肝病患者中丙型肝炎病毒感染状况分析

为了解本地区丙型肝炎病毒（ＨＣＶ）感染状况，用套式反转录聚合酶链反应及酶联免疫法测定肝炎病毒标志，分析ＨＣＶ感染情况。结果：有受血史者中，急性丙型肝炎发生率为６０．５３％，高于急性乙型肝炎的１０．５３％（Ｐ＜０．０１）。无受血史者中，急性肝炎以甲、乙型肝炎为主（４１．６７％、３０．５６％），高于丙型肝炎的４．１７％（Ｐ＜０．０１）。有受血史者的急、慢性丙型肝炎发生率及无症状ＨＣＶ感染率分别为６０．５３％，２０．３４％及２９．１７％，高于无受血史者的４．２％，８．７４％和３．３３（Ｐ＜０．０１～０．０５）。无论有无受血史，慢性肝炎、重症肝炎、肝硬化、肝细胞肝癌及无症状感染者均以乙型肝炎病毒（ＨＢＶ）感染为主，ＨＢＶ感染高于ＨＣＶ感染（Ｐ＜０．０１）。结论：输注血制品是造成丙型肝炎病毒感染的主要途径。本地区重症肝炎、慢性肝炎、肝硬化及肝细胞肝癌主要由ＨＢＶ所致     

广州市健康人群EB病毒感染情况的调查分析

目的了解广州地区健康人群中的EB病毒感染情况。方法采用ELISA法检测2007年1月至2011年12月本院体检的217935例健康人的EB—VCA—IgA抗体,统计对比男女阳性率、5年问阳性率及各年龄段（≤29岁、30,39岁、40～49岁和≥50岁5个组）阳性率的差异。结果EB—VCA-I酗抗体阳性4667例,总阳性率2．14％。其中男性135985例,阳性率1．87％（2547／135985）;女性81950例,阳性率2．59％（2120／81950）,男女阳性率差异有统计学意义（P：0．000）。5年间各年阳性率差异有统计学意义臼z=576．054,P=0．000）。EB—VCA．IgA抗体的阳性率随着年龄的增长而增高,各年龄段差异均有统计学意义（P=0．000）。结论广州地区健康人群中有一定比例的EB病毒感染者,且40岁以上健康人群感染率相对较高。     

输血后丙型肝炎病毒感染87例血清学分析

输血后丙型肝炎病毒感染８７例血清学分析谭永康马列青金铭作者单位：１０００５４北京北京佑安医院（谭永康马列青金铭）；首都医科大学传染病教研室（谭永康）１９９５年１２月１８日收稿１９９６年７月６日修回输血可能带来输血后肝炎这一问题，早已为人们所重视，目前...     

中国不同人群的抗TTV血清流行病学及TTV基因不同区段的分子流行病学研究

目的　了解不同人群血清中抗 TTV抗体及ORF1 、ORF2 区段基因的分布状况 ,并分析其间的关系。方法　根据TTV的ORF1 、ORF2 区段的基因序列分别合成巢式PCR引物 ,扩增 2 46例血清标本中的TTV部分基因片段 ;采用TTVORF2 部分基因原核表达抗原 ,应用酶联免疫吸附试验(ELISA) ,检测相同血清标本中TTV抗体。结果　不同人群TTVORF1 、ORF2 基因及抗体检测的阳性率分别为 :有偿献血者 16 0 % (12 75 ) ,10 7% (8 75 )和 2 5 3% (19 75 ) ,甲型肝炎患者 10 0 % (3 30 ) ,16 7% (5 30 )和 16 7% (5 30 ) ;乙型肝炎患者 47 5 % (19 40 ) ,42 5 % (17 40 )和 2 2 5 % (9 40 ) ,丙型肝炎患者 42 9% (15 35 ) ,37 1% (13 35 )和 2 8 6 % (10 35 ) ;丁型肝炎患者 2 0 0 % (3 15 ) ,2 6 7% (4 15 )和13 3% (2 15 ) ;戊型肝炎患者 16 7% (2 12 )、16 7% (2 12 )、33 3% (4 12 ) ;庚型肝炎患者 2 3 8% (5 2 1) ,38 1% (8 2 1)和 2 3 8% (5 2 1) ;非甲～庚型肝炎患者 6 1 1% (11 18) ,5 0 0 % (9 18)和 44 4% (8 18)。统计分析TTVORF1 与ORF2 基因的检出率相关有统计学意义 (P =0 0 0 0 <0 0 1) ;不同人群间基因检出率相差有统计学意义 (P <0 0 1) ;TTV抗体的检出率与TTVDNA的检出率相关无     

