Human chronic fascioliasis: hepatitis B and C among infected cases

Sera from one hundred and fifty three chronic Fasciola cases were screened for the presence of HB markers (HBsAg, anti HBc and anti HBs) and anti HCV using ELISA technique. Quantitative stool examination and estimation of liver enzymes (AST-ALT-bilirubin) levels of the study population were performed. HBsAg was present in 5 (3.3%), anti HBs in 13 (8.5%), HBexposed (HBex) in 44 (28.8%) and anti HCV in 13 (8.5%) of examined sera. HBV and HCV markers were significantly higher among older age groups. Concerning familial aggregation of hepatitis markers, 7 (15.9%) of the 44 HBex cases had two individuals per family who had evidence of exposure to HBV. No significant change in Fasciola GMEC and liver function tests have been noticed.     

Ten-year follow-up study of hepatitis B virus infection and vaccination status in hospital employees

We sought to determine the incidence of infection with hepatitis B virus (HBV) amongst hospital employees over a 10-year period and to assess the extent and efficacy of vaccination against HBV in this population. In 1984 a cohort of 301 hospital employees was tested for hepatitis B surface antibody (anti HBs), hepatitis B core antibody (anti HBc), and hepatitis B surface antigen (HBsAg). Ten years later, 160 (53%) of these workers remained at the hospital and were re-tested. In addition, they were tested for hepatitis C virus antibody (anti HCV). Records of the hospital vaccination program were inspected to determine the rate and effectiveness of vaccination in these workers. Over the ten year period two of the 160 retested workers (1.25%) had sero-converted to anti HBc positive, yielding an incidence density of 0.27 cases per 100 person-years exposed in unvaccinated workers. While the overall seroprevalence of anti HBc did not change significantly between 1984 (81/301, 27%) and 1994 (39/160, 24%), it was much greater than that of the general population (10%). A significantly greater percentage of Jews of Sephardi ancestry (22/65, 34%) were positive for anti HBc than those of Ashkenazi ancestry (15/90, 17%, P < 0.05). In addition, doctors were found to be less likely to be anti HBc positive than nurses (4% vs. 25%, respectively, P < 0.01). Two cases of anti HCV positivity were discovered yielding a prevalence of 1.25% in the 1994 cohort as compared to 0.15% in the population of healthy blood donors. Of the 93 employees of the 1994 cohort eligible for vaccination (i.e., anti HBc-negative and employed in an occupation involving potential exposure to HBV), 53 (57%) had received vaccination and showed protective antibody titers (anti HBs > or = 10 i.u./ml). 17/52 workers with documented vaccinations (33%) did not have detectable antibody levels one to eight years after vaccination. In conclusion, the seroprevalence of anti HBc and anti HCV is significantly higher in this cohort of hospital employees than in the general population. The relatively low vaccination rate among at-risk personnel emphasizes the need for more effective vaccination programs.     

山西省原发性肝癌丙型肝炎病毒、乙型肝炎病毒感染状况分析

目的　探讨山西地区原发性肝癌（ＰＨＣ） 中丙型肝炎病毒（ＨＣＶ） 和乙型肝炎病毒（ＨＢＶ） 感染状况。方法　选择以山西省肿瘤医院为主的省级４ 所医院ＰＨＣ患者９８ 例,检测抗－ＨＣＶ、ＨＢｓＡｇ、抗－ ＨＢｓ、ＨＢｅＡｇ、抗－ ＨＢｅ、抗－ ＨＢｃ、抗－ ＨＢｃＩｇＭ 等指标,均采用ＥＬＩＳＡ 法进行测定。结果　ＰＨＣ 组抗－ ＨＣＶ 阳性率８．１６ ％ ,ＨＢＶ 感染率６８ ．３７％ ,均显著高于对照组的阳性率（ Ｐ＜０ ．０５） 。两者的病因分值（ＡＲＰ） 分别为９４％ 和９１ ％ 。经１∶２ 条件ｌｏｇｉｓｔｉｃ 多元回归分析,抗－ ＨＣＶ、ＨＢｓＡｇ 和抗－ ＨＢｃ 均作为独立的危险因素进入了回归方程,其ＯＲ值分别为５５ ．０６、１０ ．１８ 和９．８５ 。叉生分析结果表明,抗－ ＨＣＶ和ＨＢｓＡｇ 双阳性的ＯＲ值为６１ ．３７,较两指标单一阳性的ＯＲ值明显为高,亦高于两者单独阳性的ＯＲ值之和。结论　ＨＣＶ 和ＨＢＶ 感染均是ＰＨＣ发生的主要病原学因素。ＨＣＶ感染在致肝癌作用中,是当地不可忽视的重要因素,ＨＢＶ 仍是肝癌发生的主要因素。ＨＢＶ和ＨＣＶ双重感染对肝癌的发生具有协同作用。     

