上海市部分地区散发性戊型肝炎病毒基因型别和发病危险因素研究

目的探讨上海市部分地区急性散发性戊型肝炎（戊肝）病毒（HEV）型别和发病危险因素.方法用巢式RT-PCR方法检测HEV序列,并进行序列的同源性比较分析;同时采取1：2病例对照研究的方法,选取上海市3个区2003-2004年急性散发性确诊戊肝86例住院病例,分别配以本区和其他区健康人群对照组,用单因素和多因素logistlc回归模型进行分析.结果病毒序列分析表明戊肝病例中的HEV病毒序列属于Ⅳ型;单因素分析结果显示居住条件、外出就餐、有海鲜河鲜食用史等均为戊肝发病的危险因素;多因素分析结果显示海鲜（生、炝）食用史（OR=7.048）是戊肝感染 的危险因素.结论上海市部分地区散发性HEV流行株以Ⅳ型病毒株为主,海鲜（生、炝）食用史等是戊肝发病的危险因素.

Study on risk factors of sporadic hepatitis E virus cases in some districts of Shanghai

OBJECTIVE: To study the risk factors of acute sporadic hepatitis E virus (HEV) cases and to analyze its partial sequence in some districts of Shanghai. METHODS: 30 blood samples were collected from the acute sporadic HEV cases in 2003-2004 and the RT-nPCR method was applied to obtain the sequence of HEV in these cases. Meanwhile, a 1:2 case-control study was used to identify risk factors in the process of sporadic HEV infection in these regions of Shanghai. RESULTS: Data from the sequential analysis showed that HEV of the sporadic cases belonged to HEV genotype IV. Finding from the case-control study implicated that the housing condition, outside eating history, especially seafoods (OR = 7.048) played an important role in the infection of HEV. Results from multiple logistic regression showed that eating raw seafoods appeared to be one of the risk factors of HEV infection. CONCLUSION: HEV sequences isolated from the sporadic cases of HEV in some districts of Shanghai belonged to HEV genotype IV. Foods, especially seafood, were the risk factors in the infection of HEV.