我国不同肝炎患者及献血员中SENV-D/H感染流行病学调查

目的了解SEN病毒(SENV)D亚型和H亚型在我国不同肝炎患者和献血员中的感染情况。方法采用巢式聚合酶链反应对收集的270例健康献血者和484例各型肝炎患者(包括甲肝、乙肝、丙肝和非甲非戊型肝炎患者)进行SENV-D亚型和H亚型DNA检测。结果无偿献血者中SENV-D的感染率为25.9%,SENV-H为24.4%;急性甲肝患者中SENV-D的感染率为14.5%,SENV-H为32.7%;慢性乙肝患者中SENV-D的感染率为46%,SENV-H为45.2%;在丙肝患者中SENV-D和SENV-H感染率均为65%;在非甲-非戊型肝炎患者中SENV-D的感染率为51.2%,SENV-H为43.9%。结论SENV可能与HCV和HBV具有一样的传播方式,但并不是肝病发生的原因。     

我国不同肝炎患者及献血员中SENV-D/H感染流行病学调查

目的了解SEN病毒(SENV)D亚型和H亚型在我国不同肝炎患者和献血员中的感染情况。方法采用巢式聚合酶链反应对收集的270例健康献血者和484例各型肝炎患者(包括甲肝、乙肝、丙肝和甲非戊型肝炎患者)进行SENV-D亚型和H亚型DNA检测。结果无偿献血者中SENV-D的感染率为25.9%,SENV-H为24.4%;急性甲肝患者中SENV-D的感染率为14.5%,SENV-H为32.7%;慢性乙肝患者中SENV-D的感染率炎46%,SENV-H为45.2%;在丙肝患者中SENV-D和SENV-H感染率均为65%,在非甲-非戊型肝炎患者中SENV-D的感染率为51.2%,SENV-H为43,9%。结论SENV可能为HCV和HBV具有一样的传播方式,但并不是肝病发生的原因。     

丙型肝炎及其护理

病毒性肝炎的分类,由于新近抗HCV检测方法的出现得到了迅速发展,从一向认为未知非甲非乙肝炎病毒引出丙(C)型肝炎与戊(E)型肝炎。因此,迄今为止病毒性肝炎共分五型肝炎均无交叉免疫,故一个人如果对病毒性肝炎的预防工作未作好,则一辈子可患5种不同型肝炎,也可在一个病人身上同时患两种肝炎,如甲型肝炎(甲肝)、乙型肝炎(乙肝)或乙、丙肝等混合感染。丙型肝炎病毒HCV至今尚未被任何国家所确切证实,原因是丙肝患者血中HCV数量甚小,不易检测到。但初步认为此病毒颗粒直径50～60nm,单链RIVA属于一种黄病毒的远亲。丙肝病人及HCV携带者为此病传染源,可通过输血,从献血者GPT正常者检测抗HCV为5.3％,GPT异常者可高达44.7％,受血者60～84％,平     

庚型肝炎病毒感染标志物的检测及其应用

近二十多年来病毒性肝炎的研究取得了很大的进展，继发现人甲肝病毒和乙肝病毒之后，又发现了丁肝病毒。之后在非甲非乙型肝炎病人的血清中分离出丙型肝炎病毒和戊型肝炎病毒，并建立了一系列的检测方法，为此，表明人类有甲、乙、丙、丁、戊等方型肝炎。近年来又在一些肝炎病人和输血后感染的患者中，发现一些不属上述五型肝炎。此类不明原因的非甲～戊型肝炎，说明可能存在另外类型的肝炎病毒感染。1995年初美国Kin等首先报导发现了一种输血后致肝炎的一种新肝炎病毒，并命名为庚型肝炎病毒（HepatitisGVirus缩写为HGV）。同年4月美国…     

丙型和戊型肝炎实验室诊断进展

近已确认非甲非乙型肝炎由两种不同的特异性病毒引起,并建立了特异性诊断方法,结合流行病学和临床特点,已把肠道外传播的非甲非乙型肝炎命名为丙型肝炎(HC),而把肠道传播的非甲非乙型肝炎称为戊型肝炎(HE)。这样按病毒不同,病毒性肝炎有甲、乙、丙、丁、戊型五种。HC 的传播途径主要是经血传播。即使严格筛选HBsAg 携带者,输血后肝炎发生率仍高达10～15%,且其中95%为HC。HC 发     

