鸭乙型肝炎动物模型的建立和DHBV在肝脏的定位研究

本文利用ＤＨＢＶ阳性血清感染１日龄雏鸭，感染后２、４、８周以血清斑点杂交和Ｄｏｔ－ＥＩＡ检测鸭血清中的ＤＨＢＶ－ＤＮＡ和ＤＨＢｓＡｇ，其阳性率分别为５６．３％、６５．６％、７４．２％和５３．１％、７１．９％、７０．９％。进一步采用原位杂交和免疫组化对鸭肝组织内ＤＨＢＶ－ＤＮＡ和ＤＨＢｓＡｇ进行检测，结果表明ＤＨＢＶ－ＤＮＡ主要存在于细胞浆中，而ＤＨＢｓＡｇ主要分布于细胞浆及细胞膜。对肝组织的病理检查及胶原纤维特殊检测发现，ＤＨＢＶ阳性组与阴性组无明显差别。     

庚型肝炎病毒（GBV—C／HGV）与HBV和HCV联合或重叠感染的初步研究

目的 研究庚型肝炎病毒（ＧＢＶ－Ｃ／ＨＧＶ）与ＨＢＶ和ＨＣＶ联合或重叠感染的情况，方法 采用ＥＬＩＳＡ的方法检测血液制剂和血源乙肝疫苗原料血浆中的ＨＢｓＡｇ和抗－ＨＣＶ；并用５′非编码区的引物，用逆转录聚合酶链反应（ＲＴ－ＰＣＲ）法检测ＧＢＶ－Ｃ／ＨＧＶＲＮＡ。结果 ＨＢｓＡｇ和抗ＨＣＶ均阴性血浆的ＧＢＶ－Ｃ／ＨＧＶＲＮＡ阳性率为１８．８％（１５／８０）；ＨＢｓＡｇ阳性而抗ＨＣＶ阴性血浆的ＧＢＶ－     

乙型肝炎表面抗原阳性血吸虫病患者 HDV 感染的血清学及预后调查

用酶联免疫吸附试验（ＥＬＩＳＡ）检测１２３例乙型肝炎表面抗原（ＨＢｓＡｇ）阳性的各期血吸虫病患者及５０例ＨＢｓＡｇ阳性的非血吸虫病对照人群血清丁型肝炎病毒（ＨＤＶ）标志物，用斑点杂交检测晚期血吸虫病（晚血，ＡＳ）患者ＨＢＶ－ＤＮＡ。结果表明，ＨＢｓＡｇ阳性的晚血患者ＨＤＶ标志物（ＨＤＶ－Ｍ）检出率１４．５％，显著高于急性血吸虫病（急血）、慢性血吸虫病（慢血）患者（２．５％）及对照人群（２．０％）（Ｐ＜０．０５）。随访观察发现，ＨＢＶ／ＨＤＶ双重感染的晚血患者病死率４０％，显著高于单纯ＨＢＶ感染的晚血患者（８．５％，Ｐ＜０．０５），提示晚血患者是ＨＤＶ感染的易感人群，ＨＤＶ感染是ＨＢｓＡｇ阳性晚血患者病情加重或恶化的一个重要原因，ＨＢＶ／ＨＤＶ双重感染与晚血患者死亡密切相关。     