不同人群庚型肝炎病毒感染状况分析

为了解不同人群庚型肝炎病毒（ＨＧＶ）感染状况，采用优化的ＨＧＶＮＳ５区两条合成肽为抗原，建立间接酶联免疫吸附试验（ＥＬＩＳＡ），检测了１２０９例不同人群血清中抗－ＨＧＶＩｇＧ，总阳性率为３．８％，其中非Ａ～Ｅ型肝炎患者抗－ＨＧＶＩｇＧ阳性率最高，为２０．５％，明显高于自然人群的０．８％和其它肝炎患者（Ａ～Ｅ型）的３．３％，丙型肝炎患者中抗－ＨＧＶＩｇＧ阳性率亦较高，为８．０％。职业献血员抗－ＨＧＶＩｇＧ阳性率３．４％高于义务献血员０．０％。性病患者阳性率为３．６％，有静脉吸毒史的ＨＩＶ感染者阳性率亦较高，为８．０％。结果表明，ＨＧＶ在我国有较高的感染率；ＨＧＶ可能为非Ａ～Ｅ型肝炎的重要致病因子；职业献血员和有血液接触史者ＨＧＶ感染率较高，提示血源应严格筛选     

丙型肝炎病毒感染实验室诊断进展

据世界卫生组织统计,全球丙型肝炎病毒（HCV）的感染率约为3%,每年新发HCV病例约315万例,而高度慢性化是该病的最大特征。据报道慢性丙型肝炎患者10年内约有20%发展为肝硬化,肝硬化患者每年约3%发展为肝细胞癌,严重威胁着人类的健康。     

血清中丙型肝炎NS3抗原ELISA检测方法的建立和初步应用

目的 评价血清中丙型肝炎病毒(HCV)游离NS3抗原的酶联免疫吸附(ELISA)检测方法的特异性和灵敏度,初步探讨该方法在临床应用中的意义.方法 对77例正常人血清标本,173例抗-HCV阳性标本和3708例抗-HCV阴性的其他类型肝炎血清标本检测HCV游离NS3抗原;对部分HCV NS3抗原阳性标本进行验证,包括HCV RNA测定、中和试验和免疫斑点试验;对11例患者的25份系列血清标本进行了HCV游离NS3抗原、HCV RNA和HCV抗体的联合检测,并结合临床资料综合分析.结果 3708例抗-HCV阴性的其他类型肝炎血清标本中有48例为HCV NS3抗原阳性,其中3030例单纯乙型肝炎和445例其他类型肝炎血清标本中分别有44例和4例为HCV NS3抗原阳性;173例HCV抗体阳性标本中有42例为HCV NS3抗原阳性;77例正常人血清标本的HCV NS3抗原检测结果均为阴性;15例HCV NS3抗原阳性标本中有9例为HCV RNA阳性;23例HCV NS3抗原阳性标本的中和率和免疫斑点试验的阳性率分别为87.0%和69.6%;25份系列血清标本的检测结果显示其HCV NS3抗原的吸光度值与时间呈负相关,并有2例HCV NS3抗原阳性标本随着血清中HCV NS3抗原的吸光度值下降,其HCV抗体转阳.结论 血清中HCV游离NS3抗原的ELISA检测方法有较好的特异性和敏感度,在发展中国家应用此方法进行HCV感染的早期诊断有一定的临床意义和推广价值.     