HGV和TTV不是我国非甲非戊型肝炎的主要病因

本研究通过对我国部分地区的自然人群和非甲非戊型肝炎病人进行HGV和TTV感染的分子流行病学研究 ,探讨这两种病毒在我国肝炎发病尤其是在非甲非戊型肝炎中的作用和地位。用建立的PCR方法检测血清标本中的HGVRNA和TTVDNA ,对调查的自然人群和非甲非戊型肝炎病人血清标本进行检测。HGVRNA采用反转录PCR(RT -PCR)检测 ,TTVDNA则采用巢式PCR方法检测。结果表明 ,HGV在自然人群中HGVRNA携带率为 0.6 %～ 1.1% ,TTV的病原携带率则高达 7.1%～ 12.4 % ;非甲非戊型肝炎病人中HGV和TTV的阳性率分别为 7.9%和 28.1%。在所检测的非甲非戊肝炎病人中HGV和TTV的总感染率为 35 9% (包括了HGV和TTV的混合感染 )。因此 ,HGV在自然人群中感染率低 ,而且在非甲非戊型肝炎病人中约为 10 %的病人是由HGV的感染所致 ,HGV不是非甲非戊型肝炎病人的主要病因。TTVDNA在自然人群中的携带率约为 10 % ,类似于HBVDNA的携带率。虽然在非甲非戊型肝炎病人中TTVDNA的阳性率为 2 8% ,但仍然有高达 6 0 %的病人病因不明 ,TTV 感染也不是非甲非戊型肝炎病人的主要致病病原。     

非甲非戊型肝炎患者TT病毒感染的检测

目的 了解非甲非戊型肝炎患TT病毒感染状况。方法 采用套式PCR方法对44份临床诊断为急慢性非甲非戊型肝炎患的血清标本,进行TT病毒检测。结果 14例TTV-DNA阳性,检出率31．8％(14／44)。对TTV-DNA阳性标本的PCR产物进行克隆后测序,结果表明该序列与日本株相应位置核苷酸序列同源性为98％。结论 推测TT病毒可能为临床急慢性非甲非戊型肝炎病因之一。     

2000年2月份全国疾病监测点35种法定传染病疫情动态分析

本研究通过对我国部分地区的自然人群和非甲非戊型肝炎病人进行HGV和TTV感染的分子流行病学研究,探讨这两种病毒在我国肝炎发病尤其是在非甲非戊型肝炎中的作用和地位.用建立的PCR方法检测血清标本中的HGV RNA和TTV DNA,对调查的自然人群和非甲非戊型肝炎病人血清标本进行检测.HGV RNA采用反转录PCR(RT-PCR)检测,TTV DNA则采用巢式PCR方法检测.结果表明,HGV在自然人群中HGV RNA携带率为0.6%～1.1%,TTV的病原携带率则高达7.1%～12.4%;非甲非戊型肝炎病人中HGV和TTV的阳性率分别为7.9%和28.1%.在所检测的非甲非戊肝炎病人中HGV和TTV的总感染率为35.9%(包括了HGV和TTV的混合感染).因此,HGV在自然人群中感染率低,而且在非甲非戊型肝炎病人中约为10%的病人是由HGV的感染所致,HGV不是非甲非戊型肝炎病人的主要病因.TTV DNA在自然人群中的携带率约为10%,类似于HBV DNA的携带率.虽然在非甲非戊型肝炎病人中TTV DNA的阳性率为28%,但仍然有高达60%的病人病因不明,TTV感染也不是非甲非戊型肝炎病人的主要致病病原.     

庚型肝炎流行病学和临床研究进展

由于丙型肝炎病毒和戊型肝炎病毒检测的免疫学和分子生物学方法的建立，使大部分非甲、非乙型肝炎得以诊断，但仍有一部分肝炎病人的病原体无法查明。美国有5．0％～10．O％的急性暴发型肝炎和ZO．0％～25．0％的慢性肝炎不能进行病原学诊断［’j；在我国的输血后肝炎中除外乙型肝炎，约gO．0％是丙型肝炎，其余约Ic．0％的病人查不到病原体［”，这均预示着可能存在新型肝炎病毒’‘’。1995年，一种新的肝炎病毒被成功分离，命名为庚型肝炎病毒（hepatitisGvirus，HGV）或GB病毒（GBvirusC，GBV－C），被认为是部分非甲～戊型肝炎…     

