丙型肝炎病毒分子生物学研究的近况

丙型肝炎病毒(HCV)是非甲非乙型肝炎的主要致病因子之一,它的分子生物学研究是目前非甲非乙型肝炎研究的热点。现将1990年4月休斯敦国际病毒性肝炎及肝病、会议有关文献综述如下。概述自1974年首次报告一例非甲非乙型输血后肝炎(PT-NANB)以来,对丙型肝炎病毒的研究大致经历了三个阶段:1、1974年至1985年。这一阶段的研究工作与 HAV 和HBV 的初期研究相似,主要是采用免疫学方法。但未能取得重大成果,没有分离得到病毒或其相关多肽。2、1985年至1989年。随着与病毒的克隆成功,人们开始采用分子生物     

丙型肝炎病毒及其感染的研究进展

随着对病毒性肝炎病原格测技术的不断发展，对丙型肝炎病毒（HCV）及其感染标志的检测方法的灵敏度和特异度也不断提高，因而近年对heV及其感染的临床经过和血清学变化的研究取得了许多新的认识．本文拟对这方面的进展作一综述．1病原学HCV是单股正过RNA病毒．1989年美国学者Choo等[1]首次分离到HCVcDNA克隆，1991年国际病毒命名委员会（ICTV）将其归为黄病毒科丙型肝炎病毒属[2]．我国于1992年对河北株进行了全序列出定[3]．目前多数学者认为，HCV基因组全长约10kb，有一个9033个核苷酸的开放读框（ORF），编码约3033个氨基酸的…     

广西部分吸毒人群丙型肝炎病毒及艾滋病病毒感染情况调查分析

目的了解我区吸毒人群中丙型肝炎病毒（HCV）及艾滋病病毒（HIV）感染和两者合并感染的情况,为制定艾滋病及丙型肝炎的防治措施提供理论依据。方法对我区部分在押的吸毒者共计3 000名作为调查对象,制定统一的调查问卷进行调查,并采集静脉血,分离血清,用酶联免疫吸附试验（ELISA）夹心法检测HCV抗体和HIV抗体,当HIV抗体阳性时则用蛋白免疫印迹试验（Western Blotting,WB）进行HIV抗体确证实验。结果在3 000名吸毒患者中,男性占88.4%,女性占11.6%;总的HCV抗体阳性率是85.6%,HIV抗体阳性率是18.2%,其中静脉注射吸毒者（IDUs）HCV抗体阳性2 553名,感染率为86.1%,口吸吸毒者HCV抗体阳性21名,感染率60.0%;口吸吸毒人群中HIV抗体阳性3名,感染率为8.56%,静脉吸毒人群中HIV抗体阳性543名,感染率18.31%;HCV抗体阳性合并HIV抗体阳性有537名,感染率为20.86%。结论广西吸毒人群的HCV感染率较高,尤其是静脉注射吸毒人群,应当加强对吸毒人群的综合干预措施,控制HCV及HIV的传播,降低新发感染。     

广西部分吸毒人群丙型肝炎病毒及艾滋病病毒感染情况调查分析

目的 了解我区吸毒人群中丙型肝炎病毒(HCV)及艾滋病病毒(HIV)感染和两者合并感染的情况,为制定艾滋病及丙型肝炎的防治措施提供理论依据.方法 对我区部分在押的吸毒者共计3000名作为调查对象,制定统一的调查问卷进行调查,并采集静脉血,分离血清,用酶联免疫吸附试验(ELISA)夹心法检测HCV抗体和HIV抗体,当HIV抗体阳性时则用蛋白免疫印迹试验(Westem Blotting,WB)进行HIV抗体确证实验.结果 在3000名吸毒患者中,男性占88.4%,女性占11.6%;总的HCV抗体阳性率是85.6%,HIV抗体阳性率是18.2%,其中静脉注射吸毒者(IDUs)HCV抗体阳性2553名,感染率为86.1%,口吸吸毒者HCV抗体阳性21名,感染率60.O%;口吸吸毒人群中HIV抗体阳性3名,感染率为8.56%,静脉吸毒人群中HIV抗体阳性543名,感染率18.31%;HCV抗体阳性合并HIV抗体阳性有537名,感染率为20.86%.结论 广西吸毒人群的HCV感染率较高,尤其是静脉注射吸毒人群,应当加强对吸毒人群的综合干预措施,控制HCV及HIV的传播,降低新发感染.     

