106例非甲～戊型肝炎临床分析

目的:探讨非甲～戊型病毒性肝炎的临床特点及其可能的致病因素。方法:通过对106例非甲～戊型病毒性肝炎患者的临床表现及生化检测来探讨其临床特点,对部分病例进行HGV RNA及TTV DNA检测来探讨可能的致病因素,并对其中4例病情持续波动超过6个月、HBsAb( )或HBsAb( )兼HBcAb( )的患者进行肝组织活检和采用肝组织免疫组织化学法(免疫组化)检测HBsAg和HBcAg。结果:106例非甲～戊型肝炎的临床表现、重症化比率与一般的病毒性肝炎相似,慢性化比率较一般的病毒性肝炎高,女性发病率较一般的病毒性肝炎高;男:女约为2:1。27例用PCR法检测HGV DNA为阴性,其中10例同时用PCR法检测TTV DNA也为阴性。4例HBsAb( )或HBsAb( )兼HBcAb( )的慢性肝炎患者,肝组织活检病理学改变与临床诊断相符,免疫组化显示HBsAg和HBcAg均阴性。结论:106例非甲～戊型肝炎的临床表现与一般的病毒性肝炎相似;慢性化、重症化比率较一般的病毒性肝炎高;女性发病率较一般的病毒性肝炎高;HGV、TTV可能不是非甲～戊型肝炎的主要致病因素;HBsAb( )者,肝组织内无HBsAg和HBcAg...     

广州地区非甲—戊型肝炎血清中庚型肝炎病毒核酸检测

１９９５年，美国相继报道［１－３］了两个新发现的与人类肝炎相关的ＲＮＡ病毒基因组，分别称为ＧＢＶＣ和ＨＧＶ，并指出其可能是非甲－戊型肝炎（ＨＮＡ－Ｅ）的致病因子。由于ＧＢＶＣ和ＨＧＶ的基因组序列具有较高的同源性，因此目前认为它们属同一病毒的不同基...     

庚型肝炎病毒感染的初步调查

采用酶联免疫法(ELISA)检测94例病毒性肝炎患者血清中抗庚型肝炎病毒抗体(抗-HGV),阳性率为23.4％。其中急性肝炎、慢性肝炎、重型肝炎抗-HGV阳性率分别为21.4％、21.1％、30.4％,在22例抗-HGV阳性病人中,HBV与HGV重叠感染率为36.3％。39例非甲-戊型肝炎抗HGV的阳性率(35.5％)明显高于55例乙型肝炎的阳性率(14.5％、P<0.05),说明HGV感染主要存在于非甲-戊型肝炎病人中。23例重型肝炎中有16例死亡,抗HGV(+)7例全部死亡,而单纯HBV感染的死亡率为56.25％。结果显示:HGV感染系非甲-戊型肝炎的主要原因,HGV可以与HBV重叠感染,且可能影响重型肝炎的愈后。     

不同临床型肝病患者中庚型肝炎病毒感染的研究

目的:了解不同临床型肝病患者的庚型肝炎病毒(HGV)感染状况。方法:应用酶联免疫法(ELISA)检测不同临床型肝病患者血清中抗-HGV,并对抗-HGV阳性血清应用逆转录套式聚合酶链反应法(RT-nPCR)检测HGV RNA。结果:肝硬变,慢性乙型和丙型肝炎病人及HBsAg携带者的抗-HGV阳性率(分别为36.36％、26.2％、12.5％和12.0％),均显著高于急性肝炎(4.17％)。急性和慢性非甲-戊型肝炎病人的抗-HGV阳性率也较高,分别为33.3％(1/3)和16.67％(1/6)。各临床型肝病患者中,抗-HGV阳性和阴性组血清天门冬氨酸转氨酶(AST)和丙氨酸转氨酶(ALT)水平无明显差异。结论:HGV与乙型和丙型肝炎病毒(HBV和HCV)具有较高的共同感染率,部分非甲-戊型肝炎为HGV感染;重叠感染HGV似并不加重肝损害程度。     

非甲～庚型肝炎患者中TTV感染的研究

检测了ＴＴＶ－ＤＮＡ在非甲－庚型肝炎病人中的感染状况。方法采用巢式聚合酶反应检测３８例非甲－庚型肝炎病人血清中ＴＴＶ－ＤＮＡ并观察与肝功能的关系。结果３８例非甲－庚型肝炎病人中１６例ＴＴＶ－ＤＮＡ阳性,占４２．１％,     

