国产甲肝减毒活疫苗（H2株）在小学生中的免疫效果研究

目的: 研究国产甲肝减毒活疫苗 (H2 株) 在小学生中的免疫效果。方法: 将431 名6～9 岁甲肝易感小学生随机分为两组。观察组接种甲肝减毒活疫苗(H2 株), 对照组接种乙肝基因工程疫苗。结果: 全部接种对象均未出现局部和全身不良反应;免疫后观察组抗-HAV 阳转率在T3 和T12时分别为85.44% 和85.64% ,而对照组则分别为12.93% 和28.32% 。结论: 两组的抗-HAV 阳转率差异有显著性, 表明国产甲肝减毒活疫苗 (H2 株) 具有良好的安全性和免疫原性     

Clinical,laboratory and imaging findings in Castleman's disease – The subtype decides

Castleman's disease (CD) is a rare lymphoproliferative disorder with its distinct unicentric (uCD) and multicentric (mCD) entities. The present work aimed at characterizing CD in more detail. From the 775 articles found by a PubMed search, 1133 cases were extracted. Two own cases were included. UCD was identified in 719 (42% males) and mCD in 416 (63% males) cases. Age in uCD was 34 ± 17 and in mCD 48 ± 18 years. The hyaline-vascular type predominated in uCD and the plasma cell type in mCD. Clinical symptoms were more common in mCD. The head and neck region was most frequently affected in uCD and the axillary region in mCD. Prevalence of human immunodeficiency virus (HIV) and human herpesvirus-8 (HHV-8) positivity was higher in mCD. In CT scans, high contrast enhancement and calcifications were more frequent in uCD (all p < 0.0001).The two forms of CD not only differ markedly in their clinical, laboratory and imaging findings, but also in treatment response and prognosis.     

The use of dried blood spots for assessing antibody response to hepatitis A virus after natural infection and vaccination

During recent years, vaccination against hepatitis A has been implemented in several countries. It is expected that the increase in mass vaccination against hepatitis A will eventually result in a decreased prevalence of anti-HAV antibodies in the general population. For this reason, a suitable clinical sample for diagnosis of hepatitis A must be sufficiently sensitive to enable detection of lower antibodies titers. In this study, the feasibility of using dried blood spots (DBS) was assessed for the detection of anti-HAV antibodies after a natural infection and vaccination. Seventy-four DBS and paired plasma samples were obtained from a group of college students for a cross-sectional hepatitis A seroepidemiological study. Forty-six students seronegative for anti-HAV were selected randomly and immunized with an inactivated hepatitis A vaccine using an 0-6 month schedule. Seroconversion was monitored in paired plasma and DBS samples 6 months after the first dose followed by a period of 8 and 24 months after the second dose. A strong correlation between OD/CO rates of paired plasma and DBS samples for the detection of anti-HAV was observed. The sensitivity and specificity of the DBS compared with plasma for the detection of anti-HAV antibodies after natural infection was 100%. The sensitivity of DBS in samples collected 24 months after the second dose of hepatitis A vaccine was 95.4%. The results showed that DBS samples can be used for the detection of anti-HAV antibodies both after natural infection or vaccination.     

Presence of enteric hepatitis viruses in the sewage and population of Greater Cairo

In Egypt, the disease burden of viral hepatitis is one of the heaviest worldwide. We conducted a survey of hepatitis A virus (HAV) and hepatitis E virus (HEV) in patients and sewage in Cairo. Our data showed that HAV (genotype IB) was predominant over HEV (genotype 3) and was circulating in the population and the environment.     

An in‐house‐anti‐hepatitis A virus (HAV)‐specific immunoglobulin M capture enzyme‐linked immunosorbent assay: Evaluation and application to an HAV outbreak

An anti‐hepatitis A virus (HAV)‐specific immunoglobulin M capture enzyme‐linked immunosorbent assay (anti‐HAV IgM ELISA) kit was re‐designed for laboratory use and compared with a commercial anti‐HAV IgM detection system using 58 serum samples collected from patients, vaccines, and healthy individuals. Because concordance between the two systems was high (r = 0.93, P < 0.05), 19 sets of serum and fecal samples obtained from individuals exposed to an HAV outbreak were also examined. Serum levels of anti‐HAV IgM were determined using the in‐house ELISA kit and the HAV genome in fecal samples was detected using the polymerase chain reaction (PCR). Among the 19 sets of sample, 14 were positive for both anti‐HAV IgM and the HAV genome. All of those whose serum samples were anti‐HAV IgM negative were also negative for the HAV genome in fecal samples. The results of the in‐house IgM ELISA were consistent with those of the HAV genome detected by PCR and with the commercial IgM ELISA. The in‐house anti‐HAV IgM ELISA kit was therefore proven suitable for laboratory use and applicable to epidemiological studies of HAV infection. J. Med. Virol. 81:1513–1516, 2009. © 2009 Wiley‐Liss, Inc.     