逆转录－套式－聚合酶链反应检测HCV RNA正链和负链及与肝细胞癌的关系

为了解ＨＣＶ与肝癌的关系，采用ＨＣＶ５－ＮＣＲ正相引物和反相引物逆转录－套式－聚合酶链反应（ＲＴ－Ｎｅｓｔｅｄ－ＰＣＲ）检测了２２例肝癌手术患者血清、癌组织和癌旁组织ＨＣＶＲＮＡ正链和负链；用ＨＢＶＣ保守区引物ＰＣＲ法检测了ＨＢＶＤＮＡ。结果发现：５例抗－ＨＣＶ阳性的肝癌患者中，３例血清、癌组织和癌旁组织ＨＣＶＲＮＡ正链扩增试验均阳性；１例三者均阴性；１例血清和癌旁组织阳性。３例正链扩增试验阳性的癌组织和癌旁组织均检出了ＨＣＶＲＮＡ负链，但血清中未检出负链。在２２例ＨＣＣ中１３例血清、８例癌组织和１５例癌旁组织中检出ＨＢＶＤＮＡ。５例有ＨＣＶＲＮＡ和／或抗－ＨＣＶ阳性的肝癌患者血清、和／或癌组织、和／或癌旁组织中均伴随ＨＢＶＤＮＡ和／或ＨＢ－ＶＭ阳性。提示ＨＣＶ可在癌旁肝细胞或肝癌细胞中感染并复制；ＨＢＶ感染与肝癌发生的关系比ＨＣＶ感染更密切。     

多重和套式聚合酶链反应检测血液,腹膜透析患者血清中HBV D…

利用免疫学和聚合反应（ＰＣＲ）方法，对３５例血液透析（血透），１４例腹膜透析（腹透）患者的８４份血清进行了检测。血透组抗－ＨＣＶ阳性率８２．９％，ＨＣＶ ＲＮＡ ＰＣＲ阳性率５１．４％；腹透组抗－ＨＣＶ阳性率仅７．１％，ＨＣＶ ＲＮＡ ＰＣＲ均阴性。ＨＢｓＡｇ和（或）ＨＢｅＡｇ在二组的阳性率分别为２５．７％和２１．４％；ＨＢＶＤＮＡＰＣＲ阳性率分别为４５．７％和６４．２％。透析患者ＨＣＶ和ＨＢＶ感     

输血后乙型和丙型肝炎病毒感染的前瞻性调查

目的 了解输血所致ＨＢＶ和ＨＣＶ感染现状及ＨＢｓＡｇ抗ＨＣＶ和ＡＬＴ筛检供血的效果。方法 对１３８例输血者输血前，后１，３，６，９个月血清标本及其供血检测ＨＢｓＡｇ，抗ＨＢｓ，抗ＨＢｃ，抗ＨＣＶ和ＡＬＴ，并对部分血清标本用ＰＣＲ及巢式ＲＴ－ＰＣＲ法检测ＨＢＶＤＮＡ和ＨＣＶＲＮＡ，结果和结论 输血后ＨＢＶ和ＨＣＶ感染率分别为１．４％（２／１３８）和３４．８％（４８／１３８），输血后乙型和丙型肝炎发生     

HBsAg阳性的胃溃疡患者HCV感染的情况分析

为探讨ＨＢｓＡｇ阳性的胃溃疡患者ＨＣＶ感染情况。方法用ＥＬＩＳＡ法及ＰＣＲ法对ＨＢｓＡｇ阳性的胃溃疡患者７５例（其中接受输血者３８例,未输血者３７例）和单纯ＨＢｓＡｇ阳性患者３２例的血清进行抗－ＨＣＶ和ＨＣＶＲＮＡ测定。结果接受输血者抗－ＨＣＶ及ＨＣＶＲＮＡ阳性率明显高于未输血者及单纯ＨＢｓＡｇ阳性患者（Ｐ＜０．０１）。结论输血为传播ＨＣＶ的主要途径,未发现消化道传播ＨＣＶ的证据。     

