逆转录PCR检测急性白血病患者血清中丙型肝炎病毒的研究

应用逆转录多聚酶链反应和酶联免疫吸附试验方法检测１８例经多次输血并有肝功能改变的急性白血病患者血清中丙型肝炎毒基因和抗丙型肝炎病毒抗体。ＨＣＶ ＲＮＡ阳性率７７．８；抗－ＨＣＶ阳性６６．１％；单项或两项阳性者１６例，联合判定ＨＣＶ感染率８８．９％。ＲＴ ＰＣＲ检出ＨＣＶ ＲＮＡ时间早于抗－ＨＣＶ阳转时间，而且敏感性高于后者，是一种早期，灵敏及特异的ＨＣＶ感染诊断方法。     

肝癌患者庚型肝炎病毒感染血清学研究

采用抗－ＨＧＶ酶联免疫试验（ＥＩＡ）对１６０例肝细胞癌（ＨＣＣ）和１３０人健康人群进行了检测，结果抗－ＨＧＶ阳性率分别为１４．３８％和２．３１％，表明在不同人群中存在庚型肝炎病毒（ＨＧＶ）感染；ＨＣＣ患者抗－ＨＧＶ阳性率明显高于健康人群，显示ＨＧＶ感染与ＨＣＣ发生有关；同时在抗－ＨＧＶ阳性ＨＣＣ患者中ＨＢＶ感染率高达８２．６１％，提示ＨＧＶ和ＨＢＶ重叠感染可增加ＨＣＣ的发生.     

TthDNA聚合酶在丙型肝炎病毒RNA检测中的应用

用ＴｔｈＤＮＡ聚合酶行逆转录聚合酶链反应（ＲＴ－ＰＣＲ）扩增丙型肝炎病毒（ＨＶＣ）５′端非编码序列，对２６２例肝炎患者血清进行ＨＣＶＲＮＡ测定，结果ＨＣＶＲＮＡ阳性者５３例，阳性率２０．２％，凡阳性者用酶联免疫吸附法测其抗ＨＣＶＩｇＧ，其中３０例测到抗ＨＣＶ，阳性重叠率５６％（３０／５３）；ＨＣＶ ＲＮＡ阳性中的１５例同时用成髓细胞瘤病毒酶行传统逆转录－套式聚合酶链反应检测对照，１４例阳性，符合率     

TthDNA聚合酶在丙型肝炎病毒RNA检测中的应用

用ＴｔｈＤＮＡ聚合酶行逆转录聚合酶链反应（ＲＴ－ＰＣＲ）扩增丙型肝炎病毒（ＨＶＣ）５’端非编码序列，对２６２例肝炎患者血清进行ＨＣＶＲＮＡ测定，结果ＨＣＶＲＮＡ阳性者５３例，阳性率２０．２％。凡阳性者用酶联免疫吸附法测其抗ＨＣＶＩｇＧ，其中３０例测到抗ＨＣＶ，阳性重叠率５６％（３０／５３）；ＨＣＶＲＮＡ阳性中的１５例同时用成髓细胞瘤病毒酶行传统逆转录。套式聚合酶链反应检测对照，１４例阳性，符合率达９３．３％（１４／１５）。ＴｔｈＤＮＡ聚合酶用于ＲＴ－ＰＣＲ检测ＨＣＶＲＮＡ５’端非编码序列片段具有敏感性高、特异性强、稳定性好的优点。     

血透患者检测抗HCV IgM的临床意义

为探讨丙型肝炎ＩｇＭ抗体测定在血液透析患者中的临床意义,采秀间接ＥＬＩＳＡ法检测抗ＨＣＶ ＩｇＭ。同时采用ＥＬＩＳＡ测抗ＨＣＶ ＩｇＧ,ＲＴ－ＰＣＲ法测ＨＣＶ ＲＮＡ,并进行比较。结果示６２例血液透析病人中,抗ＨＣＶ ＩｇＭ阳性２７例（４３．６％）,抗ＨＣＶ ＩｇＧ阳性２９例（４６．８％）,ＨＣＶ ＲＮＡ阳性３４例（５４．８％）,任一项阳性３７例（５９．７％）;抗ＨＣＶ ＩｇＭ与ＨＣＶ ＲＮＡ检测     