静脉吸毒人群丙型肝炎病毒抗体阳转随访研究

目的 调查四川省某地区静脉吸毒人群丙型肝炎病毒(HCV)血清抗体阳转情况及其危险因素,以了解该人群HCV流行的态势.方法 以社区为基础在四川省西昌市招募HCV血清抗体阴性的静脉吸毒人群107人,每6个月随访高危吸毒行为和性行为情况,采集血样检测HCV血清抗体.结果 队列随访2年,静脉吸毒人群队列保持率为81.3%(87/107),HCV阳转率为38.45/100人年.在多因素Poisson回归模型分析中,性别(RR,2.59;95%CI,1.18～5.65)、年龄(RR,0.52;95%CI,0.28～0.96)、近3个月静脉注射频率≥7次/周(RR,2.68;95% CI,1.33～5.42)和近3个月共用针头或注射器(RR,2.22;95%CI,1.11～4.45)是HCV血清抗体阳转的危险因素.结论 静脉吸毒人群HCV新发感染率高,应采取有效的干预措施以减少静脉吸毒人群的共用注射器行为和高危性行为.     

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。     

丙型肝炎病毒与其它病毒的联合感染

丙型肝炎病毒(HCV)与其他一些血液传播的病毒有共同的传播途径,所以极易发生联合感染,导致病情的复杂化。本文就HCV与其他病毒联合感染方面的研究进展作一综述。     

乙型和丙型肝炎病毒重叠感染的研究

目的　为了解乙型肝炎患者重叠感染丙型肝炎病毒（ＨＣＶ） 的状况,并探讨乙型肝炎病毒（ＨＢＶ） 、ＨＣＶ 重叠感染时ＨＣＶ 对ＨＢＶ 复制的影响。方法　应用ＥＬＩＳＡ 法对７１２ 例乙型肝炎患者进行了血清抗－ ＨＣＶ 检测和乙型肝炎病毒标志检测。结果　７１２ 例乙型肝炎患者血清抗－ ＨＣＶ阳性率为１４ ．４７ ％ ,其中重型肝炎患者血清抗－ ＨＣＶ 阳性率最高（４８ ．９８ ％ ） ,急性肝炎患者最低（３．２５ ％ ） 。在不同临床类型的乙型肝炎患者之间,血清抗－ ＨＣＶ 阳性率存在显著性差异（ Ｐ＜ ０ ．００１）,显示病情越重,病程越长,血清抗－ ＨＣＶ 阳性率越高;在ＨＢＶ 和ＨＣＶ 重叠感染的患者中,血清ＨＢｓＡｇ、ＨＢｅＡｇ 和抗－ ＨＢｃＩｇＭ 阳性率低于乙型肝炎患者（ Ｐ＜ ０ ．００１ ,Ｐ＜ ０ ．００１ 和Ｐ＜０ ．０５） ,而血清抗－ ＨＢｅ 阳性率高于乙型肝炎患者（ Ｐ＜ ０ ．０１）,均有显著的统计学意义。结论　乙型肝炎患者重叠感染ＨＣＶ 与病情加重和慢性化的形成有关,并使ＨＢＶ 的复制受到抑制。     

广西吸毒成瘾者的（HIV、HBV、HCV和HTLV－1）的血清学研究

选择２８３名静脉吸毒者（ＩＶＤＡｓ）和１２１名献血员（ＢＤＳ）进行Ａｎｔｉ－ＨＩＶ、ＨＢｓＡｇ、Ａｎｔｉ－ＨＢｓ、Ａｎｔｉ－ＨＢｃ、Ａｎｔｉ－ＨＣＶ和Ａｎｔｉ－ＨＴＬＶ－１的血清学检测。结果表明，２８３例ＩＶＤＡｓ的Ａｎｔｉ－ＨＩＶ、ＨＢ－ｓＡｇ、Ａｎｔｉ－ＨＢｓ、Ａｎｔｉ－ＨＢｃ、Ａｎｔｉ－ＨＣＶ和Ａｎｔｉ－ＨＴＬＶ－１的检出率分别为０％、２３．６７％、４４．１７％、９１．１７％、９７．１７％和０％；１２１例ＢＤｓ的上述６项指标分别为０％、１１．５７％、８８．４３％、６５．２９％、０．８３％和０％。     