戊型肝炎患者的护理

戊型病毒性肝炎（简称戊肝）,是由戊型肝炎病毒（HEV）引起的一种消化道肝病,既往称为肠道传播的非甲非乙型肝炎,通过被污染的水源,经粪一口途径传播。急性戊肝患者是戊肝的主要传染源,除具有一般肝炎症状外,起病急,并发症较多,严重时可危及生命。     

Antibodies to hepatitis E virus among several populations in Greece: increased prevalence in an hemodialysis unit

BACKGROUND: Hepatitis E virus (HEV) has been found to be the causative agent of enterically transmitted non-A, non-B hepatitis in tropical and subtropical countries. Several investigators, however, have indicated that HEV could be endemic in Europe, albeit at a low prevalence. STUDY DESIGN AND METHODS: The purpose of this study was to estimate the prevalence of anti-HEV in various populations in northwestern Greece (Epirus region). Healthy blood donors (2636), refugees from southern Albania (350), children (165), injecting drug users (IDUs) (65), multiply transfused patients (62), patients with chronic viral hepatitis (75), and chronic hemodialysis patients (149) were investigated for anti-HEV by enzyme immunoassay and confirmatory Western blot assay. In addition, 380 consecutive healthy blood donors and 62 hemodialysis patients from a neighboring area (Agrinion, Greece) were investigated. RESULTS: A very low presence of anti-HEV antibody was found among healthy blood donors from Epirus (0.23%) and Agrinion (0.53%). Anti-HEV was not detected in children, IDUs, or multiply transfused patients. In contrast, a low but significant prevalence of anti-HEV was found among refugees (4.85%), patients with chronic viral hepatitis (5.3%), and hemodialysis patients from Epirus (1.34%), as compared with healthy blood donors from Epirus: p < 0.0001, p < 0.00001, and p < 0.10, respectively. A high prevalence (9.7%) of anti- HEV was revealed in patients at the hemodialysis unit of the General Hospital of Agrinion (p < 0.00005, compared to healthy blood donors from Agrinion). No significant association was found between anti-HEV positivity and the age or sex of donors, the duration of hemodialysis, positivity for hepatitis B or C virus infection markers, history of hepatitis, increased alanine aminotransferase, renal transplantation, a history of transfusion, or the number of units transfused. CONCLUSION: This study demonstrated a high prevalence of anti-HEV in a separate hemodialysis unit, without an association with the known routes of transmission of blood-borne viruses. This observation suggests that a still-undefined intra-unit factor or other factors are associated with HEV transmission.     

肝炎患者中TT病毒DNA及其IgG抗体的检测

目的：了解肝炎患中TTV的感染情况，方法：应用Nested-PCR对137份甲－庚型肝炎、31份非甲－庚型肝炎及104份献血员进行TTV DNA检测，同时用ELISA法检测抗TTVIgG。结果：TTV基因检出率分别为甲－庚型肝炎20．44％，非甲－庚型肝炎29．03％，献血员13．46％，抗TTVIgG检出率分别为甲－庚型肝炎27．74％，非甲－庚型肝炎35．48％，献血员14．42％；甲－庚型肝炎、非甲－庚型肝炎与献血组相比TTV DNA及抗TTV IgG均存在显性差异（P＜0．01）。结论：肝病中存在TTV感染，TTV存在健康携带状态。     

Prevalence of TT virus in patients with fulminant hepatic failure in Japan]

A novel virus(TTV) was isolated from patients with post-transfusion hepatitis of unknown etiology. We studied the prevalence of TTV in 26 patients with fulminant hepatic failure. Serum samples at admission from seven(27%) of the 26 patients were positive for TTV. TTV was also detected in 29(27%) of the 106 healthy blood donors. There were no differences in the positive rate between patients with fulminant hepatic failure and healthy blood donors. There were no differences in clinical findings, or duration from onset to coma in patients with and without TTV. However, the outcome of the patients with TTV was significant worse than those without. TTV may not cause severe hepatitis such as fulminant hepatic failure.     