丙型肝炎病毒感染在各类型慢性乙型肝炎患者中的血清流行病学分析

本文以抗－ＨＣＶ和ＨＣＶ－ＲＮＡ作为观察指标，对广州地区４２８例各类型慢性乙型肝炎患者的丙型肝炎病毒（ＨＣＶ）重叠感染状况进行了流行病学调查。结果显示慢性乙型肝炎患者中ＨＣＶ重叠感染中１０．１％，明显高于对照组的１．４％（Ｐ＝０．０００８）慢重肝与肝硬化的重叠感染率高于慢迁肝与慢活肝（Ｐ〈０．００１），有输血史的患者ＨＣＶ重叠感染率高于无输血史者（Ｐ〈０．０００１）。     

逆转录PCR检测丙型肝炎病毒RNA

逆转录ＰＣＲ检测丙型肝炎病毒ＲＮＡ王捷，杨太成，江悦华，王晓怀（广州军区总医院医学实验科，５１００１０）丙型肝炎病毒（ＨＣＶ）是单股正链ＲＮＡ病毒，流行病学研究表明，大约９０％的输血后肝炎均由ＨＣＶ引起，原发性肝癌的发生也与ＨＣＶ感染相关［１］。目前...     

江门市120例静脉毒瘾者HBV,HCV,HGV感染状况调查分析

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（ＨＧＶ）的感染状况。方法：对广东省江门市１２０例静脉毒产瘾者血浆ＨＢＶ,ＨＣＶ和ＨＧＶ的标记物进行检测,采用ＥＬＩＳＡ法检测ＨＢｓＡｇ,ＨＢｅＡｇ,抗ＨＢｃＡｂ,抗ＨＢｓＡｂ,抗ＨＣＶ抗体;逆转录聚合酶链反应（ＲＴ－ＰＣＲ）检测ＨＧＶＲＮＡ。结果：１２０例静脉毒瘾者中ＨＢｓＡｇ转阳１３例（１０．８３％）,抗ＨＢｓＡｂ     

重组抗原在戊型肝炎病毒感染诊断中的应用

目的探讨重组抗原在戊型肝炎病毒（ＨＥＶ）感染诊断中的应用。方法用ＨＥＶ重组抗原建立酶免疫试验（ＥＩＡ）检测肝病患者和健康人群血清中抗戊型肝炎病毒抗体（抗－ＨＥＶ）。结果５５份用新加坡ＤＢＬ公司抗－ＨＥＶ诊断试剂盒检测为抗－ＨＥＶ阳性的肝炎患者血清中，５３份（９６．４％）用本方法检测也为阳性；４５份ＤＢＬ试剂盒检测为抗－ＨＥＶ阴性的血清中，本法检测有３份为抗－ＨＥＶ阳性。检测甲、乙、丙型肝炎患者血清各３０份，抗－ＨＥＶ阳性率分别为１３．３％（４／３０）、１３．３％（４／３０）和１０．０％（３／３０）。健康人抗－ＨＥＶ阳性率为５．０％（８／１６０）。重组抗原与合成肽抗原混合用于ＥＩＡ，可以检出两种抗原单独阳性的抗－ＨＥＶ。结论以重组抗原为基础的ＥＩＡ特异性强、灵敏度高、快速简便，是戊型肝炎血清学诊断及流行病学调查的一种可靠方法     

