患者配偶的血清抗-HCV及HCVRNA的阳性率为22.22%(12/54)、24.07%(13/54),与健康对照组相比较,经χ2检验有统计学意义,P<0.05。结论慢性丙型肝炎患者精液可感染HCV;HCV可经夫妻性生活途径传播。     

Insulin resistance in chronic hepatitis C

Insulin resistance (IR), glucose intolerance and diabetes mellitus are commonly associated with cirrhosis. The exact pathogenetic mechanisms responsible are still unknown; however, they may be related to both hepatitis C virus itself and to liver injury. IR may be the earliest abnormality, which in the following years may progress to clinical diabetes mellitus. The aim of this study was to investigate the presence of IR by euglycaemic hyperinsulinemic clamp technique, in chronic hepatitis C patients. 15 patients and nine healthy controls without any known condition that may affect IR were enrolled to the study. Chronic hepatitis C was diagnosed by liver biopsy (hepatic activity index was also determined in 10 patients) and appropriate viral and biochemical tests. Eight patients were given interferon therapy, which had been stopped for at least 3 months before the study. Euglycaemic hyperinsulinemic clamp technique was performed as previously described and peripheral glucose utilisation rate, M value, was calculated in mg/kg/min by infusion of 40 IU/m2/min regular insulin. M value of the control group was significantly higher than that of chronic hepatitis C patients (M = 5.1+/-1 vs. 3.7+/-1; p = 0.004), which was consistent with IR in the patient group. There was no significant correlation between the M value and alanine aminotransferase, aspartate aminotransferase and hepatic activity index (p = 0.621, 0.549, 0.479, respectively). Our results suggest that IR is present in chronic hepatitis C patients; it is not directly related to hepatic injury, moreover, it may be associated with some component(s) inherent to hepatitis C virus.     

Viral hepatitis C in Hong Kong

OBJECTIVE: Hepatitis C virus (HCV) infection can lead to serious liver disease. Its medico-socio-economic burden on society can be immense. This study investigates the epidemiology of HCV infection in Hong Kong. METHODS: Data from the Department of Health, relevant publications from Medline search and data from two acute hospitals were reviewed. RESULTS: The prevalence of anti-HCV among voluntary blood donors is stable, remaining at approximately 0.035-0.099% over the past 10 years, and is higher in the older age group. Among the high-risk groups, the anti-HCV prevalence is as follows: (1) hospital patients 0.8%, (2) intravenous drug users 46.0%, (3) patients infected with HIV 7.9%, (4) children with transfusion-dependent hematologic disease 16.3%, (5) patients on continuous ambulatory peritoneal dialysis 1.8%, patients on hemodialysis 16.4%, recipients of kidney transplants 6.2% and (6) patients with hepatocellular carcinoma 7.3%. Among blood donors, 58.8% were infected with HCV genotype 1b and 27.0% with genotype 6a. Genotype 6a is particularly common among intravenous drug users. CONCLUSION: Hong Kong has a low prevalence of HCV infection. Patients are mostly infected through transfusion with blood or products prior to the introduction of anti-HCV screening to the blood transfusion service. Illicit drug use constitutes another significant risk. Since 1997, there has been a great increase in population movement between China and Hong Kong which might affect the epidemiology of HCV infection.