HIV-1感染者中HCV感染对于隐匿性HBV感染的影响

目的探讨在人免疫缺陷病毒-1(human immunodeficiency virus-1,HIV-1)感染者中丙型肝炎病毒(hepatitis C virus,HCV)感染对于隐匿性乙型肝炎病毒(hepatitis B virus,HBV)感染的影响。方法研究对象为河南某艾滋病治疗示范区中178例乙型肝炎表面抗原(hepatitis B surface antigen,HBsAg)阴性的经有偿献血感染HIV-1未经抗病毒治疗的患者,检测项目包括肝功能,HBV及HCV血清标志物,HBV DNA和HCV RNA。分析HIV-1阳性,抗HCV阳性、抗HCV阴性组及HIV-1/HCV感染组中不同HCV RNA载量组HBV病原学检测结果方面的差异。结果 178例HBsAg阴性的HIV-1感染者中,HBV-M全阴性35例;单独抗HBs阳性25例;单独抗HBc阳性51例;HBsAb及HBcAb均阳性34例。抗HCV阳性HIV-1感染者与抗HCV阴性HIV-1感染者的年龄、性别比较差异无统计学意义(P>0.05);丙氨酸转移酶(alanine transaminase,ALT)、天冬氨酸氨基转移酶(aspartate aminotransferase,AST)浓度比较差异有统计学意义(P<0.05);总胆红素(total bilirubin,TBIL)浓度比较差异无统计学意义(P>0.05);乙肝标志物(HBV marker,HBV-M)阴性、单独乙肝表面抗体(hepatitis B surface antibody,HBsAb)阳性、单独乙肝核心抗体(hepatitis B core antibody,HBcAb)阳性、HBsAb及HBcAb均阳性及HBV DNA阳性例数比较差异均无统计学意义(P>0.05)。不同HCV RNA载量患者HBV DNA检测结果比较差异无统计学意义(P>0.05)。结论经有偿献血感染HIV-1人群中,HCV感染及HCV RNA载量高低与隐匿性HBV感染的发生无关;但合并HCV感染可加重HIV-1感染者的肝功能损害。     

血液透析患者庚型肝炎病毒感染的研究

目的探讨血透患者庚型肝炎病毒(HGV)感染情况及其感染相关因素。方法采用ELISA法和RT—PCR法检测264例血透患者抗HGV和HGV—RNA，并同时检测抗HCV、HCV—RNA、HBsAg和抗HBc。结果血透人群HGV感染率为13．6％．其中，36例HGV阳性患者有21例与其它肝炎病毒合并感染(58．3％)，6例(16．7％)与HBsAg，6例(16．7％)与抗HCV／HCV—RNA，9例(25．0％)与抗HBc／HBsAg／抗HCV。HGV—RNA与HBV、HCV合并发生率为66．7％。HGV感染以女性人群多见，与年龄、输血史、输血次数、透析时间、HBV感染及HCV感染无相关性，感染者肝功能生化指标无异常改变。结论血透人群有较高的HGV感染率，其中多数感染与HBV、HCV合并发生。     

Comparative assay of Hepatitis B and C virus infection markers by different assay kits

In order to compare sensitivity of EIA and RIA assay kits for hepatitis B and C virus(HBV and HCV,respectively)infection markers,100 serum samples in total wre collected form 50 adult women each in urban and rual areas in northeast China.The number of positive cases to the three infection markers on HBV(i.e..,HBsAg^ ,anti-HBs^ ,and anti-HBc^ )and the one on HVC (anti-HCV)were examined in two laboratories,i.e.,in Laboratory A with EIA kits produced in China and in Laboratory B with RIA kits.HCV infection positivity(anti-HCV^ )was examined by EIA kits in both laboratories,but from diffeent sources in and outside of China,respectively.The assay in Laboratory A gave 2 HBsAg^ cases out of the 100 cases examined,whereas there were 9 positive cases in Labortory B,In contrast,19 cases were positive to anti-HCV when examined in Laborator A,and there were 3 cases in Laboratory B.Thus,the kits used in Laboratory A gave fewer HBsAg^ and more anti-HCV^ cases than the kits used in Laboratory B.The prevlence of antiHBs^ or anti-HBc^ and cases did not differ when assayed in the two laboratories with EIA and RIA kts,respectively,The agreement of positive and negative findings between the two set of testing were 93%,93%,93%,86%and 82% for HBsAg,anti-HBs,anti-HBc,BHV(i.e.,either positive to anyone of the three markers or negative to all three markers),and anti-HCV,respectively.The implication of the observation on epidemiology on HBV and HCV infection prevalence was discussed.     