昆明市静脉注射吸毒人群丙型肝炎病毒基因型分析

目的 研究云南省昆明市静脉注射吸毒人群(IDUs)中丙型肝炎病毒(HCV)基因型的流行特点。方法 2014年4－7月在昆明市连续收集276份IDUs的血浆,其中199份样品为HCV抗体阳性,提取RNA后用巢式PCR对E1E2基因和NS5B基因的部分片段进行扩增。扩增产物经基因序列测定,所得序列通过构建系统进化树确定HCV的分子亚型。结果 结合2 个基因片段,共有125份样品获得了分型结果,3b为主要的亚型,占48.8%(61/125);其他亚型按照比例依次为3a(30.4%,38/125)、6n(14.4%,18/125)、6a(3.2%,4/125)和1b(3.2%,4/125)。各HCV亚型按性别、婚姻、民族和HIV-1抗体是否阳性差异无统计学意义,按年龄分布差异有统计学意义,45岁以下组亚型多样化。分别计算不同亚型在E1E2和NS5B基因区的基因距离,结果显示3a、3b和6a亚型的基因距离大于1b和6n亚型的基因距离。3a、3b、6a 3种亚型中3b亚型毒株的基因距离大于3a亚型毒株。结论 昆明市IDUs人群中HCV存在5种亚型,3b和3a是主要毒株且在该人群中具有较长的流行时间。     

Hepatitis C virus infection among short-term intravenous drug users in southern Taiwan

The purpose of this study was to determine the correlation between the prevalence of hepatitis C virus (HCV) infection with duration of drug use and other risk factors among drug users. This survey covered 899 male drug users from Kaohsiung Narcotic Abstention Institute and Kaohsiung prison. The prevalence of positive anti-HCV was 67.2% among intravenous drug users (IVDU) and 14.7% among non-intravenous drug users (non-IVDU). Among intravenous (IV) drug users, age and duration of drug use were independently related to HCV seropositivity. Seroprevalence rate for HCV in the IVDU group increased with increasing duration of injection use within the first seven years of drug use. However, the steepest trajectory in seroprevalence of HCV infection occurred within the first four months. Due to the high rate of HCV infection among drug users, investigation of risk behaviors should be routine in such a group. A high frequency of HCV infection was also found among short-term injectors, which indicated that early risk reduction intervention was an important measure in moderating HCV infection.     

Prevalence of hepatitis C virus genotypes in southern Italy

HCV is ubiquitous. In 50% of all cases it causes chronic hepatitis that often evolves into liver cirrhosis and hepatocellular carcinoma. Recently HCV has been classified in 5 genotypes by Okamoto. The purpose of this study is to evaluate the prevalence of 5 genotypes in Campania, a region of Southern Italy, where the prevalence of anti-HCV antibodies ranges from 0.87 to 4%, and to evaluate the correlation between the HCV genotypes and the severity of histological damage. One hundred and thirty-five anti-HCV positive patients were enrolled and tested by PCR to identify HCV-RNA. One hundred and twenty-four patients resulted HCV-RNA positive. Genotyping was performed as described by Okamoto et al. with minor modifications of the specific primer to type III proposed by Silini et al. Eight patients were negative for all genotypes. Eight patients were positive for type I(1a), 61 for type II(1b), 39 for type III(2a), 11 for type IV(2b) and 1 for type V(3a). In 4 cases two different genotypes were present in the same sample [II(1b)-IV(2b), III(2a)-II(1b) twice, III(2a)-IV(2b)]. Histological evaluation of liver damage showed: CPH (22 cases), minimal CAH (56), severe CAH (31) and liver cirrhosis (15). There was no statistically significant correlation between the 5 genotypes and the severity of histological damage. Data on the prevalence of genotype II(1b) in Italy are similar to those reported for other European countries. The prevalence of genotypes in Southern Italy is similar to that reported in the population of Northern Italy.     