献血人群隐匿性乙型肝炎病毒感染的流行病学和血清学研究

目的了解广州地区献血人群隐匿性乙型肝炎病毒感染（OBI）的流行病学和血清学情况。方法对广州地区199631例无偿献血者标本同时用ELISA法检测HBsAg、紫外-乳酸脱氢酶法检测ALT、核酸扩增技术（NAT）联合检测HBV/HCV/HIV及HBV单项鉴别试验,对HBsAg阴性HBV DNA阳性者进行随访,用荧光定量PCR检测病毒载量,用ELISA法检测乙肝两对半。结果 199631例标本中共检出104例HBsAg阴性HBV DNA阳性者,经随访有54例为OBI,OBI检出率为0.027%,年龄以46～55岁组检出率最高（P〈0.01）,外地身份证的献血者检出率高于广州市身份证者（P〈0.01）,OBI检出率与性别和献血次数无关（P〉0.05）。104例HBsAg阴性HBV DNA阳性的标本ALT均正常,病毒载量均〈1000IU/ml,平均值为162IU/ml。随访标本中,除6例ALT异常外其余均正常,54例OBI标本病毒载量均〈1000IU/ml,平均值为122IU/ml,乙肝两对半中抗-HBc阳性率明显高于其他项目（P〈0.01）。结论 HBsAg阴性献血者中存在OBI,有必要在献血者中开展核酸检测。     

325名吸毒者乙型和丙型肝炎病毒感染情况分析

３２５名吸毒者乙型和丙型肝炎病毒感染情况分析万萍邱石方李蔚曾德贤长期滥用海洛因等毒品造成各种类型肝炎病毒感染已有报道〔１，２〕，我们对３２５名吸毒者乙型肝炎病毒感染标志物（ＨＢＶＭ）５项及抗－丙型肝炎病毒（ＨＣＶ）抗体进行了检测。１材料和方法１１观...     

巨细胞病毒感染的致病机制初探

目的 探讨人巨细胞(HCMV)的致病机制。方法 应用酶联免疫吸附试验(ELISA)对36例早孕人工流产妇女进行了HCMV抗体IgG、IgM的检测，对抗体阳性者的绒毛及蜕膜进行了HCMV的PCR检测，对DNA阳性者进行了绒毛蜕膜的病理切片分析。结果 HCMV免疫抗体阳性的31例患者仅有10例DNA阳性者绒毛蜕膜均发生了明显的病理变化，绒毛细胞滋养层增生过长，蜕膜变性坏死，伴淋巴细胞浸润。结论 绒毛蜕膜的病理改变可能参与了HCMV的致病机制。     

近十年广东地区丙型肝炎感染途径的特点

目的了解最近十年广东地区丙型肝炎病毒（HCV）感染途径的特点。方法 采用回顾性调查与前瞻性研究相结合的方法,进行定群随访观察。结果 感染途径明确者占34.5%（38/110）,包括静脉吸毒15.5%（17/110）,输血及血制品14.5%（16/110）和血液透析4.5%（5/110）;感染途径不明确,存在可疑感染因素者占30%（33/110）,包括家庭内传播3.6%（4/110）,小手术及注射史12.7%（14/110）,皮肤损伤性美容10.9%（12/110）,职业暴露2.7%（3/110）;不明感染途径者占35.4%（39/110）。各组之间年龄大小差异无统计学意义（P〉0.05）,静脉吸毒均为男性,职业暴露均为女性,与其他组比较,P〈0.001。结论 在广东地区,近十年HCV感染的多种途径并存,小手术及注射、皮肤损伤性美容正在成为与静脉吸毒、输血及血制品同等重要的感染途径。不明感染途径者无论数量还是比例都排第一位,是今后预防的主要问题。     

Hepatitis C virus infection in cameroon: A cohort-effect

A hepatitis C virus (HCV) serological study conducted in 2003 on 1,434 individuals in Yaounde and other HCV seroepidemiological studies on 2,066 sera sampled between 1993 and 1997 in four geographically distinct rural areas (Ntem, Mekas, Yokadouma, and Nditam) in Cameroon, are described. Two patterns of HCV seroprevalence were observed. The first pattern, represented by Nditam and Yokadouma populations, showed low HCV seroprevalence rates (2.9% and 3.3%, respectively) increasing moderately with age (9.0% and 16.7% after age 50). The second pattern showed high seroprevalence rates (6.9% for Yaounde, 14.4% and 16.7% for Ntem and Mekas, respectively). These rates increased dramatically with age (32.8%-49.5% after age 50). The age-specific anti-HCV prevalence curve of the 1993 Mekas survey paralleled those of the 1997 Ntem and 2003 Yaounde surveys. Using the year of birth as the x-axis, the three curves closely matched each other. This clearly indicates a cohort effect for which the seroprevalence trends are clearly related with the year of birth, rather than the age. The highest prevalence was observed among people born around 1940.     

