贵州地区丙型肝炎病毒基因亚型分布状态

目的:探讨贵州地区丙型肝炎病毒(HCV)基因亚型分布状态.方法:在164份抗HCV抗体和HCVRNA均阳性的血清标本中,分别提取HCV RNA,通过逆转录巢式PCR(RT nested-PCR)扩增C基因的羧基端至E1基因的氨基端长度为474 bp的片段,测定其核苷酸序列,与GenBank中已知的HCV序列进行系谱分析,确定HCV基因亚型.结果:164份HCV感染者血清标本通过RT-nested均获得阳性条带,特异性和敏感性均较好,序列与系谱分析显示1a3例(1.8％)、1b 58例(35.4％)、2a 2例(1.2％)、3a 25例(15.2％)、3b 38例(23.2％)及6a 35例(21.3％).结论:贵州地区HCV流行的基因亚型有1a,1b,2a,3a,3b,6a共6种,主要为1b、3a、3b和6a亚型,提示贵州地区HCV流行的基因亚型呈现多样性.     

Hepatitis C and steatosis

Hepatitis C infection and non-alcohol-related hepatic steatosis are the most common liver diseases worldwide, and both conditions often co-exist in the same patient. Hepatitis C virus (HCV) genotype 3 directly induces development of steatosis, whereas in patients with non-genotype 3 chronic hepatitis C infection, insulin resistance plays a key role in the pathophysiology of steatosis. Insulin resistance and its clinical components including obesity, hyperglycemia, hypertriglyceridemia, increased blood pressure, and low HDL-cholesterol levels are often seen in patients with chronic hepatitis C infection. Both increased adipocity and presence of steatosis may increase the risk of fibrosis progression, and both have been associated with a decreased rate of response to antiviral treatment. Hence, liver steatosis in the setting of HCV infection is a distinct condition with specific clinical and prognostic implications. Accumulating evidence suggests that weight management may lead not only to a decrease in steatosis but also improvement in fibrosis severity. However, further studies are necessary to determine whether weight reduction improves response to antiviral therapy.     

Hepatitis C and diabetes mellitus

Hepatitis C virus infection in diabetes mellitus is more common than in non-diabetic population. Earlier it was thought to be due to more use of needles for insulin injections and frequent blood examination which has been recently antagonised by recent studies. Hepatitis C virus infection has shown to produce insulin resistance (because of liberated cytokines) insulin secretory defect (by viral infection or auto-immune damage). Hepatitis C virus infection also leads to non-alcoholic fatty liver disease (a probable component of insulin resistance syndrome) and increased iron increased iron storage in the body. All these factors may explain hepatitic C virus infection as an aetiology for diabetes mellitus. If future researches strongly establish this fact, antiviral or vaccines for hepatitis C virus infection should be thought of for preventing diabetes mellitus.     

聚合酶链反应研究血液透析患者丙型肝炎

目的：探讨维持性血液透析患者ＨＣＶ感染的临床与流行病学问题。方法：采用聚合酶链反应方法（ＰＣＲ），检测２０例丙肝病毒抗体（抗－ＨＣＶ）阳性的维持性血液透析患者血清和透后的透析液中丙型肝炎病毒ＲＮＡ。结果：血清ＨＣＶ－ＲＮＡ阳性者为６例（３０％），而透后透析液ＨＣＶ－ＲＮＡ均为阴性。结论：血透患者ＨＣＶ感染与透析液污染之间未发现直接相关性依据。     

Hepatitis C virus genotypes in Saudi Arabia

Hepatitis C virus genotypes have been associated with specific geographical areas and in many cases with specific mode of transmission. In developed countries, genotype determination has formed a part of the management of patients with hepatitis C virus seropositivity and liver diseases due to hepatitis C virus. The epidemiology of hepatitis C virus has been shown to be changing rapidly in many countries due to population movement and different life-styles; hence the distribution of the genotypes is being monitored closely in many countries. In the Kingdom of Saudi Arabia, there are only a handful of publications recording the hepatitis C virus genotypes in various population groups. These studies have been carried out mainly in Riyadh (Central province) and Jeddah (Western province). There are no studies emanating from the Eastern or Northern provinces. According to these studies, the most prevalent genotype in the Western Province and probably in the whole Kingdom of Saudi Arabia was genotype 4, followed by genotypes 1a and 1b. Genotypes 1, 2a,/2b, 3 and 6 are very rare in the Kingdom of Saudi Arabia. Genotype 5 was identified exclusively in the Western province and nowhere else. Genotypes 1b and 4 were associated with different histological grades of liver disease. Mixed infections with more than one genotype were observed in some studies. More detailed epidemiological studies of hepatitis C virus infections are needed in the Kingdom of Saudi Arabia to gain more insight into a possible type/subtype-specific pathogenesis of hepatitis C virus in the different regions of the Kingdom of Saudi Arabia as well as the distribution of the genotypes in the various localities.     