庚型肝炎——不同临床型肝病患者中庚型肝炎病毒感染的研究

目的：了解不同临床型肝病患的庚型肝炎病毒（HGV）感染状况。方法：应用酶联免疫法（ELIS）检测不同临床肝病患血清中抗-HGV,并对抗-HGV阳性血清应用逆转录套式聚合酶链反应法（RT-nPCR）检测HGVRNA。结果：肝硬变，慢性乙型和丙型肝炎病人及HBsAg携带的抗-HGV阳性率（分别为36．36％、26．2％、12．5％和12．0％）均显高于急性肝炎（4．17％）。急性和慢性非甲-戊型肝炎病人的抗-HGV阳性率也较高，分别为33．3％（1／3）和16．67％（1／6）。各临床型肝病患中，抗-HGV阳性和阴性组血清天门冬氨酸转氨酶（AST）水平无明显差异。结论：HGV与乙型和丙型肝炎病毒（HBV和HCV）具有较高的共同感染率，部分非甲-戊型肝炎为HGV感染：重叠感染HGV似乎并不加重肝损害程度。     

急性病毒性肝炎患者中庚型肝炎病毒RNA检测研究

为观察庚型肝炎病毒在急性病毒性肝炎中感染情况,对239例急性肝炎患者的血清,采用两步法筛选进行HGV RNA的检测,并经HGV RNA确证试验,结果显示:HGV RNA阳性者9例,其中合并乙肝1例,合并丙肝3例,合并戊肝1例,非甲-戊型肝炎中占4例。提示:①HGV与其它型肝炎病毒重叠感染较多。②6例患者无输血史,而HGV RNA仍为阳性,提示HGV的输血外传播。③NA-E急性肝炎患者中,HGV的阳性率为23.5％,证实HGV为其病原之一,同时提示还可能存在其它的致病因子。     

24例非甲—戊型肝炎患者血清庚肝病毒RNA检测结果分析

采用逆转录－套式聚合酶链反应（ＲＴ－ｎＰＣＲ）技术对２４例非甲－戊（Ａ－Ｅ）型肝炎患者进行庚肝病毒ＲＮＡ（ＨＧＶ－ＲＮＡ）检测。结果：ＨＧＶ－ＲＮＡ阳性６例（２５．０％），其中急性肝炎１例（１／９）、慢性肝炎２例（２／９）、肝为肝硬变３例（３／４）；１例有输血史，余５例均无输血或血浆史。提示庚肝病毒可能为非Ａ－Ｅ型肝炎的病原体之一，且存在输血外传播途径。     

临床诊断为"非甲～戊型肝炎"患者血清乙型肝炎病毒 DNA测定

为了解目前临床诊断为“非甲～戊型肝炎”病人中ＨＢＶ感染所占的比例 ,本研究应用巢式ＰＣＲ法 (ｎＰＣＲ) ,对北京地坛医院 6 0例临床诊断为“非甲～戊型肝炎”患者进行了ＨＢＶＤＮＡ测定。现将结果报告如下。一、资料与方法1 血清标本 :血清标本采自 6 0例于 1997年 3月至 1999年 3月在北京地坛医院住院和门诊病例 ,临床诊断为“非甲～戊型肝炎” ,具有肝炎的症状和体征 ,ＡＬＴ异常 (>4 0Ｕ) ,经 2次甲、乙、丙、丁、戊型肝炎病毒 (ＨＡＶ、ＨＢＶ、ＨＣＶ、ＨＤＶ、ＨＥＶ)抗原或抗体 (ＥＩＡ法 ,美国Ａｂｂｏｔｔ公司生产 )及ＥＢ病…     

TTV在非甲～庚型肝炎患者中的检测及临床意义

目的 研究TTV在非甲～庚型肝炎中的临床意义。方法 用聚合酶链反应(PCR)方法检测了50例非甲～庚型肝炎的TTV DNA。结果 在50例肝炎患者中,TTV DNA阳性检出率为28.O％(14/50)。结论 TTV感染可能是非甲～庚型肝炎的病因之一。     