Hepatitis C virus seroconversion rate in established blood donors

The results of hepatitis C virus (HCV) antibody test of 237, 813 blood donations collected from 143, 815 donors by the West Midlands Blood Transfusion Centre in 1993 were analyzed retrospectively in order to determine the seroconversion rate among established previously anti-HCV negative donors. Three hundred sixteen (0.22%; 1 in 455) donors were positive by the enzyme linked immunosorbent assay (ELISA) screening test and 34 (0.024%; 1 in 4, 230) donors were positive by ELISA and the Recombinant Immuno Blot Assay (RIBA). Three donors previously negative for HCV antibody reacted positively by both tests. The annual seroconversion rate was calculated as one in 35, 937 donors. This figure argues against limitation of HCV antibody screening to new blood donors. A further 45 donors negative on previous screening reacted positively by ELISA and were indeterminate by RIBA. Unexpectedly, lapsed blood donors first tested for HCV antibody in 1993 had high positive reaction rates by ELSA and RIBA, which was significantly (P < 0.001) higher than those of new donors. RIBA-positive reaction rate among ELISA-positive donors was significantly higher amongst males than females (P < 0.0011. © 1995 Wiley-Liss, Inc.     

Hepatitis C virus infection in the family setting of patients with occult hepatitis C

Family members of patients with chronic hepatitis C virus (HCV) infection are at increased risk of HCV infection but the prevalence of HCV among family members of patients with occult HCV infection is not known. Anti‐HCV, serum HCV RNA and levels of liver enzymes were determined in 102 family members of 50 index patients with occult HCV infection and in 118 family members of 59 chronic hepatitis C index patients. HCV RNA and/or anti‐HCV were detected in 10/102 (9.8%) relatives of patients with occult HCV infection and in 4/118 (3.4%) of patients with chronic hepatitis C. Fourteen additional family members (seven were relatives of index patients with occult HCV infection) had abnormal values of liver enzymes without serological markers of HCV infection. Two of these patients (who were relatives of two index patients with occult HCV infection) underwent a liver biopsy and were diagnosed with an occult HCV infection because HCV RNA was detected in the liver cells in the absence of serological HCV markers. In conclusion, the prevalence of HCV infection among family members of patients with occult HCV infection was similar to that found among family members of patients with chronic hepatitis C. This stresses the need to adopt strategies to prevent the transmission of HCV in the family setting of patients with occult HCV infection. J. Med. Virol. 81:1198–1203, 2009. © 2009 Wiley‐Liss, Inc.     

广州地区不同人群女性性传播感染状况调查与分析

目的调查广州地区不同人群女性性传播感染（STI）的流行现状。方法由调查员进行现场问卷调查,采集血液进行HIV、RPR／TPPA、HSV-2抗体检测,采集白带涂片检测白念珠菌、阴道加特纳菌、阴道毛滴虫;宫颈拭子培养萘瑟氏淋病双球菌（GC）、沙眼衣原体（CT）、脲原体（UU）。结果共调查788例不同人群组的女性。流动女工STI总体感染率为41．6％,位居前3位的病原体感染分别为UU（25．1％）、HSV-2（14．9％）、CT（6．2％）;妇科门诊人群总体STI感染率为71．1％,位居前3位分别为uu（41．5％）、HSV-2（18．7％）、CT（11．1％）;暗娼STI总体感染率为90．1％,前3位感染分别为UU（74．6％）、HSV．2（47．5％）、阴道白念珠菌（17．8％）,其它依次为加特纳菌（14．9％）、TP（14．9％）、CT（14．4％）。除了门诊组及暗娼组分别发现1例HIV感染,差异无统计学意义外,不同组间STI感染差异均有统计学意义。结论广州地区3组女性人群中,位居前2位的STI感染率分别为UU（25．1％-74．6％）、HSV-2（14．9％～47．5％）,CT感染率为6．2％～14．4％。因此,除了加强妇科门诊STI防治外,加强对流动女工STI感染防治宣传很有必要。     

