慢性重型肝炎及肝炎肝硬化患者HGV感染状况分析

庚型肝炎病毒 (ＨＧＶ)可引起急性和慢性肝炎 ,且可与乙型肝炎病毒 (ＨＢＶ)、丙型肝炎病毒 (ＨＣＶ)同时或重叠感染。本文应用逆转录套式聚合酶链反应法 (ＲＴ ｎｅｓｔｅｄＰＣＲ)检测了 2 64例慢性重型肝炎患者和 466例肝炎肝硬化患者 (共 73 0例 )中ＨＧＶ的感染情况 ,现报     

聚合酶链反应检测HGV RNA

庚型肝炎病毒(HGV)呈全球性分布。在志愿供血员中 HGV 感染率约为1.7%,职业供血员中为12.9%,在一些不明原因肝病患者中约为9%。HGV 感染可表现为急性、慢性或暴发性肝炎。目前采用聚合酶链反应检测 HGV RNA 是诊断 HGV 感染的主要手段。我们在 HGV5′端非翻译区(5′UTR)设计引物。建立了检测 HGV RNA 的逆转录-套式-聚合酶链反应(RT-Nested-PCR),并用于 HGV感染的诊断。材料与方法一、标本来源     

RT-PCR法检测HGV RNA和ELISA法检测抗-HGV意义探讨

目的:探讨检测HGV RNA和抗-HGV的临床意义。方法:采用逆转录聚合酶链反应(RT-PCR)技术和ELISA法分别对351例住院肝炎患者血清中HGV RNA和抗-HGV进行检测。结果:351例中有32例(9.11％)HGV RNA阳性,34例(9.68％)抗HGV阳性,5例(1.41％)两项同时阳性;在11例患者不同住院期间的检测中发现,7例检测结果无变化,1例HGV RNA阴转,1例抗-HGV阴转,2例抗-HGV阳转。结论:HGV RNA和抗-HGV同时阳性的病例比较少。大多数情况两者不是同时存在,诊断意义可能有所差异;HGV RNA阳性表示现症感染,而抗-HGV阳性可能是感染后期或恢复期的标志。在HGV感染过程中会出现HGV RNA阴转或抗-HGV阴转和阳转的可能。     

敏感特异RT-nPCR检测高危人群HGV感染状况

目的建立敏感、特异的RT-nPCR技术以检测高危人群中HGV感染状况.方法根据已知并已公认的HGV序列,在其5'UTR区寻找最大同源序列并设计套式引物建立HGVRNA的RT-nPCR检测法,对129例高危人群(包括48例静脉药瘾者,15例血透患者及各型肝炎患者66例)的血清标本进行检测.结果我们所建立的5′UTR引物的RT-nPCR检测HGVRNA的敏感性高于NS3区引物的RT-nPCR的敏感性(高10～100倍);IVDUs、血透者及乙型、丙型、非甲-戊型肝炎患者HGVRNA的检出率分别为12%(6/48),13%(2/15)及17%(3/18),22%(7/32),6.2%(1/16),抗-HGV的检出率分别为10%(5/48),7%(1/15)及22%(4/18),28%(9/32),25%(4/16).输血组的HGV感染率(38%)显著高于未输血组(18%)(P＜0.05).结论5′UTR区引物的HGVRNA RT-nPCR检测法敏感、特异;HGV在高危人群中的感染普遍存在,是部分非甲-戊型肝炎的病因,输血和使用血制品为HGV传播的重要的途径.     

江门市120例静脉吸毒者HBV、HCV和HGV感染状况

目的 了解静脉毒瘾者乙型肝炎病毒(HBV),丙型肝炎病毒(HCV)及庚型肝炎病毒的感染状况。方法 对广东省江门市120例静脉毒瘾者血浆的HBV、HCV和HGV的标记物进行了检测,采用ELISA法检测HBsAg,HBeAg,抗-HBc,抗-HBe,抗-HBs,抗-HCV;逆转录聚合酶链反应(RT-PCR)检测HGV RNA。结果 120例静脉毒瘾者中HBsAg阳性有13例(10.83％),抗-HBs阳性41例(34.71％),单项抗-HBc阳性7例(5.83％),抗-HCV阳性89例(74.17％),HGV RNA阳性28例(23.33％)。13例HBsAg阳性中9例抗-HCV阳性,3例HGV RNA阳性;7例单项抗-HBc阳性中5例抗-HCV阳性,2例HGV RNA阳性;28例HGV RNA阳性中20例抗-HCV阳性;2例HBsAg、抗-HCV、HGV RNA同时阳性。结论 静脉毒瘾者是HCV和HGV的高危感染人群;HBV,HCV和HGV三种病毒的感染之间在静脉毒瘾者中无相关性。     

HGV：一种新的肝炎病毒

自从１９９５年证实ＨＧＶ／ＧＢＶＣ为人类新的肝炎病毒以来，已引起医学界广泛重视．作者阅读近年来国外主要文献，对其分子结构，传播方式，致病情况，检测手段，治疗方案及预后进行综述．早在２０世纪６０年代，Ｄｅｉｎｈａｒｄｔｅｔａｌ就发现可引起人急性肝炎并...     