Prevalence of anti HCV, HBsAg and HIV antibodies in high risk recipients of blood and blood products

Along with hepatitis B virus (HBV) and human immunodeficiency virus (HIV), Hepatitis C virus (HCV) is emerging as a major transfusion hazard. 22 cases of haemophilia (A 19, B 3) and 20 cases of thalassaemia (2 16, E(2) 4) constituted the study group. Patients tested for anti HCV (using third generation ELISA), HBsAg and antibodies to HIV I and II. Prevalence of anti HCV was 54.5% in haemophilics and 5% in thalassaemics. HBsAg was detected in 9.09% haemophilics and 5% thalassaemics. No anti HIV was detected in this cohort. Anti HCV seropositivity in haemophilics has increased compare to previous studies.     

The occurrence of hepatitis B and C viruses in Pakistani patients with chronic liver disease and hepatocellular carcinoma.

To study the occurrence of hepatitis B virus (HBV) and hepatitis C virus (HCV) in patients with chronic liver disease (CLD) and hepatocellular carcinoma (HCC) in Pakistan, blood samples from 105 sequential patients with biopsy-proven CLD (n = 82) and HCC (n = 23) were tested for HBV and HCV markers. Of the 105, 87 (83%) had evidence of hepatitis B exposure, 58 (55%) were positive for hepatitis B surface antigen (HBsAg), 23 (22%) had hepatitis C antibodies and 25 (24%) had detectable HCV RNA. Significantly more patients with HCC had evidence of HBV exposure in the absence of HCV markers (49/82 vs. 20/23, odds ratio 4.49, 95% CI 1.17-25.16). The proportion of patients positive for HBsAg with no HCV markers was also significantly higher in the HCC group (34/82 vs. 18/23, odds ratio 5.08, 95% CI 1.59-18.96). There were more patients with only HCV markers in the CLD group than the HCC group but the difference was not statistically significant (19/82 vs. 1/23, odds ratio 6.63, 95% CI 0.93-288.01). A modified non-isotopic restriction fragment length polymorphism study on PCR products was used to investigate the epidemiology of HCV genotypes in Pakistan. Due to depletion of the initial samples, a second series of specimens collected one year afterwards was used. Fifteen out of 40 samples had amplifiable product and all were identified as type 3. A commercial serological typing method on the same samples also confirmed that type 3 was the predominant HCV genotype in Pakistan.     

Hepatitis B and C markers among alcoholics in Israel: High incidence of HCV infection