肝细胞癌患者GB病毒C感染状况及其相关性研究

为了解ＧＢ病毒Ｃ（ＧＢＶ－Ｃ）感染与肝细胞癌（下称肝癌）之间可能的相关性,采用一步法逆转录聚合酶链反应（ＲＴ－ＰＣＲ）对１２４例肝癌患者进行了ＧＢＶ－Ｃ ＲＮＡ检测。结果：ＧＢＶ－Ｃ ＲＮＡ总检出率高达２６．６％（３３／１２４）,３３例ＧＢＶ－Ｃ ＲＮＡ检出阳性者中,９０．９％合并有ＨＢＶ、ＨＣＶ感染;３３例非Ｂ非Ｃ型肝癌中,ＧＢＶ－Ｃ ＲＮＡ检出率为９．１％（３／３３）。３３例ＧＢＶ－Ｃ感染阳性     

献血者中抗-HCV和HBsAg阳性与ALT水平相关性研究

目的探讨无偿献血者丙氨酸氨基转移酶(ALT)异常与HBsAg和丙型肝炎病毒(HCV)感染及非病理因素的关系。方法对242480例献血者标本进行检测,统计ALT、HBsAg和抗-HCV阳性不合格项目的构成比,分析ALT水平与HBsAg和HCV感染的相关性。结果 ALT水平与HBsAg阳性显著相关(r=0.6140,P<0.005),与抗-HCV阳性呈低度相关(r=0.3684,P<0.001)。结论 ALT水平与HCV和HBsAg感染呈正的直线相关。     

性乱个体血清抗-HCV的调查

用第二代酶免疫试剂对208位性乱个体进行血清丙型肝炎病毒抗体(抗-HCV)的检测,107位献血员作对照,并结合部分乙肝病毒血清标志(HBVM)进行分析和比较。结果抗-HCV总阳性率为8.65％(18/208),伴有性病者阳性率12.73%(14/110),不伴性病者4.1％(4/98),对照组抗-HCV阳性率1.87％(2/107)。18例抗-HCV阳性血清中检出乙肝病毒表面抗原(HBsAg)及核心抗体(抗-HBc)13例(72.2％),未发现抗-HCV阳性与年龄、性别相关。结果提示,性乱个体中有着不可忽视的HCV感染率,感染的危险因子似与性病及HBV感染有关。     

Evaluation of circulating natural type 1 interferon-producing cells in HIV/GBV-C and HIV/HCV coinfected patients: a preliminary study

BACKGROUND: GB virus-C (GBV-C) is a flavivirus that probably influences HIV infection-associated disease among HIV/GBV-C coinfected patients and inhibits the progression of HIV infection to AIDS. To address the possibility of immune-modulating effects of GBV-C coinfection in HIV patients, we evaluated interferon-producing cells in HIV/GBV-C coinfected patients and compared them to HIV-infected patients. METHODS: We performed a pilot study to enumerate interferon-producing cell count by two-color flow cytometric analysis and also for determining the frequency of ongoing GBV-C and HCV infection among patients infected with HIV. Then, 83 asymptomatic HIV-positive patients were considered for evaluation of interferon-producing cells. Eighty three patients were stratified in four groups according to the HCV and GBV-C infection status: patients infected with HCV and GBV-C (GBV-C+/HCV+), patients infected with GBV-C but not with HCV (GBV-C+/HCV-), patients infected with HCV but not with GBV-C (GBV-C-/HCV+), and patients not infected by GBV-C and HCV (GBV-C-/HCV-). RESULTS: GBV-C was detected in plasma samples from 15.5% of HIV-infected patients and the frequency of HCV infection was 47.5%. Interferon-producing cells in GBV-C coinfected individuals revealed a wider range of numbers; however, there was no significant difference in the interferon-producing cell count among HIV-infected individuals. CONCLUSIONS: It does not appear that GBV-C coinfection affects generation or redistribution of interferon-producing cells in HIV-infected patients with relatively intact immune system.     