套式及免疫套式聚合酶链反应检测乙型肝炎表面抗原阴性肝病患者血清中乙型肝炎病毒DNA

为了更准确、简便而又快速地了解乙型肝炎表面抗原（ＨＢｓＡｇ）阴性肝病患者的病因，建立了套式和免疫套式聚合酶链反应（ＰＣＲ）检测血清中乙型肝炎病毒（ＨＢＶ）ＤＮＡ的技术，结合丙型肝炎病毒（ＨＣＶ）感染指标的检测，对ＨＢｓＡｇ阴性肝病患者的病因进行了研究。发现套式ＰＣＲ能将单次ＰＣＲ的敏感性稳定地提高１０００倍；免疫套式ＰＣＲ可检测到０．１～０．０１ｐｇ／Ｌ水平。检测ＨＢｓＡｇ阴性肝硬化２２例（Ａ组）、ＨＢｓＡｇ阴性慢性肝炎１３例（Ｂ组）、ＨＢｓＡｇ阴性和乙型肝炎病毒核心抗体（抗－ＨＢｃ）阳性正常对照组３０例（Ｃ组）及ＨＢｓＡｇ（＋）／ＨＢｅＡｇ（－）肝硬化患者１２例（Ｄ组），分别有４５．５％、３０．８％、１３．３％和１００％患者血清中ＨＢＶＤＮＡ阳性。ＨＢＶＤＮＡ在一些抗－ＨＢｓ（＋）肝病患者和所谓健康人的血清中也存在。Ａ、Ｂ两组检出有ＨＢＶ和（或）ＨＣＶ感染患者分别占８１．８％和５３．８％。提示套式和免疫套式ＰＣＲ是简便、快速而又高度敏感的检测方法；ＨＢＶ感染可能是引起ＨＢｓＡｇ阴性慢性肝病的重要原因，且ＨＢｓＡｇ阴性肝病病因大多与病毒感染有关；应该重新认识自然感染者血清中抗－ＨＢｓ的临床意义。     

乙型肝炎表面抗原阳性血吸虫病患者HDV感染的血清学…

用酶联免疫吸附试验检测１２３例乙型肝炎表面抗原阳性的各期血吸虫病患者及５０例ＨＢｓＡｇ的阳性的非血吸虫病对照人群血清丁型肝炎病毒标志物，用斑点杂交检测晚期血吸虫病患者ＨＢＶ－ＤＮＡ。结果表明，ＨＢｓＡｇ阳性的晚血患者ＨＤＶ标志物检出率为率１４．５％显著高于急性血吸虫病，慢性血吸虫病患者及对照人群。随访观察发现，ＨＢＶ／ＨＤＶ双重感染的和晚血患者病死率４０％，显著高于单纯ＨＢＶ感染的晚血患者，提示晚     

血液透析患者血液中丙型及乙型肝炎病毒的检测

为了解血液透析患者血液中丙型肝炎病毒（ＨＣＶ）及乙型肝炎病毒（ＨＢＶ）的感染情况，对２２例维持性血液透析患者应用逆转录聚合酶链反应及酶联免疫吸附实验，检测了血清中ＨＣＶＲＮＡ及其抗体水平；同时采用斑点杂交及固相放射免疫法检测了血清中ＨＢＶＤＮＡ及其血清标志物。结果显示，２７％的血液透析患者血清ＨＣＶ抗体阳性，其中３３％的患者血清存在ＨＣＶＲＮＡ。在血清ＨＣＶ抗体阴性的１６例患者中，也有１例（６％）血清ＨＣＶＲＮＡ阳性。在２２例血液透析患者中，３例（１４％）血清ＨＢＶＤＮＡ阳性（ＨＢｅＡｇ也均阳性）。其余１９例ＨＢＶＤＮＡ阴性患者（ＨＢｅＡｇ均阴性），有１２例（６３％）血清抗－ＨＢｃ阳性。在７例血清ＨＣＶＲＮＡ或（和）抗－ＨＣＶ阳性者，５例有既往或现在ＨＢＶ感染的证据，但未见ＨＣＶＲＮＡ与ＨＢＶＤＮＡ同时存在者。提示在相当数量的血液透析患者体内存在肝炎病毒血症，应加强对血液透析患者肝炎病毒感染的监测及预防工作     