Patients with alcoholic liver disease have an increased prevalence of viral hepatitis. However, the role of demographic characteristics has not been adequately delineated. Therefore, we examined and compared the seroprevalences of hepatitis B and C in Israeli alcoholic patients to that of blood donors control group by their country of birth and origin. Hepatitis B surface antigen, hepatitis B core antibody and hepatitis C virus antibody testing (second generation ELISA) and a confirmatory recombinant immunoblot assay was performed on 496 alcoholic attending an alcoholic abstinence program and compared to 193,806 randomly non-alcoholic blood donors on the basis of their country of birth. Three hundred twenty-eight alcoholic patients (66%) were immigrants and Israeli born Jews and 168 (34%) were Israeli Arabs. Of the 496 alcoholic patients, 24 (4.8%) were HBsAg positive, 38 (7.6%) were anti HCV positive, and 2 (North African Jews) were positive for both markers. HBsAg was detected in 13 (3.9%) immigrant and Israeli Jews and 11 (6.5%) Israeli Arabs, significantly higher than in the adjusted non alcoholic blood donors (p < 0.01). Anti-HCV was detected in 33 (10%) immigrants and Israeli Jews and 5 (2.9%) Israeli Arabs, significantly higher than in the control group (p < 0.005). In the subgroup alcoholic Jews there was no significant difference in hepatitis B seropositivity among alcoholic that were native Israeli, Eastern Europe and former USSR, and western Europe and American immigrants comparing to the control group. In contrast, anti-HCV recombinant immunoblot assay seropositivity in alcoholic Jews from all subgroups was significantly greater than in non alcoholic blood donors (p < 0.001). Odds analysis of all ethnic groups revealed that alcoholism requiring detoxification have a significant risk factor for hepatitis C more than hepatitis B (p < 0.001). The increased seroprevalence of hepatitis C among Israeli alcoholic patients, regardless their country of birth and origin, suggest that alcoholism is likely to have a predisposing factor for HCV infection.     

Health status assessment of drug addicts in Alexandria

The case-control study was conducted among addicts in Alexandria to determine the different health problems among them, as well as to study the correlation between addiction and these problems. One hundred drug addicts and eighty apparently healthy controls were included in this study. The whole sample was subjected to the following: filling a predesigned questionnaire sheet, clinical and electrocardiogram (ECG) examination, measurements of Body Mass Index (BMI), complete blood picture and antistreptolysin O titre (ASO), testing for hepatitis B surface antigen (HBsAg) and antibody to hepatitis B core antigen (anti HBc), skin scrapings from superficial fungal lesions in addition to complete urine and stool examination. The results revealed that chest rhonchi, hepatomegaly, central nervous system (CNS) abnormalities, skin lesions lymphadenopathy, underweight and anaemia were significantly higher among addicts than the controls. Hepatitis B virus (HBV) exposure and HBsAg seropositivity were found 48.0% and 21.0%, respectively among addicts compared to 26.3% and 5.0%, respectively among the controls. The intravenous injections and tattooing were the most risky routes for HBV infection among addicts. A positive correlation was revealed between HBV exposure and both the duration and the number of daily injections. Chest X-ray suggestive of pulmonary tuberculosis were found in 7.0% of the addicts. Addiction potentiated the risk of fungal infection among low social class, but it had no effect on the relationship between anaemia and social class nor on that between loss of appetite and underweight.     

济南市济阳县15~40岁人群乙型肝炎血清流行病学调查

目的了解济阳县乙型肝炎（乙肝）病毒（HBV）感染标志的分布情况。方法2003年11月在济南市济阳县开展了15～40岁人群HBV感染标志分布的横断面调查，共采集合格外周静脉血1994人份。乙肝病毒表面抗原（HBsAg）、乙肝病毒表面抗体（抗-HBs）、乙肝病毒核心抗体（抗-HBc）均用固相放射免疫（SPRIA）法检测。结果15～40岁人群HBsAg、抗-HBs、抗-HBc和HBV感染率分别为6．52％、24．77％、30．99％和43．63％。HBsAg感染率随年龄的增长而升高，HBsAg感染率在男女之间的差异无统计学意义。结论济阳县15～40岁人群HBsAg的阳性率仍处于较高水平，提示我们未来应加强儿童乙肝疫苗计划免疫的同时，加强高危人群和成人的预防接种工作。     

性乱人群乙型肝炎和丙型肝炎病毒感染的血清流行病学研究

通过对４３１名卖淫妇女和１０９名正常妇女ＨＢＶ及ＨＣＶ感染的血清学指标的检测、性传播有关因素的调查。表明卖淫妇女中有较严重的ＨＢＶ和ＨＣＶ感染。     

Occupational risk of blood-borne viruses in healthcare workers: a 5-year surveillance program.