对血站合格献血员复检HBV HCV阳性率分析

目的：了解我区献血员的管理及筛查情况。方法：随机采集了我区4个盟市血站503份合格献血员血样,并进行了相关调查,采用ELISA法复检。结果：HBsAg阳性率为1.99%（10/503）;抗-HBc阳性率15.90%(80/503);抗-HBs阳性率21.87%(110/503);抗-HCV阳性率2.19%(11/503),其中HBV、HCV双重感染的8例,HBsAg、抗-HBc双阳性3例。对抗-HBc、抗-HBs双阳性以及单纯阳性者经PCR法检测HBVDNA均为阴性。结论：说明我区血站管理及对献血员筛查工作还存在着一定的漏洞,献血员筛查抗-HBc对预防输血后乙肝无多大价值,应把重点放在选用灵敏度高的试剂进行筛查。     

原发性肝癌78例血清HCVRNA和抗HCV的观察

用逆转录－聚合酶链反应和酶联免疫吸附试验检测了７８例原发性肝癌患者清丙型肝炎病毒（ＨＣＶ）ＲＮＡ、抗ＨＣＶ和乙型肝炎病毒（ＨＢＶ）免疫学标物。     

122例艾滋病患者合并乙肝病毒 丙肝病毒感染的临床流行病学研究

目的 研究在抗逆转录病毒药物治疗(HAART)状态下HIV/AIDS患者合并乙肝病毒(HBV)、丙肝病毒(HCV)的流行状况以及相关血清生化和病毒学特征.方法 对122例正在接受HAART治疗的HIV/AIDS患者采集血标本,使用酶免法(ME-IA)检测乙肝五项指标(HBs Ag、抗-HBs、HBe Ag、抗-HBe、抗-HBc)、肝功能,应用酶联免疫吸附法(ELISA)检测丙型肝炎病毒抗体,运用RT-PCR法对丙肝病毒抗体阳性标本以及表面抗原和/或核心抗体阳性标本分别进行HCV-RNA以及HBV-DNA测定.以43名单纯HCV感染者作为对照组进行研究.结果 122名 HIV/AIDS患者,乙肝五项指标全阴性97例(78.86％),表面抗原阳性3例(2.46％),表面抗体阳性者总计19例(15.57％),单纯核心抗体阳性者3例(2.46％).HCV 抗体阳性84例(68.85％),84例HCV抗体阳性标本中HCV-RNA 阳性58例(69.05％),HIV/HCV/HBV合并感染者为0.HIV/HCV合并感染组 HCV-RNA 水平与感染者性别,CD4 +细胞数水平无明显差异(P＞0.05);HIV/HCV合并感染组与单纯HCV感染组 HCV-RNA水平、肝功能异常率无明显差异(P＞0.05).结论 HIV感染者HBsAg阳性率低于普通人群,HIV/HCV合并感染的比例显著高于普通人群.HIV/HCV合并感染与单纯HCV感染者血清生化及病毒学改变相似.     