输血及血制品者丙型肝炎病毒感染调查

对深圳九龙海关职员有输血或血制品史者６６铭及对照组１４７名调查其ＨＣＶ感染情况。结果：输血组抗ＨＣＶ组性率为９．１％，明显高于抽样组的０．７％。输血组中以血浆者抗－ＨＣＶ检出最高，传播风险较大。丙种球蛋白及补血康输入者抗－ＨＣＶ阴性。抗－ＨＣＶ检出阳性者中ＡＬＴ升高者ＨＣＶＲＮＡ均阳性，提示ＨＣＶＲＮＡ水平与活动性肝损害相关。     

血液透析患者肝炎病毒感染危险因素分析

目的 了解血液透析患者乙型、丙型和庚型肝炎病毒(HBV、HCV和HGV)感染及合并感染的危险因素。方法 采用酶联免疫法(ELISA)检测了44例血透患者的HBV标志物、抗-HCV和抗-HGV抗体,逆转录-套式PCR法检HCV BNA及HGV RNA。结果 血透患者三种肝炎总感染率达77.3％,HBV、HCV、HGV感染率分别为72.7％、13.6％和13.6％,HBV/HCV、HCV/HGV、HGV/HBV合并感染分别为11.4％、2.3％和11.4％,HBV、HCVT HGV三重感染率为2.3％。HCV感染与输血次数、透析年限明显相关,而HBV和HGV感染与输血次数、透析年限无显著相关。肝炎病毒合并感染组与单纯感染组、阴性组比较,输血次数明显增多、透析年限明显延长。结论 血透患者HBV、HCV和HGV感染率均较高。严格消毒措施,减少输血,血源筛查,对减少透析中肝炎病毒感染至关重要。     

GB virus type C/HGV markers in HCV RNA-positive French blood donors: correlation with HCV genotypes and risk factors

BACKGROUND: Exposure to GB virus type C/HGV (GBV-C/HGV) could be determined by detection either of RNA by RT-PCR or of antibodies of the envelope protein E2. STUDY DESIGN AND METHODS: The aim of the study was to determine the proportion of the GBV-C/HGV markers of infection in a blood donor population infected with HCV and to identify GBV-C/HGV routes of transmission that are associated with HCV genotypes and risk factors. RESULTS: Among 306 HCV RNA-positive blood donors, the proportion of GBV-C/HGV RNA-positive donors and anti-E2-positive donors was 19.3 percent (95% CI = 15.0-24.2%) and 42.1 percent (95% CI = 36.6-47.9%), respectively. Exposure to GBV-C/HGV (RNA or anti-E2) was significantly associated with the risk factor of IV drug use. There was a trend toward association with HCV subtypes 1a and 3a, probably because these HCV subtypes are the most frequent in IV drug users. No correlation was observed between ALT elevation and the presence of GBV-C/HGV RNA. CONCLUSION: In persons with HCV infection, IV drug use seems to be a major route of GBV-C/HGV transmission. Precautions taken to avoid HCV infection will probably also decrease GBV-C/HGV transmission.     

High rate of GB virus type C/HGV transmission from mother to infant: possible implications for the prevalence of infection in blood donors

BACKGROUND: Because GB virus type C(GBV-C)/HGV (GBV-C/HGV) is blood-borne and sexually transmitted, persons at risk of infection with such viruses have a high prevalence of GBV-C/HGV markers. However, adults with no apparent risk factors, such as blood donors, frequently are positive for GBV-C/HGV markers. Mother-to-infant transmission could explain this high prevalence, but it has been studied only through small series of GBV-C/HGV-infected mothers co-infected with HCV or HIV. STUDY DESIGN AND METHODS: To determine the rate of mother-to-infant transmission of GBV-C/HGV RNA in women who are HCV- or HIV-negative, a prospective study was performed in a cohort of 288 mothers screened for viral RNA and in the infants born to GBV-C/HGV-infected mothers. RESULTS: Thirteen mothers (4.5%) were found positive for GBV-C/HGV RNA. Of the infants in whom at least one blood sample was collected between the third and the ninth months of life, 89 percent were positive for viral RNA. The majority of these newborns were negative for GBV-C/HGV RNA at birth and positive after the third month. The viral RNA titers of infants born to GBV-C/HGV-infected mothers appeared as elevated as those of their mothers. All the GBV-C/HGV-infected infants remained positive for viral RNA during the entire study period. No clinical events possibly linked to a primary GBV-C/HGV infection were reported in infants. Serum ALT level and blood count remained within normal values throughout the follow-up of all GBV-C/HGV-infected infants. CONCLUSION: The frequency of mother-to-infant GBV-C/HGV transmission is elevated and could explain the high prevalence of GBV-C/HGV markers (viral RNA and E2 antibody) in adults at low risk for blood-borne or sexually transmitted viruses, such as blood donors.     