OBJECTIVE: This study presents the results of a 5-year surveillance program involving the prospective follow-up of healthcare workers (HCWs) in the Veneto region of Italy exposed to blood-borne viruses. DESIGN: All HCWs who reported an occupational exposure to blood-borne infection joined the surveillance program. Both HCWs and patients were tested for viral markers (hepatitis B surface antigen [HBsAg], antibody to hepatitis B surface antigen [anti-HBs], antibody to hepatitis B core antigen [anti-HBc], antibody to hepatitis C virus [anti-HCV], HCV RNA, and antibody to human immunodeficiency virus [HIV]) and had these markers plus transaminases assayed at 3, 6, and 12 months and then yearly thereafter. Moreover, a program of hepatitis B virus (HBV) prophylaxis was offered to those whose anti-HBs levels were less than 10 IU/mL. PARTICIPANTS: Two hundred forty-five HCWs (156 women and 89 men) with a mean age of 37 (+/- 10) years who reported occupational exposure during the 5-year period. RESULTS: At the time of exposure, 1 HCW was positive for HBsAg (0.4%) and 2 were positive for HCV RNA (0.8%). Among the patients involved, 28 (11.4%) were positive for HBsAg, 68 (27.8%) were positive for HCV RNA, 6 (2.4%) were positive for HIV, and 147 (60.0%) were negative for all viral markers (4 patients were positive for both HCV and HIV). During the follow-up period after exposure (mean, 2.7 [+/- 1.6] years), there was no increase in transaminases or seroconversions to any of the viral markers. CONCLUSION: Our accurate postexposure follow-up revealed a lack of transmission of HBV, HCV, and HIV.     

新生儿乙型肝炎病毒感染情况的研究

目的 了解广州市新生儿围产期ＨＢＶ的感染情况。方法 采用酶联免疫吸附试验（ＥＬＩＳＡ）和斑点发校技术对２４１例新生儿脐血的乙肝病毒标志物进行检测。结果 广州市新生儿围生期ＨＢｓＡｇ阳性率为２．０７％（５／２４１）,ＨＢｓＡｇ阴性、单纯Ａｎｔｉ－ＨＢ阳性且ＨＢＶ ＤＮＡ阳性者１９例,占７．８９％（１９／２４１）,新生儿脐血ＨＢＶ感染率为９．９６％（２４／２４１）,现症ＨＢＶ感染母亲的新生儿脐血ＨＢＶ     

我国四个地区肝炎病毒感染与肝癌的病例对照研究

为研究乙型、丙型和庚型肝炎与原发性肝癌的关系，对我国江苏海门、福建同安、广西扶绥和河北石家庄四地，进行了以人群或医院为基础的肝癌病例对照研究。在四个地区病例与对照中，ＨＢｓＡｇ阳性率分别为６６．３％（２３８／３５９）和２３．４％（８４／３５９），其ＯＲ值为６．６０；抗－ＨＣＶ阳性率分别为１７．９％（６１／３４０）和６．５％（２２／３４０），ＯＲ＝３．３１；合并乙丙型肝炎感染其肝癌危险度大大增加（ＯＲ＝１１０．０８）。另对海门病例对照各５０例进行ＨＧＶ－ＲＮＡ检测，阳性率分别为２２％和１０％。结果说明：在我国乙型肝炎感染与肝癌关系更为密切     