Hepatitis C. An update

Hepatitis C is a long-term viral infection affecting the liver caused by the hepatitis C virus HCV. Hepatitis C can be silent for years before symptoms appear, and liver damage occurs. The hepatitis C virus is extremely infectious, which means that only a tiny amount of HCV can cause illness. Hepatitis C is a major public health problem worldwide with far-reaching implications because of the chronicity of the infection that leads to chronic liver disease, cirrhosis, and primary hepatocellular carcinoma.     

丙型肝炎治疗的研究进展

丙型肝炎严重威胁着人类的健康,目前寻找一种有效的疗法至关重要。撰文对丙型肝炎的药物治疗、RNA干扰、病毒抗原编码基因的转基因表达、反义核酸技术及表位疫苗等项治疗方案予以综述,提出了包含有多个保守丙型肝炎病毒(HCV)抗原表位的多价融合抗原基因的DNA疫苗将成为今后丙型肝炎治疗的研究方向。该疫苗可以在不同个体中激起广泛而强烈的对不同HCV基因型有交叉反应性的T细胞免疫应答,并有望用于丙型肝炎人群的治疗。     

Hepatitis C virus in intravenous drug users

Sera from 172 intravenous drug users were tested for the presence of antibodies to hepatitis C virus (anti-HCV). The results were analysed in relation to aspects of the history of drug use and evidence of liver disease. The presence of anti-HCV was strongly associated with duration of intravenous drug use. Two-thirds of patients were anti-HCV seropositive within two years of commencing regular intravenous drug use, and there was 100% seropositivity among people injecting drugs for more than eight years. Seropositivity for hepatitis C virus closely paralleled exposure to hepatitis B virus, which was also endemic in this population. In contrast, only one patient tested positive for antibodies to the human immunodeficiency virus. The presence of anti-HCV correlated poorly with biochemical markers of hepatitis. About half the patients with anti-HCV had normal serum levels of alanine aminotransferase, whereas an abnormal liver biochemistry was frequently observed in anti-HCV seronegative subjects. Previous studies of non-A, non-B hepatitis that have used abnormal liver biochemistry as a marker have underestimated the prevalence of chronic hepatitis among intravenous drug users; the use of a specific screening test reveals that infection with hepatitis C virus is very common in this population.     

丙型肝炎病毒实验室检测技术进展

分子生物学技术是临床诊断和治疗监测慢性丙型肝炎病毒(HCV)感染的常用手段。这些技术可以检测和定量病毒核酸并且分析核酸序列,确定HCV的基因型和亚型,识别病毒的耐药突变位点。实时荧光技术,由于敏感性高,特异性好,已广泛应用于HCV感染的临床诊断和治疗监测;下一代基因测序技术可明显提高测序深度,但目前多限于科学研究。该文回顾性分析了用于HCV感染诊断的实验室检测技术。     

丙型肝炎病毒感染外周血单个核细胞对丙型肝炎的影响

为了研究丙型肝炎病毒(HCV)感染外周血单个核细胞(PBMC)对丙型肝炎的影响,运用非同位素原位杂交法(NISH)和链酶亲和素-生物素(SABC)法分别检测20例慢性丙型肝炎患者PBMC中的HCV-RNA及其T淋巴细胞亚群,同时检测这些患者的肝功能指标。结果显示8例(40．0％)HCV患者的PBMC中的HCV-RNA呈阳性结果。HCV-RNA呈散在颗粒状或弥漫分布,主要位于胞浆中。HCV-RNA阳性组和阴性组的CD+4T细胞比例低于正常对照组,CD+8T细胞比例高于正常对照组,CD+4／CD+8比值下降;而HCV-RNA阳性组的CD+4T细胞比例则又低于阴性组,CD+8T细胞比例高于阴性组,CD+4／CD+8比值出现倒置(P<0．01)。两组的肝功能检查结果之间无显著差异(P>0．05)。提示HCV感染PBMC后引起T淋巴细胞亚群发生变化,使CD+4和CD+8T细胞功能下降或不能很好地协调作用,从而成为HCV持续感染的重要原因之一。HCV感染PBMC对肝脏炎症程度的影响可能不大。