Incidence and clinical presentation of posttransfusion TT virus infection in prospectively followed transfusion recipients: emphasis on its relevance to hepatitis

BACKGROUND: A novel transfusion-transmissible human DNA virus, TT virus (TTV), has been discovered recently. An attempt was made to determine the incidence and clinical outcome of TTV infection in recipients of blood transfusion. STUDY DESIGN AND METHODS: Serial serum samples collected as part of a prospective study of posttransfusion hepatitis were examined for TTV DNA by a nested PCR assay. RESULTS: Among 150 adults undergoing cardiac surgery, posttransfusion specimens from 59 individuals were positive for TTV DNA. Pretransfusion sera were found to be positive in 13 of these individuals. Therefore, 46 (33.6%) of the 137 previously uninfected patients developed new TTV viremia after transfusion. Among the 46 patients, 3 were coinfected with HCV, 5 were coinfected with HGV, and 38 were infected with TTV alone. No apparent symptoms or signs were noted in the 38 patients infected by TTV alone or the 5 infected with HGV plus TTV. The average peak serum ALT activity was 31 IU per L, with persistently normal levels in 34 of the 38 patients with TTV infection alone. In 8 other patients who subsequently developed well-documented non-A-G hepatitis, 3 were positive for TTV (3/8 vs. 46/137, p = 0.8). In 12 patients followed for more than 1 year, TTV viremia persisted in every case. CONCLUSION: In this population, TTV is transmitted by transfusion to approximately 30 percent of patients who undergo cardiac surgery. Most of the infections appear to become persistent. Despite the high prevalence rate, TTV does not appear to cause hepatitis on its own.     

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.     

丙型病毒性肝炎与性传播关系的临床研究

目的　研究丙型病毒性肝炎与性传播的关系。方法　应用逆转录巢式聚合酶链反应 (RT PCR)检测丙型病毒性肝炎患者、性病患者精液以及阴道分泌物中HCVRNA。应用ELISA法检测其配偶的抗 HCV ,并与正常健康夫妇 18对作对照观察。结果　① 3 3例男性丙型病毒性肝炎患者精液中HCVRNA阳性 6例 (18 18% ) ,2 5例女性丙型病毒性肝炎患者阴道分泌物中HCVRNA阳性 9例 (3 6 0 % )。② 6例男性丙型病毒性肝炎患者精液HCVRNA阳性者配偶抗 HCV阳性1例 (16 67% ) ,9例女性丙型病毒性肝炎患者阴道分泌物HCVRNA阳性者配偶抗 HCV阳性 7例 (77 78% )。③ 72例性病患者生殖道分泌物HCVRNA阳性 4例 (5 5 % )。④对照组配偶抗 HCV均为阴性。结论　①丙型病毒性肝炎患者精液、阴道分泌物中可检出HCVRNA ,丙型病毒性肝炎病毒存在性传播的可能性。②女性丙型病毒性肝炎患者性传播丙型病毒性肝炎病毒可能性比男性丙型病毒性肝炎患者要大。③性乱人群通过性接触感染丙型病毒性肝炎病毒的可能性高于正常人群     

Evaluation of RNA and E2 antibodies in prospectively followed recipients of hepatitis G virus-infected blood