Hepatitis C virus molecular epidemiology in Uzbekistan

The aim of this study was to identify hepatitis C virus (HCV) genotypes and to estimate their prevalence in various risk groups and the regional distribution in Uzbekistan. Preliminary serological screening of 1,269 subjects revealed 6.5% anti-HCV-positive in a general population, 27.1% in patient groups, and 51.7% among intravenous drug users. HCV genotypes of 104 anti-HCV-positive subjects were determined using a PCR-genotyping system in core region, and the results were supported by nucleotide sequencing of the NS5B region. Genotype 1b identified in total 64.2%, was the most prevalent. The genotype 3a identified in 25.0% was the second one distributed. HCV genotypes 2a, 1a, 2b, and 3b were identified in 3.8%, 2.9%, 2.9%, and 1.0% of cases, respectively. The intravenous drug users were distinguished from other groups by having the highest prevalence of genotype 3a, i.e., 50.0%, higher than the 33.3% for genotype 1b in this group. Geographically, genotype 1b was common; genotype 3a was also found frequently in all three regions. Uncommon HCV genotypes (1a, 2a, 2b, and 3b) were found in comparatively greater variability in the western region. Molecular evolutionary analysis based on the NS5B region did not reveal specific clustering or indigenous strains among Uzbekistan HCV isolates. In summary, two main mechanisms of HCV infection distribution were observed in Uzbekistan: HCV 1b genotype infection is widespread through blood products, and HCV 3a genotype infection is spreading through the growing number of intravenous drug users.     

Prevalence of hepatitis C virus infection among long-term hemodialysis patients: Detection of hepatitis C virus RNA in plasma

Two hundred and twelve urine specimens, from several clinical groups, were examined for BK virus (BKV) using the polymerase chain reaction (PCR) to detect the VP1 region of BKV DNA. Positive results were obtained on 14 specimens from 44 post-transplant patients (31.8%), 10 specimens from 39 pregnant women (25.6%), and 5 specimens from 100 children (5%) but not on any specimens from 29 laboratory staff. Twentyeight of the amplified BKV genomes, 19 from urine specimens, eight from culture fluid of inoculated tissue, and also one from a throat washing were directly sequenced from single-stranded templates immobilized via a biotinylated primer; it was possible to assign all to one of the four subtypes of BKV which had previously been identified on the basis of variation in nucleotide sequence of the VP1 region. Serological subgroup classification correlated with the genomic subtyping results in 21 of the isolates. The distribution of the BKV subtypes and the clinical status of the infected individuals are discussed.     

Hepatitis C virus genetic variability in 52 human immunodeficiency virus-coinfected patients

The aim of this study was to examine whether hepatitis C virus (HCV) pretreatment quasispecies complexity was linked to virological response or other clinical and biological parameters, in human immunodeficiency virus (HIV)-coinfected patients undergoing anti-HCV treatment. In addition, HCV quasispecies composition is described longitudinally in these patients before, during, and after treatment. The 52 HIV-coinfected patients were included in a randomized therapeutic trial. At inclusion, they had CD4(+) counts of >250/micro l, HIV plasma load of <10,000 copies/ml, and chronic HCV infection with genotype 1 (n = 27), 2 (n = 2) or 3 (n = 23). These values were compared at baseline with 32 HCV-only-infected, interferon-naive patients who were infected with genotype 1, 2, or 3 (n = 16, 1, or 15, respectively). HCV complexity was studied by single-strand conformation polymorphism (SSCP) in E2 hypervariable region 1 (HVR1), and diversity was evaluated at inclusion in 20 coinfected patients by sequencing four major SSCP bands. The baseline number of SSCP bands was identical in HIV-infected and control patients. In HIV-infected patients, HCV complexity was not predictive of sustained virological response to anti-HCV treatment and was unrelated to epidemiological factors, immunological parameters linked to HIV infection (CD4(+) counts, T CD4(+) proliferative responses to HIV-1 p24), protease inhibitor treatment, HCV plasma load, or genotype. HCV diversity was lower in genotype 2- and 3-infected patients. Six months after completion of the anti-HCV treatment, in comparison with baseline, SSCP profiles were modified in 13 of the 21 nonresponding coinfected patients with analyzable samples. In conclusion, in HIV-infected patients, HCV variability had no significant influence on virological response to anti-HCV treatment.     

酶联法抗-HCV和HCV-cAg联检对丙型肝炎实验室诊断的应用价值

目的 探讨联合丙型肝炎病毒核心抗原(HCV-cAg)及抗-HCV抗体酶联免疫检测对丙型肝炎实验室诊断的应用价值.方法 289份血清标本按抗-HCV阳性、弱阳性、阴性及HCV-cAg阳性、弱阳性及阴性分组,用PCR扩增法检测其HCV RNA含量.结果 单项抗-HCV阳性及弱阳性标本其HCV RNA检测阳性符合率分别为87...