沿海农村健康人群乙丙肝病毒感染血清流行病学研究

目的 :为了解沿海农村健康人群乙型和丙型病毒性肝炎感染现状 ,建立有效的防治措施。方法 :应用间接反向血凝法 (RPHA)和酶联免疫吸附试验 (EL ISA)对 10 78名健康人群分别进行了血清乙肝表面抗原 (HBs Ag)和抗 - HCV检测。结果 :共检出 HBs Ag阳性 115人 ,抗 - HCV阳性 6 6人 ,阳性率分别为 10 .6 7% (8.83% - 12 .5 1% )和 6 .12 % (4.6 9% -7.5 5 % ) ,同时检出乙型和丙型肝炎病毒感染 8例 ,检出率为 0 .74%。结论 :本次调查健康人群中 HBV和抗 - HCV感染与国内农村一般人群 HBV和抗 - HCV的感染一致。     

宝鸡铁路职工乙肝血清学标志物分析

目的探讨7318名宝鸡铁路职工乙肝血清学标志物模式。方法采用ELISA试剂对7318名宝鸡铁路职工的静脉血进行HBV5项血清学标志物检测。结果宝鸡铁路职工乙肝标志物表达模式共14种,人群单独抗．HBs阳性47．73％。乙肝HBsAg、抗-HBs、抗-HBc阳性率以及HBV感染率分别为3．80％、62．53％、17．82％和20．62％。乙肝疫苗以集体接种为主。结论建议继续扩大乙肝疫苗接种范围,加强职工劳动保护。     

3家大型建筑工地外来民工病毒性肝炎血清学调查

[目的]了解上海市杨浦区建筑工地外来民工病毒性肝炎感染状况。[方法]选择大型建筑工地3家,对所有的外来民工781人收集血标本,采用酶联免疫法(ELISA)检测抗-HAV IgG、抗-HEV IgG、HBsAg、抗-HBs、抗-HBc;对表面抗原阳性的血标本进一步检测HBeAg。[结果]781人中抗-HAV IgG阳性率为72.86%,高于本市居民61.40%的水平,抗-HEV IgG阳性率为3.33%。HBV感染率为55.31%,其中HBsAg阳性率(7.94%)和抗-HBc阳性率(24.58%)高于本市居民的3.94%和7.89%,抗-HBs阳性率为41.74%;HBsAg阳性合并抗-HBc阳性率为7.55%,HBsAg和HBeAg双阳性感染率为2.18%。各型肝炎病毒存在混合重叠感染,占27.14%,其中HBV混合感染HAV、HEV及HAV和HEV的分别占24.32%、0.64%和1.15%,HAV和HEV重叠感染占1.02%。[结论]外来民工存在水平不等的HAV、HEV、HBV感染,其中HAV和HBV感染率处于较高水平,相关部门应制定外来民工健康体检制度。     

Prevalence of markers for hepatitis A, B and C in the German population. Results of the German National Health Interview and Examination Survey 1998

The prevalence of serological parameters indicative of infection with hepatitis A, B and C was determined using sera collected from representative population samples in the former East German (new) federal states and the West German (old) federal states during the German National Health and Examination Survey in 1998. Sera were tested for antibodies to hepatitis A virus (HAV), to hepatitis B core antigen (HBc) and to hepatitis B surface antigen (HBsAg), hepatitis C Virus (HCV), as well as for the presence of HBsAg and HCV-RNA. The mean weighted prevalence of anti-HAV was 46.5% (95% CI: 45.3–47.7) and increased markedly with age. The mean weighted prevalence of past infection with hepatitis B was 7.7% (95% CI: 7.0–8.4) in the old federal states and 4.3% (95% CI: 3.2–5.3) in the new federal states, corresponding to an overall prevalence of 7.0% (95% CI: 6.4–7.6). The mean weighted prevalence of HBsAg carriage was 0.6% (95% CI: 0.4–0.8), while the prevalence of HCV antibodies was 0.4% (95% CI: 0.2–0.5).     