庚型肝炎与HGV研究的进展

庚型肝炎病原学１９９５０４１１，在美国ＴｈｅＮｅｗＹｏｕｒＴｉｍｅｓ上发表了关于ＧＢ肝炎的报道．通过近年来对ＧＢ组病毒分子生物学研究发现，它与丙型肝炎病毒（ＨＣＶ）不同，经鉴定属于似黄热病毒（ｆｌａｖｉｖｉｒｕｓ），为单股正链ＲＮＡ病毒．ＧＢ组肝...     

聚合酶链反应和杂交试验检测上海地区庚型肝炎病毒感染的初步报告

为探讨上海地区庚型肝炎病毒感染的现状，采用逆转录套式聚合酶链反应（ＲＴＮｅｓｔｅｄＰＣＲ）检测庚型肝炎病毒（ＨＧＶ／ＧＢＶＣ）核酸（ＨＧＶＲＮＡ）。结果在各类患者和助血员中ＨＧＶＲＮＡ的检出率分别是：血液透析和肾移植为１５７％（８／５１）、丙型肝炎为３３％（１／３０）、乙型肝炎为０（０／１９）、散发性非Ａ～Ｅ型肝炎为０（０／２８）、义务助血员为７５％（５／６７）。提示ＨＧＶ感染多为无症状或亚临床型，常与ＨＣＶ重叠感染，并与输血密切相关。作者肯定了上海地区存在庚型肝炎，指出筛选助血员对控制输血后庚型肝炎至关重要。     

非乙非丙型慢性肝病患者庚型肝炎病毒感染状况

目的:了解非乙非丙型慢性肝病患者庚型肝炎病毒的感染状况。方法:应用逆转录聚合酶链反应,进行庚型肝炎病毒检测。结果:37例非乙非丙型慢性肝病患者血清中发现了5例阳性,占非乙非丙型慢性肝病患者的13.5％,且均伴有长期的肝功能损伤。结论:庚型肝炎病毒是非乙非丙型慢性肝病的致病因子之一,可能还存在其它的致慢性肝病因子。     

肾透析患者血清中庚型肝炎病毒核酸的检测和与乙、丙型肝炎病毒同时感染分析

目的:了解肾透析患者庚型肝炎病毒(HGV)、乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)合并感染的状况。方法:应用逆转录多聚酶链反应扩增庚型肝炎病毒基因,采用蛋白酶K裂解法提取血清中HGV RNA,逆转录为cDNA后进行巢式扩增,获得238bp的特异性片段。用此方法对28例肾透析患者血清标本进行检测。结果:发现28例患者血清中有4例HGV RNA阳性。这4例患者同时合并HCV感染,其中2例为HBV、HCV、HGV合并感染。结论:肾透析患者是HGV感染的高危人群,HGV在肾透析患者中常与HCV、HBV合并感染。     

Prevalence of hepatitis C infection among intravenous drug users in Shanghai

AIM:To characterize the prevalence of hepatitis C virus(HCV)infection among Chinese intravenous drug users(IDUs).METHODS:A total of 432 adult IDUs(95 women and337 men)in Shanghai were included in the study.The third-generation Elecsys Anti-HCV assay(Roche Diagnostics GmbH,Sandhofer Strasse 116,D-68305,Mannheim,Germany)was used to screen for antibodies against HCV.The RIBA strip,a supplemental antiHCV test with high specificity,was performed on all of the samples that tested positive during the initial screening.All of the anti-HCV positive samples were analyzed with a Cobas TaqMan 48 Analyzer(Roche Diagnostics)for direct detection of HCV RNA.All of the HCV RNA-positive samples were sequenced for genotype determination.RESULTS:The preliminary screening identified 262(60.6%)subjects who were seropositive for HCV.Of the 62 females and 200 males seropositive subjects,16(16.7%)and 65(19.3%),respectively,were confirmed by RIBA,yielding an overall HCV seropositive rate of18.8%.Four female(6.5%)and 14 male(7.0%)subjects tested positive for HCV RNA,indicating an active infection rate of 4.2%for the entire study population.The 18 HCV RNA-positive serum samples were genotyped.Seven individuals were genotype 1b,and four were genotype 1a.One individual each was infected with genotypes 2a,2b and 3a.Four subjects were coinfected with multiple strains:two with genotypes 1a and 2a,and two with genotypes 1b and 2a.The active infection rate among HCV-seropositive individuals was22.2%,which was significantly lower than most estimates.CONCLUSION:The prevalence of HCV is relatively low among IDUs in Shanghai,with a spontaneous recovery rate much higher than previous estimates.     