甲/戊型肝炎重组抗原的表达、纯化及与传统甲肝疫苗免疫原性的比较

目的比较基因工程重组抗原与传统疫苗的免疫原性;探讨同一载体表达不同抗原的能力和抗原间的相互作用。方法将编码甲型肝炎病毒Vp1aa24-171和戊型肝炎病毒ORF2aa431-615的重组表达质粒pBV220-EAAg342及pBV220-AEAg342转化入大肠杆菌BL-21,筛选出高效表达的菌种进行目的蛋白的表达。用DEAE-sepharose FF和CM-sepharoseFF离子层析交换柱纯化表达重组蛋白,采用SDS-PAGE、Western blotting方法进行分析鉴定。用纯化的重组蛋白及传统甲肝疫苗灭活疫苗与减毒活疫苗免疫小鼠,比较特异性抗体的产生水平。结果表达的重组蛋白相对分子质量约为36000,表达量约占菌体总量的25%;且重组嵌合抗原EAAg342可以形成直径10～20nm的类病毒(virus-like particles,VLP)颗粒。Western blotting证实2种重组蛋白均能分别与甲型肝炎和戊型肝炎患者阳性血清发生特异性反应。免疫小鼠后可诱导产生高滴度的抗戊肝特异性抗体;而抗甲肝特异性抗体水平与传统甲肝疫苗相比较低。结论使用原核系统表达的甲/戊肝重组抗原能够高效表达,2种不同的融合蛋白均分别具有良好的抗原性和免疫原性,具有开发双价疫苗及同时诊断甲型戊型肝炎试剂盒的前景。     

Multiple viral hepatitis in injection drug users and associated risk factors

BACKGROUND: While infections due to hepatitis B virus (HBV) and hepatitis C virus (HCV) have been well-studied in injection drug users (IDUs), hepatitis A virus (HAV) infection and coinfection with multiple hepatitis viruses have received less attention. METHODS: Hepatitis serology as well as sociodemographic and drug-related parameters were explored in patients (n = 1512) admitted for opiate detoxification. RESULTS: Antibodies to HAV were positive in 57.7%, to HBV in 53.0%, and to HCV in 75.0% of the sample. Lack of any hepatic marker was reported in 11.2%; one marker was positive in 24.7%; two markers were positive in 31.2%; and all markers were positive in 32.9%. In patients with one positive marker, 58.8% had had exposure to HCV, and 27% had exposure to HAV. In patients with two positive markers, 46.7% were HAV/HCV and 41.8% HBV/HCV antibody positive. Presence of HBV and HCV antibodies was associated with older age, longer duration of (i.v.) heroin use, and a higher number of rehabilitation treatment episodes (anova), current coconsumption of cocaine was associated with presence of antibodies to either HAV, HBV, and HCV. CONCLUSIONS: Coinfection with hepatic viruses is highly relevant in IDUs, although HAV does not necessarily share the same risk factors relevant for HBV or HCV transmission. The need for outreach vaccination programs is emphasized for HAV and HBV in the target population. Primary prevention should be implemented before initiation or at early stages of a drug career. Epidemiology and transmission of HAV in IDUs requires further research.     

Increased circulation of hepatitis A virus genotype IIIA over the last decade in St Petersburg, Russia

The current study, covering the period 2004–2009, is a part of long‐term monitoring for hepatitis A virus (HAV) strains circulating in St Petersburg, Russia. The HAV RNA was isolated directly from the sera of hepatitis A patients and RT‐PCR was carried out using primer pairs for VP1/2A and VP1 genomic regions. PCR products were sequenced and 324 nucleotides from VP1/2A and 332 from the VP1 region were used for phylogenetic analysis. The results show that the IA subtype was the most common circulating subtype during the follow‐up period, as found in the previous study: almost 90% of the isolated HAV strains belonged to the IA subtype. The large hepatitis A food‐borne outbreak in St Petersburg in 2005 was caused by HAV IA. However, the proportion of HAV isolates belonging to subtype IIIA significantly increased in the period 2001–2009 (7.9%) compared to the period 1997–2000 (none found). The subtype IIIA was first found in St Petersburg in 2001 among a group of intravenous drug users. The increase in its circulation during the decade suggests that this previously unusual genotype has been permanently introduced into the general population of St Petersburg. These results indicate the usefulness of molecular epidemiological methods for studying changes in the circulation of HAV strains. J. Med. Virol. 84:1528–1534, 2012. © 2012 Wiley Periodicals, Inc.     

南宁市服务行业人员甲肝和戊肝的感染状况及防治对策

目的了解南宁市从业人员HAV、HEV的感染状况。方法对2010年3月～2011年11月南宁市从业人员健康体检结果中的HAV-IgM、HEV-IgM的阳性结果进行分析。结果 2010、2011年南宁市从业人员甲肝感染率分别为0.07%、0.05%,戊肝感染率均为0.18%,两年相比差异均无统计学意义。戊肝感染20～49岁多见,男性多于女性,接触感染是戊肝的常见传播途径。甲肝和戊肝均有一定的季节性。结论南宁市从业人员HAV、HEV感染率较高,建议对所有从业人员均进行HAV-IgM、HEV-IgM检测,从源头控制传染源,加强卫生执法,做好卫生知识宣传,提高人们自我防护意识是预防甲肝和戊肝的重要措施,而疫苗的接种则是降低甲肝和戊肝的有效措施。