Viral hepatitis: Past,present, and future

Each hepatitis virus—Hepatitis A, B, C, D, E, and G—poses a distinct scenario to the patient and clinician alike. Since the discovery of each virus, extensive knowledge regarding epidemiology, virologic properties, and the natural clinical and immunologic history of acute and chronic infections has been generated. Basic discoveries about host immunologic responses to acute and chronic viral infections, combined with virologic data, has led to vaccines to prevent Hepatitis A, B, and E and highly efficacious antivirals for Hepatitis B and C. These therapeutic breakthroughs are transforming the fields of hepatology, transplant medicine in general, and public and global health. Most notably, there is even an ambitious global effort to eliminate chronic viral hepatitis within the next decade. While attainable, there are many barriers to this goal that are being actively investigated in basic and clinical labs on the local, national, and international scales. Herein, we discuss pertinent clinical information and recent organizational guidelines for each of the individual hepatitis viruses while also synthesizing this information with the latest research to focus on exciting future directions for each virus.     

急性非甲乙丙丁戊型病毒性肝炎的临床分析

本文对４３例未定型病毒性肝炎患者的流行病学资料、临床表现等进行了分析。结果表明：本组患者起病急，常有短暂发热、消化道症状、黄疸、肝大。在同期住院的急性病毒性肝炎中占１２．４６％。发病时间以冬末及春季为多见，中、老年病人占相当比例。本组患者皮疹，关节痛等血清病样表现极少见，其ＡＬＴ活性及ＳＢ多明显增高，除２例因亚急性重型肝炎死亡外，其余病例都在１个月左右顺利康复，与文献中提及的己、庚型病毒性肝炎的临     

From hepatitis A to E: A critical review of viral hepatitis

Viral infections affecting the liver have had an important impact on humanity, as they have led to significant morbidity and mortality in patients with acute and chronic infections. Once an unknown etiology, the discovery of the viral agents triggered interest of the scientific community to establish the pathogenesis and diagnostic modalities to identify the affected population. With the rapid scientific and technological advances in the last centuries, controlling and even curing the infections became a possibility, with a large focus on preventive medicine through vaccination. Hence, a comprehensive understanding of hepatitis A, B, C, D and E is required by primary care physicians and gastroenterologists to provide care to these patients. The review article describes the epidemiology, pathogenesis, clinical presentation, diagnostic tools and current medication regimens, with a focus on upcoming treatment options and the role of liver transplantation.     

Viral hepatitis in 2021:The challenges remaining and how we should tackle them

Viral hepatitis results in 1.4 million deaths annually.The World Health Organization(WHO)set an ambitious target to eliminate viral hepatitis by 2030,but significant challenges remain.These include inequalities in access to healthcare,reaching at risk populations and providing access to screening and effective treatment.Stigma around viral hepatitis persists and must be addressed.The WHO goal of global elimination by 2030 is a worthy aim,but remains ambitious and the coronavirus 2019 pandemic undoubtedly has set back progress.This review article will focus on hepatitis A to E,highlighting problems that have been resolved in the field over the past decade,those that remain to be resolved and suggest directions for future problem solving and research.     

HDV感染后乙型肝炎患者血清肝炎病毒标志物的变化

目的　分析HDV感染患者血清病毒性肝炎标志物的变化和意义 ,探讨HDV致病机理。方法　对 469例HDV阳性乙型肝炎患者常见各类型病毒性肝炎血清标志物的变化等作统计分析 ,以 2 13例HDV( -)乙型肝炎患者作对照。结果　HDV感染后血清HBeAg检出率降低 (P <0 .0 1)。在HDV ( +)HBVDNA( -)组 ,HBeAg( -)的机会大 (P <0 .0 1)。在急性肝炎、重型肝炎和肝硬化患者HDAg( +)HBeAg( -)为主要血清病毒表现形式 (P <0 .0 1或 0 .0 5 )。HDV感染后合并其它肝炎病毒感染率高于乙型肝炎组。结论　HDV感染可抑制HBV复制或HBeAg表达 ,混合感染HDV的乙型肝炎中HDV的直接细胞毒性作用可能起主要致病作用。重叠感染HDV的乙型肝炎患者其病情重、病死率高和容易慢性化。     