Molecular epidemiology of hepatitis C virus infection among intravenous drug users

Background/Aims: The clinico-pathologic features of hepatitis C virus infection intravenous drug users are different from those found in other hepatitis C virus-infected patients. Our airm was to test whether specific viral variants circulate within this particular patient population.Methods: We studied the distribution of hepatitis C virus genotypes in 90 drug addicts and 484 controls, according to the method described by Okamoto.Results: Hepatitis C virus type 1a and 3a infections were more frequent among intravenous drug users than in 125 age-matched controls (48.8% and 21.1% vs 17.6% and 11.2%), accounting for the majority of infections in intravenous drug users. Analysis of hepatitis C virus genotypes according to age showed that, in the general population, hepatitis C virus types 1a and 3a were more prevalent among patients younger than 40 years of age than in older individual (17.6% and 11.2% vs. 1.4% and 0.6%).Conclusions: These findings suggest that hepatitis C virus types 1a and 3a were recently introduced in Italy, presumably via needle-sharing among intravenous drug users, and from this reservoir they are extending to the general population, particularly among younger subjects.     

静脉注射吸毒人群丙型肝炎病毒感染研究进展

吸毒是世界性难题,其导致的公共卫生问题直接影响一般人群的健康.静脉注射吸毒者(IVDUs)人群丙型肝炎病毒(HCV)感染率远远高于一般人群,是重要的传染源.本文概述近年来国内外学者在IVDUs人群HCV感染方面的主要研究成果和观点,探讨IVDUs人群感染HCV的病毒学特点,重点介绍IVDUs人群吸毒方式,吸毒年限,器具共用,性行为特征以及民族差异等因素对该人群感染HCV的影响作用.     

广州地区部分人群庚型肝炎病毒感染的流行病学调查

目的 为了解广州地区庚型肝炎病毒（HGV）感染的现状和流行特点，我们对348例住院和门诊的肝病患者进行了HGV RNA、HGV抗体（HGV－Ab)检测，现将结果报道如下。材料和方法，从广东省人民医院门诊和住院肝病患者收集血清标本348份，其中丙型肝炎93份，乙型肝炎120份，肝硬化75份，肝细胞癌60份。采用逆转录套式PCR检测HGV RNA。引物序列为：HGV1（F外）5′-CGCTCAAGCCAGCGAAGTAAGCA－3′，HGV2(R外）5′－CAATACCTCTCACCGACGGG－3′，HGV3（F内）5′－GGACTTCCGGATAGCTGAAAGCT－3′，HGV4（R内）5′－GCGTCCACACAGATGGCGA－3′。两次PCR循环条件相同，均为：94℃ 1min、55℃ 1min、72℃ 1min，35个循环。产物进行琼脂糖凝胶电泳，紫外灯下观察结果。采用酶联免疫吸附试验（ELISA）检测HGV－Ab。诊断试剂为北京大学医学院产品。结果 348份标本中，HGV RNA阳性检出率为8．62％（30／348）。其中丙肝标本检出率为6．45％（6／93），乙肝标本检出率为7．50％（9／120），肝硬化标本检出率为8．00％（6／75），肝细胞癌标本检出率为15．00％（9／60）。HGV－Ab阳性检出率为12．93％（45／348）。其中丙肝标本检出率为12．90％（12／93），乙肝标本检出率为10．00％（12／120），肝硬化标本检出率为8．00％（6／75），肝细胞癌标本检出率为25．00％（15／60）。30份HGV RNA阳性标本中HGV－Ab均为阳性。结论 HGV在广州地区多种肝病人群中的感染状况较普遍，与其它肝病重叠感染的情况较严重。应得到足够重视。℃℃℃     