BACKGROUND: Hepatitis G virus (HGV) has recently been cloned and tests for HGV RNA and envelope antibodies (anti-E2) have been developed. HGV infection is widespread among blood donors worldwide, but the clinical and serologic outcome of transfusion-associated HGV infection has not been fully characterized. STUDY DESIGN AND METHODS: Consecutive blood donors (n = 2210) were investigated for HGV markers (RNA and anti-E2). The recipients of HGV RNA-positive blood were followed for 1 year after transfusion. RESULTS: Forty-two blood donors (1.9%) were positive for HGV RNA. Eight recipients of HGV RNA-positive blood were retrospectively identified within 2 weeks of transfusion and prospectively followed. In four patients, the presence of anti-E2 before transfusion or an early antibody response protected them from reinfection or prevented HGV persistence, while, in the remaining four patients, transient or persistent viremia was detected shortly after exposure. None of the infected recipients had any evidence of liver disease. CONCLUSION: These results do not support the screening of donors to prevent transfusion-associated HGV infection.     

Prevalence and infectivity of hepatitis G virus and its strain variant, the GB agent, in volunteer blood donors in Taiwan

BACKGROUND: The prevalence of hepatitis G virus (HGV) and its strain variant, the GB agent (GBV-C) is high in non-virus-inactivated plasma products, but, persistent infection in recipients is relatively low. STUDY DESIGN AND METHODS: Stored samples from transfusion donors and recipients in a prospective study of posttransfusion hepatitis were tested for HGV RNA and antibody to the E2 protein (anti-E2). RESULTS: Thirty-two (2.1%) of the 1500 qualified donors were positive for HGV RNA. Twenty-four persons had received a transfusion of blood from one of these 32 viremic donors. Of these 24 recipients, 3 were positive for HGV RNA before transfusion. Of the remaining 21 recipients, 8 became viremic after transfusion, while the other 13 were not infected. Four of the eight infected recipients were persistently positive for HGV RNA, while four became negative in 1 to 3 years. Three of the four patients with HGV clearance seroconverted to anti-E2 positivity. Comparison of the viral titer, viral sequences at E2, storage period of blood donations, and clinical data in the infected and noninfected recipients revealed no significant differences. However, the noninfected recipients seemed to have a higher prevalence of anti-E2 before transfusion. CONCLUSION: The prevalence of HGV viremia in volunteer blood donors in Taiwan is 2.1 percent, and blood from 0.6 percent of them actually causes HGV infection in the recipients. In half of infected recipients, clearance of HGV occurs. Anti-E2 appears in most recipients whose viremia is cleared.     

Prevalence of hepatitis G virus RNA and antibodies to HGV envelope protein (anti-E2) in patients with liver injury in Japan]

To assess the role of hepatitis G virus (HGV) in acute and chronic liver diseases, we investigated the prevalence of HGV RNA and antibodies to HGV envelope protein (anti-E2) among patients with liver diseases diagnosed in our hospital from 1992 to 1997. Among 24 patients with acute hepatitis (HAV: 13, HBV: 2, HCV: 3, CMV: 1, non A-C: 5), only 1 patient with non A-C hepatitis (4%) were positive for HGV RNA and none was positive for anti-E2. Among 461 patients with chronic liver diseases (alcohol: 27, HBV: 74, HCV: 297, HBV + HCV: 10, non B non C: 14, autoimmune and metabolic: 39), 40 patients (alcohol: 1, HBV: 3, HCV: 33, HBV + HCV: 3) were positive for HGV RNA(9%) and 48 patients were positive for anti-E2(17%). In the patients with positive for anti-E2, only 8% were positive for HGV RNA. 98% of HGV RNA positive patients were infected with HBV or HCV, and especially 82% were infected with HCV. In patients with non A-C hepatitis, none was positive for HGV RNA, so HGV seems not to have important role in liver diseases.