各型病毒性肝炎患者庚型肝炎病毒感染状况

目的:了解武汉地区各型病毒性肝炎患者中庚型肝炎病毒(HGV)感染的情况。方法:用酶联免疫吸附试验(ELISA)及逆转录聚合酶链反应(RT-PCR)方法测定各型病毒性肝炎患者的抗HGV和HGV RNA,并对庚肝病毒感染者进行临床分析。结果:351例各型病毒性肝炎患者中抗HGV阳性者56例,占15.05％;此56例中HGV RNA阳性者21例,占37.50％。各型病毒性肝炎患者中抗HGV阳性率及庚肝抗体阳性者中HGV RNA阳性率分别为:甲肝14.29％(5/35)及20.00％(1/5);乙肝17.29％(37/214)及35.14％(13/37);丙肝14.52％(9/62)及55.56％(5/9);戊肝4.00％(1/25),0.00％(0/1);非甲～戊肝26.67％(4/15),50.00％(2/4)。56例抗HGV阳性者中43例有输血、使用血制品或静脉药癌史,占76.79％。HGV感染在肝炎各临床类型分布为急性、慢性和重型肝炎患者无明显差异,且无性别和年龄分布的差异。HBV重叠感染HGV患者的SALT及TBil水平明显高于单纯HBV感染者(P<0.05),而HGV和其它肝炎病毒((HAV、HCV、HEV)重叠感染患者与单纯其它肝炎病毒感染者的SALT及TBiL水平无明显差异(P>0.05)。结论:武汉地区各型病毒性肝炎患者均可存在HGV感染。HGV可单独感染或与其它病毒混合感染。血液传播是HGV感染的主要途径。乙型肝炎患者合并庚肝病毒重叠感染可加重病情,而甲、丙、戊型肝     

血液病患者中庚型肝炎病毒检测及感染情况研究

目的：了解武汉地区血液病患者中庚型肝炎病毒（ＨＧＶ）的感染情况,探讨ＨＧＶ的传播途径。方法：采用酶联免疫吸附试验（ＥＬＩＳＡ）及逆转 录聚合酶链反应（ＲＴ－ＰＣＲ）方法测定各型血液病患者血清中的抗ＨＧＶ和ＨＧＶＲＮＡ。结果：５１例血液病患者中血清抗ＨＧＶ阳性６例,占１１．８％（５／６１）,ＨＧＶＲＮＡ均阴性。６例抗ＧＨＶ阳性患者中急粒２例,占２５％（２／８）,慢粒１例,占５０％（１／２）,再障２例     

GB Virus C/Hepatitis G Virus Infections in Traumatologic Outpatients, Chronic Non-A-E Hepatitis and Extrahepatic Malignancies

Summary GB virus C/hepatitis G virus (GBV-C/HGV) is a recently discovered flavivirus of still unknown pathogenic relevance. We examined traumatologic outpatients to determine GBV-C/HGV viremia for further epidemiological studies, as blood donors hitherto used as controls represent healthy individuals without risk factors. Anti-GBV-C/HGV antibodies were detectable in 13.2% (95% confidence interval [CI] 9.3–18.2) and GBV-C/HGV RNA was detectable in 4.5% (95% CI 2.4–8.2) of the outpatients. In chronic non-A-E hepatitis patients GBV-C/HGV viremia was detectable at a significantly higher level of 16.1% (95% CI 6.1–:34.5), while the prevalence of anti-GBV-C/HGV antibodies was 12.9% (95% CI 4.2–30.8). The rate of GBV-C/HGV viremia in patients with malignant diseases (different types of tumors, blood recipients were excluded) was 12.5% (95% CI 8.4– 18.1), a significant elevation compared to traumatologic outpatients. The seroprevalence in the tumor group was 22.1% (95% CI 16.7–28.6), also significantly elevated. Thus, there are two messages. Firstly, testing for GBV-C/HGV may be a useful extension of the diagnostic procedure of viral hepatitis. Secondly, common risk factors or etiologic relations of GBV-C/HGV and extrahepatic malignancies should be discussed. Received: March 29, 1999 · Revision accepted: November 22, 1999     

Lower Hepatitis G Virus Infection Prevalence Compared to Hepatitis B and C Virus Infection Prevalences

To more accurately determine the seroprevalence of hepatitis G virus (HGV) infection, we surveyed antibody to HGV (anti-E2) by enzyme-linked immunosorbent assay (ELISA) and HGV RNA by nested polymerase chain reaction (PCR) in 298 residents of a hepatitis C virus (HCV)-endemic area of Japan and in 225 hemodialysis patients. We then compared these findings with known HCV and hepatitis B virus (HBV) infection prevalences. Anti-E2 and HGV RNA prevalences were 32 (10.7%) and 5 (1.7%) in the residents and 24 (10.7%) and 10 (4.4%) in the hemodialysis patients, respectively. Anti-E2 and HGV RNA concurrence was found in two of the hemodialysis patients. Total HGV marker (anti-E2 and/or HGV RNA) prevalences [37 (12.4%) in residents and 32 (14.2%) in hemodialysis patients], were significantly lower than the prevalences of antibody to HCV (anti-HCV) by ELISA [59 (19.8%) and 96 (42.7%)], and antibody to hepatitis B core antigen (anti-HBc) by radioimmunoassay (RIA) [87 (29.2%) and 101 (44.9%)] (P < 0.05). The anti-HCV prevalence in subjects with total HGV marker was significantly higher than in those without total HGV marker. There was no significant difference in anti-HBc prevalence between those with and without total HGV marker. The viremic rate was highest in HCV infection (HCV RNA by PCR/anti-HCV) (83.2%), with HGV infection (HGV RNA/total HGV marker) (21.7%) intermediate, and HBV infection (hepatitis B surface antigen by RIA/anti-HBc) (5.3%) lowest (P < 0.05). These findings indicate that HGV infection was less endemic than HCV and HBV. HGV was eliminated naturally more frequently than HCV infection and less frequently than HBV infection.     