急性病毒性肝炎756例血清学及流行病学调查

目的 对2002年l-12月份市传染病医院收治的756例急性病毒性肝炎病例进行血清学及流行病学调查。方法 采用RIA(放射免疫测定)法检测HBsAg、HBeAg、抗-HBc IgM；采用：EIA(酶免疫测定)法检测抗-HAV IgM、抗-HCV IgM、抗-HDV IgM、抗-HEV IgM。结果 756例急性病毒性肝炎病例中甲肝34．66％，乙肝37．04％，丙肝6．48％，丁肝2．25％，戊肝25．13％。各型肝炎感染形式可以单一型，也可以是混合型或重叠型。结论 通过调查揭示我市五型病毒性肝炎的流行特征及不同性别、年龄、职业、月份中分布规律．对制定病毒性肝炎的预防策略、落实防治措施提供依据。     

珠海市健康体检人员乙型肝炎病毒感染调查

目的通过对珠海市健康体检人员乙型肝炎病毒感染的调查,为社会开展乙型肝炎防治工作提供依据. 方法采用ELISA法对珠海健康体检人员进行乙型肝炎病毒感染的血清学调查. 结果 13 210名珠海市健康体检人员的HBsAg阳性率为10.03%,其中男性为11.21%,女性为8.66%,HBsAg阳性率男性高于女性,以<40岁年龄段阳性率最高;HBsAg阳性合并抗-HBe、抗-HBc阳性与HBsAg阳性合并HBeAg、抗-HBc阳性是感染的主要模式,分别占43.17%和15.17%. 结论本次调查发现社会人群乙型肝炎病毒感染水平较高,感染者大多不知情,提示人们应有自我防护意识,加强健康检查,及时采取防治措施.     

Pre-S2抗原与乙肝病毒血清标志物关系新探

目的探讨Pre-S2抗原（前是抗原）在乙型肝炎病毒的各类隐性、显性感染中的地位及科研、临床应用价值。方法以乙肝病毒隐性感染者（为主）及适量显性感染者作为研究对象，采用ELISA（酶联免疫吸附试验）法，同时检测感染者的Pre-S2抗原和乙肝血清标志物，然后进行各类、群感染者之间的比较、分析。结果在乙肝病毒隐性感染者人群中，乙肝e抗原阳性人员、e抗体阳性人员的Pre-S2抗原阳性率分别为93．10％、60．00％；“乙肝大三阳”人员、“小三阳”人员的Pre-S2抗原阳性率分别为92．31％、62．50％。在乙肝病毒显性感染者——急、慢性乙肝患者两类对比人群中，Pre-S2抗原的阳性率分别为90．91％、61．54％。结论Pre-S2抗原在判断乙肝病毒突变、感染者尤其是隐性感染者血清的传染性强度方面，有较高使用价值和补缺作用；在判断隐性感染者的发展转化和显性感染者的临床转归方面，亦有较大参考意义。     

Immune response to hepatitis B vaccine in parenteral drug abusers.

Responsiveness was assessed to a programme of vaccination of hepatitis B vaccine in a cohort of 197 intravenous drug addicts (mean age, 23.7 years) and their antibody response was compared with that of 271 healthy controls (mean age, 24.2 years). All participants were seronegative for hepatitis B surface antigen (HBsAg) and antibody to HBsAg (anti-HBs). The vaccination schedule consisted of three intramuscular injections (deltoid area) at months 0, 1 and 2. Although 70% of parenteral drug abusers received the three doses of vaccination, only 43.6% were evaluable for immune response. Fifty-eight per cent of heroin addicts and 80% of controls had evidence of anti-HBs seroconversion at 1 month after vaccination (chi 2 = 15.52, p less than 0.001). Geometric mean antibody titres were also significantly higher in controls (69.1 IU l-1; confidence interval 95%, 56.83 and 84.04) than in parenteral drug abusers (18.2 IU l-1; confidence interval 95%, 12.85 and 25.73) (F = 20.951, p less than 0.0001). The anti-HBs response was not influenced by coexistent anti-HBc, HCV antibody or HIV antibody seropositivity.