Urban-rural comparison of HBV and HCV infection prevalence in eastern China

The present study was initiated to make and urban-rural comparison of the prevalence of cases positive to hepatitis B and C virus(HBV and HCV,respectively)infection markers in densely populated eastern half of China.For this purpose.10 survey sites were selected,i.e.,six sites in urban areas(the city group;Beijing,shangahi and four provincial capitals)and four sites in rural areas(the village group;one village each in Jilin and Shandong provinces,and two villages in Shaanxi Province),About 50 adult women per site volunteered to participate,from whom 494 valid bllod samples were collected.Positivities to HBsAg(HBsAg^ ),anti-HBs(anti-HBs^ )and antiHBc(anti-HBc^ )were examined by RIA methods.and that to anti-HCV(anti-HCV^ )by either EIA or RIA.Those positive to any one of the three HBV infection markers were taken as HBV infection-positive(HBV^ ).The prevalence of HBsAg^ ,HBV^ and anti-HBc^ was 8%,70%and 2.7% in the city group,and 8%,65% and 2.0%in the village group,and no significant difference was found between the two groups.The overall prevalence was 8% for HBsAg^ ,68% for HBV^ ,and 2.4% for anti-HVC^ ,The results were discussed in reference to some 20 papers each on HBV^ and anti-HCV^ prevalence in China published since(1991),The reviewing of these papers of anti-HCV was low(well below 5%),and that no substantial difference was found between the rural and urban populations.     

分析重庆市HIV/AIDS患者合并HBV、HCV感染状况

目的 分析重庆市艾滋病病毒感染者(HIV)和获得性免疫缺陷综合征(acquired immunedeficiency syndrome,AIDS)患者(简称HIV/AIDS患者)合并感染乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)状况.方法 利用《艾滋病综合防治系统——抗病毒治疗管理》数据库,回顾收集重庆市2004-2015年HIV/AIDS治疗患者基本情况和HBsAg、Anti-HCV实验室检测结果,利用SPSS 19.0统计软件进行统计分析.结果 截至2015年12月31日,重庆市HIV/AIDS患者中HBsAg和(或)Anti-HCV总检测率55.1％ (11 231/20 397),其中HBsAg和Anti-HCV都进行检测的患者有9 307例.HIV/HBV、HIV/HBV/HCV、HIV/HCV合并感染的比例分别为9.8％、0.9％、4.5％.HIV/HCV合并感染在30 ～ 45岁年龄段构成比最高;HIV/HBV合并感染在男性中构成比最高,与HIV单纯感染组比较,差异均具有统计学意义(P＜0.05).HIV/HBV合并感染及HIV单纯感染均在性传播中构成比最高,差异无统计学意义(P=0.177);HIV/HCV和HIV/HBV/HCV合并感染在静脉吸毒中构成比最高,与HIV单纯感染比较,差异具有统计学意义(P＜0.05).主城9区中HIV/AIDS患者及合并感染患者比例最高.合并感染组病死率均高于HIV单纯感染组,HIV/HBV/HCV组病死率最高.结论 重庆市HIV/AIDS患者中HBsAg、Anti-HCV检测率较低,不同感染模式具有不同的流行病学特征,且合并感染的病死率较高,需要进一步加强对重庆市HIV/AIDS患者中HBV、HCV合并感染检测率和治疗情况的管理.     

职业献血浆员HBV和HCV感染状况的研究

本文采用ELISA法检测247名职业健康献血浆员中抗-HCV和HBV感染标志(HB-VM),并用PCR技术检测其中85人血清HBV-DNA的存在状况.发现抗-HCV阳性率为4.0%,HBVM阳性率为29.1%,HBV-DNA阳性率为11.8%≥40岁人群抗-HCV阳性率明显高于30岁以下人群(7.7%比0,P=0.042).HBVM阳性者抗-HCV阳性率明显高于HBVM阴性者(8.3%比2.3%,P=0.038),HBV感染与HCV感染之间存在一定的伴随关系.HBVM阳性者血清HBV-DNA阳性率明显高于HBVM阴性者(18.2%比 0,P<0.05).结论认为目前常规筛选献血员的方法不安全,建议加以改进.     

丙型肝炎病毒感染与原发性肝癌关系的研究

用酶联免疫(ELISA)法检测210例肝癌、30例急性肝炎和60例健康人血清中的抗HCV(丙型肝炎抗体).结果:抗HCV的阳性率分别为41.42%、6.6%和0%(未检出抗HCV).相互比较,P<0.01,差异非常显著,特别是HBsAg阴性肝癌抗HCV的阳性率为51.6%,显著高于HBsAg阳性肝癌抗HCV的阳性率33.6%,两组比较,X~2=6.9,P<0.01,差异亦非常显著.这一结果表明:广西部分肝癌病人与丙型肝炎病毒感染有密切关系.     