Hepatitis B Virus Vaccine for Patients with Hepatitis C Virus Infection

Summary Hepatitis C is a disease with varying rates of progression. The role of hepatitis B virus (HBV) as a cofactor in the development of hepatitis C virus (HCV)-related cirrhosis and hepatocellular carcinoma (HCC) has been suggested and the use of HBV vaccine in all HCV-infected patients has been advocated. This review presents the implications of HBV and HCV coinfection and addresses the issues of HBV vaccine immunogenicity and safety in patients with chronic HCV infection. Received: December, 1999 · Revision accepted: July 1, 2000     

Clinical Course of Chronic Hepatitis C Virus Infection Is Not Influenced by Concurrent Hepatitis G Virus Infection

To determine the effects of hepatitis G virus(HGV) infection on chronic hepatitis C virus infection(HCV) and to evaluate HGV response to interferon, weinvestigated HGV RNA by polymerase chain reaction in 247 Japanese patients with chronic HCVinfection (166 men and 81 women; 124 had chronichepatitis and 26 cirrhosis, and 97 hepatocellularcarcinoma). HGV RNA was detectable in 22 (8.9%)patients, among whom 21 were men: this male predominance wasstatistically significant (P < 0.01). There were nodifferences in age, aminotransferase level, stage ofliver disease, HCV RNA level by competitive polymerase chain reaction, genotype, or interferonresponse to HCV RNA between patients with HCV infectionalone or with HCV/HGV coinfection. Sustained eliminationof HGV RNA was found in 28.6% of the 14 treated patients with HCV/HGV coinfection. In the 14 treatedpatients, sustained elimination of both viruses was seenin two, HCV alone was eliminated in two, and HGV alonewas eliminated in two. Aminotransferase level improvement by interferon treatment wasassociated with clearance of HCV, but not of HGV. Thus,HGV infection had no apparent effects on HCV infection,and the sensitivity of HGV to interferon is comparable to but independent of HCV.     

乙、丙型肝炎病毒单纯和重叠感染——附503例临床对比分析

503例病毒性肝炎分为乙型肝炎(HB)、丙型肝炎(HC)、乙丙型肝炎(HBC)三组进行临床对比分析,以探讨双重病毒感染对病情的影响。结果:HBC组肝硬变比率和血清透明质酸(HA)异常率显著高于HB(P<0.05)和HC(P<0.001和P<0.05);重型肝炎比率和病死率与HB和HC相似;无症状病毒携带比率与HB相似而显著低于HC;血清谷丙转氨酶(ALT)和血清胞红素(SB)异常率与HC相近,较HB为低(P均<0.01)。HB与HC相比,HB肝硬变比率和SB异常率显著高于HC(P均<0.001);无症状病毒携带比率显著低于HC。HBV单纯感染较HCV单纯感染病情重;HBV与HCV双重感染者肝硬变比率增高,但并不一定加重肝损害的严重程度。     

庚型病毒性肝炎17例的临床和病原学分析

目的:对南京地区庚型病毒性肝炎的临床和病原学特点进行分析。方法:用反转录聚合酶链反应(RT-PCR)法检测血清HGV-RNA。从274例病毒性肝炎患者中检测出17例庚型病毒性肝炎,观察其临床表现及血清病原学标志,并分析庚型肝炎病毒(HGV)部分核酸序列。结果与结论:17例患者男性成年人多见,全年散发,经输血感染为重要传播途径。HGV可以单独感染,也可重叠(混合)其它肝炎病毒感染。少数为急性肝炎,多数为慢性肝炎或肝硬化,尤其在重叠(混合)感染。单纯HGV感染者症状轻,多隐匿发病,肝功能损害较轻。重叠(混合)感染者多有慢性肝炎的症状,与HBV重叠(混合)感染时有形成重型肝炎的趋势。核酸序列分析表明HGV南京株部分核苷酸序列与HGV美国株HGU 44402、HGU 45966、HGU 36380及HGV河北株在对应位置的核苷酸同源性从87.27%~93.94%,可能HGV有不同的基因型。     

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。