临床肝病患者中庚型肝炎病毒(GBV-C/HGV)的感染

本文应用抗-HGV酶联免疫法(EIA)和逆转录套式聚合酶链反应法(RT-PCR)检测150份乙型、120份丙型、15份戊型和49份非甲-戊型肝炎患者血清。结果显示:乙肝、丙肝、戊肝和非甲-戊型肝炎患者中抗-HGV抗体的阳性率分别为22.0％(33/150)、25.0％(30/120)、33.3％(5/15)和40.1％(20/49)。其中乙型、丙型、戊型和非甲-戊型肝炎的抗-HGV抗体阳性者中,HGV RNA的阳性率分别为58.3％(7/12)、60.0％(6/10)、40.0％(2/5)和45.5％(9/12)。说明GBV-C/HGV可与HBV、HCV或HEV合并感染,该病毒可能引起临床型肝炎。     

Sustained Virological Response in Chronic Hepatitis C Patients after a 6- and a 36-Month Interferon-a2b Treatment Schedule. A Multicenter,Randomized, Controlled Study

With the introduction of medical treatment (chenodeoxycholic acid therapy) of cholesterol gallstones, the prediction of the gallstone type, cholesterol — non-cholesterol stones (i.e. cholesterol predominating or not), has become important. In 24 consecutive patients admitted for surgery because of gallstones, the value of various criteria for differentiation between the two types of stones was assessed. It is concluded that the combined requirements of radiolucency of the stones and a cholesterol saturation index in duodenal bile above 1.00 constitutes a fairly reliable method for selection of patients for dissolution therapy with chenodeoxycholic acid.     

铜相关蛋白和组织铁在丙型、丁型、庚型肝炎肝组织中的定位比较

目的 研究铜相关蛋白(C-AP)和组织铁(IT)在丙型肝炎,丁型肝炎和庚型肝炎中的变化特点。方法应用改良的Shikata和Berlin blue方法,检测三种肝炎患者肝穿活检组织中的C-AP和IT的定位及分级程度。结果 C-AP和IT的阳性率和分级程度随着肝组织损伤的严重程度而递增。在三种肝炎肝组织中,C-AP和IT的阳性率及分级程度有明显差异。结论 C-AP和IT可以反映出三种病毒性肝炎肝组织损伤的差异,庚型肝炎肝组织损伤比丙型肝炎和丁型肝炎肝组织损伤轻。     

Health Related Quality of Life in Iranian Hemodialysis Patients With Viral Hepatitis: Changing Epidemiology

Background

There are surprisingly a few studies that evaluate the impact of chronic viral hepatitis, which is common in HD (hemodialysis) patients, on HRQOL (health related quality of life).

Objectives

We conducted a study to evaluate the impact of chronic viral hepatitis on HRQOL and to compare their HRQOL with non-infected HD patients via a HRQOL questionnaire.

Patients and Methods

The Iranian adapted version of the Kidney Disease Quality of Life Short Form (KDQOL-SF) version 1.3 questionnaires were filled out by the HD patients. In all HD patients, serum HBsAg, HBS Abs, and HCV Abs [enzyme-linked immunosorbant assay (ELISA)] were routinely checked every six months. Patients were considered to have chronic HBV infection if HBsAg was positive for more than six months. In all HD patients, third generation assay was used to detect HCV infection. Furthermore, serum HCV-RNA (PCR) was examined in anti-HCV-positive patients for confirmation of HCV infection.

Results

in this cross sectional study 4101 patients from 103 dialysis units in Iran between October 2010 and August 2011 were included. Prevalence of hepatitis B and hepatitis C infection was 2.1% and 1.3% respectively. Almost all KDQOL items for viral hepatitis patients had equivalent or better scores than those without viral hepatitis. In the logistic regression after adjustment for age, sex, educational level, marital status, dialysis vintage, HBs Ag positivity and HCV Ab positivity, only age (P < 0.001) and educational level (P = 0.015) had negative impact on quality of life.

Conclusions

Our data show that not only general health and physical activity were preserved but also health perception may be better among HD patients with viral hepatitis.