慢性乙型肝炎患者的HCV重叠感染

研究45例慢性乙型肝炎患者的HCV重叠感染。病例均为后发抗HCV阳性的慢性HBsAg携带者,无先抗HCV阳性而后HBsAg阳性的个案,这可能反映HBV和HCV两种病毒感染的先后次序、不同传播方式及HBV对HCV易感性的增进作用。用RT-PCR检出30/45例血浆HCV RNA阳性,不仅确证HCV重叠感染诊断,还证实HCV复制及传染性。23/30例HCVRNA阳性者有输血史,提示输血是其获得HCV重叠感染的主要途迳。用PCR检出25/45例血清HBV DNA阳性,其中抗HBe阳性者的HBV DNA检出率为42.9％(12/18),明显低于(P<0.001)我们前文报道,提示重叠HCV感染对HBV复制有抑制作用。此外有9例抗HBe阳性者,其HBV DNA阴性但HCV RNA阳性,反映HCV可能已取代HBV成为致肝损害的主要病因。     

山东省血友病患者乙型肝炎、丙型肝炎和人类免疫缺陷病毒感染情况调查分析

目的了解山东省血友病患者乙型肝炎病毒（HBV）、丙型肝炎病毒（HCV）和人类免疫缺陷病毒（HIV）的感染情况。方法对2005～2011年山东省血友病诊疗中心确诊或治疗的628例血友病患者进行HBsAg、抗-HCV和抗-HIV检测,并根据年龄段进行分组。结果 628例血友病患者HBsAg、抗-HCV和抗-HIV阳性率分别为3.3%（21/628）、9.6%（60/628）和0.6%（4/628）,总感染率为13.5%,不同年龄段患者HBsAg和抗-HCV阳性率有明显差异。结论山东省血友病患者乙型肝炎感染率低于一般人群,而丙型肝炎感染率高于一般人群,艾滋病感染有上升趋势,乙型肝炎和丙型肝炎感染与年龄密切相关。     

Seroprevalence of Hepatitis B, Hepatitis C, HIV Infections in Blood Donors of Khulna, Bangladesh

To determine changes (Trends) in infection rates of Hepatitis B surface antigen (HBsAg), Hepatitis C virus (HCV) and Human immunodeficiency virus (HIV) in blood donors of Khulna Population. Specimens of 34953 voluntary blood donors & party or relative donors in Transfusion Medicine Department of Khulna Medical College Hospital from 2007 to 2009 were screened for HBsAg, anti-HCV, anti-HIV 1 & 2 reactivity in a cross-sectional survey by rapid test method. Reactive samples were verified using a recognized confirmatory test which consisted of a second generation enzyme immune assay (HBsAg), anti-HCV antibodies by anti-HCV EIA & for HIV by western Blot, respectively. The seroprevalence of HBsAg, Anti-HCV, HIV antibody 1 & 2 was 1.4%, 0.09% & 0.03% respectively in all blood donors. Prevalence of confirmed positivity was 0.62% for HBsAg, 0.04 % for Anti-HCV, 0.02% for HIV Western Blot. Between 2007 to 2009 a decreasing trend was observed in HBsAg frequency, HCV frequency decreased in 2009 compared to 2007. One HIV positivity found in 2009. Although the frequency of transfusion transmitted infections is low, party or relative donors have some risk factors than voluntary blood donors. Through more scrutiny in donor selection, improved serological test & reevaluation of infections routes in donor, infection reduction can be achieved.     