Variability in the incidence of human immunodeficiency virus,hepatitis B virus,and hepatitis C virus infection among young injecting drug users in New York City

Cohort studies of young (aged 18-30 years) injecting drug users recruited in 1997-1999 in the Harlem and Lower East Side areas of New York City, New York, were used to assess the incidence of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV). The authors found that HIV incidence was low at both sites: 0.8/100 person-years at the Harlem site and 0/100 person-years at the Lower East Side site. In contrast, HBV incidence was moderate (12.2/100 person-years) at the Harlem site and high (30.7/100 person-years) at the Lower East Side site. Similarly, HCV incidence was moderate (9.3/100 person-years) at the Harlem site and high (34.0/100 person-years) at the Lower East Side site. Results show that high rates of HBV and HCV transmission do not imply high rates of HIV transmission, even within an area of high HIV seroprevalence.     

深圳市外来务工人群丙型肝炎基因型分布及感染危险因素研究

目的 了解深圳市外来务工人群丙型肝炎病毒(HCV)感染者的基因型分布,并探讨该群体感染HCV的危险因素,为掌握本市外来务工群体HCV流行特点提供科学依据.方法 选取为本地外来务工人员提供体检服务的健康体检门诊2个,选择2014年1月至12月期间诊断出的HCV感染者进行基因型检测分析;并将其作为病例组,选择同时期同门诊中...     

An epidemic of hepatitis B virus infection among intravenous drug users in Iceland

This study describes an outbreak of hepatitis B primarily among intravenous drug users in Iceland which has a population with a very low incidence of hepatitis B virus infection. The incidence of acute hepatitis B is generally low in the Nordic Countries, in the order of one to five cases per 100,000 people per year. Between 1989 and 1992 there was an outbreak of hepatitis B virus infection primarily among the intravenous drug user (IVDU) population in Iceland. At the Department of Medical Virology, University of Iceland there were 44 cases of acute hepatitis B identified during the peak year 1990, an incidence of 16.9 cases of acute hepatitis B per 100,000 people. 63.6% of these were known to be IVDUs. The seroprevalence of the hepatitis B core antibody (anti-HBc) marker was assessed among 1100 randomly selected individuals. The average prevalence of this marker was 2.9% and rose from zero at the age of 15 and younger to 6.5% at the age of 65 and older. Among IVDUs attending a detoxification clinic in 1990 the prevalence of the anti-HBc was 32%. In contrast, those attending the same clinic, due to alcoholism only, did not have a significantly higher prevalence of anti-HBc than the group used for comparison.     

注射毒品者丙型肝炎病毒感染率及其危险因素研究

目的了解北京市注射毒品者HCV感染状况及其危险因素,评估注射毒品人群中HIV感染高危行为流行水平,为制定预防和控制艾滋病的策略和措施提供科学依据。方法选择北京市强制戒毒所新收治的注射毒品者和自社区招募的注射毒品者作为研究对象,采用问卷调查的方法进行资料的收集,采集静脉血5ml,实验室检测HCV抗体。资料的分析采用单因素分析、多因素分析。结果北京市注射毒品者的HIV感染率和HCV感染率分别为7.33%和52.59%。多因素分析结果表明HCV感染的危险因素有在强制戒毒所(OR=2.37,95%CI为1.55~5.72)、非北京市户籍(OR=1.94,95%CI为1.05~3.45)和注射次数≥100次(OR=2.60,95%CI为1.54~7.03)。结论北京市注射毒品人群HCV的感染率高达52.59%,标志着HIV感染高危行为在这一人群中广泛存在,应立即采取相应措施控制HIV和HCV感染的进一步扩散。     

Prevalence and incidence of hepatitis C virus infection among male prison inmates in Maryland

To identify incidence of antibody to hepatitis C virus among 265 male prison inmates, we assayed paired serum specimens obtained at intake in 1985–1986 with follow-up specimens in 1987. Intake prevalence was 38 percent. Seroincidence was 1.1/100 person years in prison. This finding might reflect saturation of high-risk subgroups or possibly reduced frequency of exposures following incarceration.