慢性乙型肝炎患者中庚型肝炎病毒检测

目的了解慢性乙型肝炎中庚型肝炎病毒（ＨＧＶ）的感染率及其对病变程度和ＨＢＶ复制的影响。方法逆转录聚合酶链反应（ＲＴＰＣＲ）检测６５例经肝活检证实的慢性乙型肝炎患者血清中ＨＧＶＲＮＡ。结果有８例（１２．３％）慢性乙型肝炎患者合并ＨＧＶ感染,轻度、中度和重度患者中的ＨＧＶ检出率统计学处理差异无显著性,ＨＧＶ混合感染与其临床表现无相关性,ＨＧＶ阳性组与阴性组患者的肝功能改变相近。ＨＢｅＡｇ阳性组和ＨＢｅＡｇ阴性组患者的ＨＧＶ检出率亦相当。结论在慢性乙型肝炎患者中,ＨＧＶ混合感染对慢性乙型肝炎的病变程度及病毒复制无明显影响     

抗-HGV在各型病毒性肝炎患者中的检出情况及意义

目的了解抗庚型肝炎病毒抗体（抗－ＨＧＶ）在各型病毒性肝炎患者中的检出情况及临床意义。方法对１９０例不同病原的病毒性肝炎患者进行抗－ＨＧＶ（ＥＬＩＳＡ）检测,对其中抗－ＨＧＶ阳性者进行ＨＧＶ－ＲＮＡ（ＲＴＰＣＲ）检测。结果①在各型病毒性肝炎患者中总的抗－ＨＧＶ阳性率为１２１％（２３／１９０）。②ＨＣＶ感染者中抗－ＨＧＶ的阳性率（２６９％）最高,其后依次为ＨＥＶ（１８２％）,ＨＢＶ（１１２％）,ＨＤＶ（８３％）。③２３例抗－ＨＧＶ阳性的患者中仅有５例（２１７％）ＨＧＶ－ＲＮＡ同时检测阳性。④抗－ＨＧＶ阳性组与抗－ＨＧＶ阴性组比较,两组肝功能指标无统计学差异（Ｐ＞００５）。结论①抗－ＨＧＶ阳性并不一定代表ＨＧＶ病毒复制或现症感染。②ＨＧＶ致病性可能较弱。③ＨＧＶ可能通过多途径传播。     

Long-term clinical impact of occult hepatitis B virus infection in chronic hepatitis B patients

BACKGROUND/AIMS: Long-term clinical outcomes of occult hepatitis B virus (HBV) infection were studied. METHODS: Fifteen chronic hepatitis B patients were monitored for a median of 4.4 years (range 0.9-15.3) after hepatitis B surface antigen (HBsAg) seroclearance. Serum HBV DNA was measured by real-time detection polymerase chain reaction. Thirteen patients underwent liver biopsies at the end of follow-up and liver histology was evaluated by Ishak score. Liver HBV DNA was also measured for 12 patients. RESULTS: At the end of follow-up, HBV viremia was absent in 13 (87%) patients, and antibody titers to hepatitis B core antigen showed an inverse correlation with time from HBsAg seroclearance (r=-0.554; P=0.0040). However, all patients retained liver HBV DNA and tested positive for the covalently closed circular HBV DNA replicative intermediate. The hepatic HBV DNA loads had no relation to liver histology. Paired biopsies from 11 patients disclosed that each necroinflammatory score significantly improved after HBsAg seroclearance. Amelioration of liver fibrosis was also evident in eight (73%) patients (P=0.0391 by signed rank test). CONCLUSIONS: A long-standing but strongly suppressed HBV infection may confer histological amelioration after HBsAg seroclearance.     

重型肝炎患者血浆置换后SEN病毒感染及临床意义

目的 了解重型肝炎患者血浆置换前、后SEN病毒(SENV)感染情况及对肝功能的影响.方法 采用套式PCR对40例重型肝炎患者血浆置换前、后血清中SENVD亚型和H亚型进行检测,并检测血浆置换前、后血液生化改变,数据行t检验和配对X2检验.结果 40例重型肝炎患者血浆置换前、后SENV D亚型的检出率分别为27.5%(11/40)和42.5%(17/40),SENVH亚型为27.5%(11/40)和50.0%(20/40),差异均有统计学意义(X24.17,X27.11;均P<0.05).血浆置换后,SENV阳性患者的ALT为(164±75)U/L,明显高于阴性患者的(48±12)U/L,差异有统计学意义(t=3.13,P<0.05);但肝功能其他各项指标比较,差异无统计学意义.结论 SENV可经血浆置换方式传播,且重叠SENV感染可能会影响重型肝炎患者血浆置换后肝功能的恢复.