The clinical features of chronic hepatitis C are not affected by the coexistence of hepatitis B virus DNA in patients negative for hepatitis B surface antigen

Hepatitis B virus (HBV) DNA has been detected in the sera of hepatitis patients who are negative for hepatitis B surface antigen (HBsAg) by polymerase chain reaction (PCR). The purpose of the present study was to clarify the clinical characteristics of patients with chronic hepatitis C who are negative for serum HBsAg and positive for HBV DNA. The subjects included 49 patients with chronic hepatitis C who were negative for serum HBsAg and 119 blood donors who served as healthy controls. Serum samples were tested for the presence of HBV DNA by the nested PCR method. Serum HBV DNA was detected in 18 (37.7%) of the 49 chronic hepatitis C patients and in none (0%) of the 119 blood donors. Among the hepatitis C patients, HBV DNA was detected in 20.7% of those who were negative for all HBV-associated markers and in 57.1% of those who were positive for one or more HBV-associated marker. The HBV DNA-positive rate among those in each F stage did not significantly differ. The liver function parameters of the HBV DNA-positive and the HBV DNA-negative chronic hepatitis C patients did not significantly differ. These results suggest that hepatitis C virus is frequently coinfected with serum HBsAg-negative HBV, and that the incidence of HBV infection in blood donors is low. However, it is considered that HBsAg-negative HBV infection does not modify the blood biochemical features of chronic hepatitis C.     

Prevalence of TT virus in serum and peripheral mononuclear cells from a CAPD population.

BACKGROUND: A novel virus named TT virus (TTV) has been isolated recently from patients with posttransfusional hepatitis of unknown etiology. The prevalence of TTV in several groups at risk has been reported, however, there is no information about the prevalence of TTV in patients on continuous ambulatory peritoneal dialysis (CAPD) without blood transfusions or hemodialysis antecedents. OBJECTIVE: To study the incidence of TTV in serum and peripheral blood mononuclear cells (PBMC) of CAPD patients. DESIGN: TTV DNA was detected by polymerase chain reaction, using primers from the open reading frames (ORF) 1 and 2, in serum and PBMC from 22 CAPD patients who had not received blood transfusions or hemodialysis therapy prior to CAPD. As controls, sera from 20 patients with chronic viral hepatitis (10 with HBV and 10 with HCV) and 20 healthy donors were included in the study. RESULTS: TTV DNA was detected in the serum of 5 of 22 (22.7%) CAPD patients with both sets of primers. Four of the 5 (80%) patients with TTV DNA in their serum were TTV positive in their PBMC with primers from ORF1 and ORF2. Five of 20 (25%) patients with chronic viral hepatitis (2 patients with HBV and 3 with HCV) and 4 of 20 (20%) healthy donors were TTV DNA positive in serum. No relation was found between TTV infection and the underlying kidney disease, previous surgery, and abnormal alanine aminotransferase levels. CONCLUSION: We have found a relatively high prevalence of TTV that is similar to that found in healthy donors and in patients with chronic viral hepatitis.     

献血者TT病毒DNA及其IgG抗体的检测

目的　观察献血者输血传播病毒 (TTV)的感染情况。方法　应用 Nested- PCR对 388例献血者、16 8例非肝炎住院患者进行 TTV DNA检测 ,同时用 EL ISA法检测抗 TTV Ig G。结果　 TTV基因检出率分别为献血组 15 .46 % ,对照组 2 4.40 % ;5 5 6例受检血清中 TTV DNA总的阳性检出率为 18.17% ,抗 TTV Ig G检出率分别为献血组 13.14% ,对照组 2 7.98% ;献血组与对照组相比 TTV DNA及抗 TTV Ig G均存在显著性差异 (P<0 .0 5 )。结论　献血者存在TTV感染 ,TTV存在健康携带状态。     

Prevalence of hepatitis G in patients on chronic hemodialysis

Hepatitis G virus (HGV) is a newly described RNA virus from the family of flaviviridae. It is closely related to the hepatitis C Virus (HCV) but is more common than HCV among healthy blood donors. The pathogenicity of HGV in immunosuppressed patients such as those undergoing hemodialysis is unclear. We measured the incidence of HGV in 105 patients undergoing hemodialysis in a chronic outpatient hemodialysis facility. HGV-RNA was detected using a RT-PCR method with primers directed against the 5' non-coding region and the NS5a gene of HGV. Nine (8.6%) patients were HGV RNA positive, eleven (10.5%) were anti-HCV positive, three (2.9%) were positive for hepatitis B surface antigen. Four patients were positive for both HGV and HCV; three of them had normal liver enzymes while one showed elevated ALT levels but no other signs of exacerbation of preexisting hepatitis. The prevalence of HGV among dialysis patients is comparable to that of HCV. The transmission route for HCV is nosocomial transmission during dialysis, whereas HGV shows both ways of transmission: blood transfusion mediated by a high prevalence of HGV among healthy blood donors and nosocomial transmission. HGV appears to play a minor role in acute hepatitis, even in immunosuppressed patients.