再生障碍性贫血患者乙型肝炎病毒感染及其与预后的关系

目的 研究再生障碍性贫血(AA)患者中乙肝病毒(HBV)感染发生情况及接受免疫抑制治疗(IST)后 HBV再激活发生概率,探讨 HBV感染与 AA预后的关系.方法 纳入2006年1月至2016年12月南充市中心医院及川北医学院附属医院AA住院患者245例为研究对象,依据有无 HBV感染及感染状况分为 HBsAg 阳性组(n=36)、HBsAg阴性/抗-HBc阳性组(n=96)及 HBsAg 阴性/抗-HBc 阴性组(n=113),所有入组患者均接受IST治疗,中位随访时间在44个月以上.对不同组别 AA 患者病情程度进行比较,总结接受 IST 治疗后 HBV 再激活情况及所有患者总生存率的差别.结果 1)245例 AA 患者中132例存在 HBV 感染,总感染率53.88%,其中36例为 HBsAg阳性,96例为 HBsAg阴性/抗-HBc 阳性;2)3例 HBsAg阳性接受预防性抗病毒治疗者无 HBV再激活发生,33例 HBsAg阳性及96例 HBsAg阴性/抗-HBc 阳性均未接受预防性抗病毒治疗者中各有1例发生HBV再激活,HBV 再激活发生率1.55%(2/129);3)HBsAg 阳性组 AA 患者随访7年,总体存活率84.4%, HBsAg 阴性/抗-HBc阴性组 AA组患者总体存活率87.5%,HBsAg 阴性/抗-HBc阳性组总体存活率81.6%,组间比较差异无统计学意义(P=0.862);纳入研究的全部 HBV感染 AA 患者没有发生与肝炎相关的死亡.结论 AA 患者的HBV 感染率较普通人群增高;有HBV 感染的AA 患者接受IST 治疗后,未发生病毒激活率增加,HBV感染对AA 患者预后亦无明显影响.     

肝硬化及肝癌患者HBV-M模式差异性

目的探讨乙型肝炎病毒标志物（HBV—M）在肝硬化（IJC）和肝细胞癌（HCC）中表现模式的差异及其临床意义。方法HBV—M五项中至少有一项阳性的LC患者68例，HCC患者64例，对2组间HBV—M的表现模式进行比较分析。结果LC和HCC间HBV—M表现模式有明显差异，HCC中HBeAg阳性模式明显高于LC患者，2组分别为46．0％和23．9％（P〈0．01），LC患者中则以HBeAg阴性的“小三阳”（B）和“二阳”（C）占多数，分别为34．3％和41.8％，而B、C模式在HCC患者中分别为20．6％和31．7％。结论HCC中HBeAg阳性的HBV—M模式明显高于LC患者；对于HBV感染者，尤其是HBeAg阳性的患者要警惕发生HCC的可能。     

三种肝炎病毒在肝细胞癌组织及慢性肝炎肝组织中的表达

目的:探讨乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)及庚型肝炎病毒(HGV)在肝细胞癌(HCC)及慢性肝炎肝组织中的存在状态。方法:分别采用抗HBVS,抗-HBVC,抗HCVNS5及抗-HGVNS5单克隆抗体,以免疫组织化学SPAB法检测27例HCC及37例慢性肝病患者石蜡包埋的肝组织中HBVS抗原(HBsAg)、HBVC抗原(HBcAg)、HCVNS5抗原(HCAg)和HGVNS5抗原(HGAg)。结果:HCC中检出HBsAg18例(66.7%),HCAg13例(48.2%)及HGAg9例(33.3%)。其中HBV/HCV/HGV重叠感染7例,HBV/HCV重叠感染4例,HBV单独感染7例,HCV单独感染2例,HGV单独感染2例;在慢性肝炎中检出HBsAg26例(70.3%),HCAg19例(51.4%)及HGAg12例(32.4%)。其中HBV/HCV/HGV重叠感染10例,HBV/HCV重叠感染5例,HBV单独感染11例,HCV单独感染5例,HGV单独感染2例。HBsAg、HCAg、HGAg均表达于肝细胞或肝癌细胞浆内,呈细颗粒状分布。HBcAg表达于肝细胞或肝癌细胞胞核或胞浆内。结论:慢性肝炎及HCC患者有较高的HBV、HCV及HGV感染率,HBV感染在HCC的发生过程中起重要作用,HCV和HGV的感染可能是HCC发生的相关因素。