Hepatitis B and C markers among alcoholics in Israel: High incidence of HCV infection

Patients with alcoholic liver disease have an increased prevalence of viral hepatitis. However, the role of demographic characteristics has not been adequately delineated. Therefore, we examined and compared the seroprevalences of hepatitis B and C in Israeli alcoholic patients to that of blood donors control group by their country of birth and origin. Hepatitis B surface antigen, hepatitis B core antibody and hepatitis C virus antibody testing (second generation ELISA) and a confirmatory recombinant immunoblot assay was performed on 496 alcoholic attending an alcoholic abstinence program and compared to 193,806 randomly non-alcoholic blood donors on the basis of their country of birth. Three hundred twenty-eight alcoholic patients (66%) were immigrants and Israeli born Jews and 168 (34%) were Israeli Arabs. Of the 496 alcoholic patients, 24 (4.8%) were HBsAg positive, 38 (7.6%) were anti HCV positive, and 2 (North African Jews) were positive for both markers. HBsAg was detected in 13 (3.9%) immigrant and Israeli Jews and 11 (6.5%) Israeli Arabs, significantly higher than in the adjusted non alcoholic blood donors (p < 0.01). Anti-HCV was detected in 33 (10%) immigrants and Israeli Jews and 5 (2.9%) Israeli Arabs, significantly higher than in the control group (p < 0.005). In the subgroup alcoholic Jews there was no significant difference in hepatitis B seropositivity among alcoholic that were native Israeli, Eastern Europe and former USSR, and western Europe and American immigrants comparing to the control group. In contrast, anti-HCV recombinant immunoblot assay seropositivity in alcoholic Jews from all subgroups was significantly greater than in non alcoholic blood donors (p < 0.001). Odds analysis of all ethnic groups revealed that alcoholism requiring detoxification have a significant risk factor for hepatitis C more than hepatitis B (p < 0.001). The increased seroprevalence of hepatitis C among Israeli alcoholic patients, regardless their country of birth and origin, suggest that alcoholism is likely to have a predisposing factor for HCV infection.     

Prevalence of hepatitis B markers in patients with hepatitis C infection in north-eastern Poland: Risk factors and vaccine use

We evaluated the prevalence of hepatitis B virus (HBV) markers and established HBV vaccination status among 111 patients with hepatitis C virus (HCV) infection. A history of HBV immunisation was recorded in 30 patients (27.0%) and only 17/30 (66.7%) had anti-HBs level 10 mIU/ml. All patients were HBsAg-negative and 22.2% of nonvaccinated subjects had evidence of HBV infection as determined by anti-HBc presence. Among patients with anti-HBc in 7/18 cases (38.9%) anti-HBc was the only marker of HBV infection (without anti-HBs). The prevalence of anti-HBc was significantly higher among patients who reported a history of acute hepatitis. In conclusion the prevalence of HBV markers in patients with HCV infection in north-eastern Poland is similar to the prevalence in general population, which suggests no increased risk for nosocomial HBV infection among those individuals. HCV infection seems to favour unusual serological pattern of HBV infection with anti-HBc as the only marker. HBV vaccine use is low among patients with HCV infection in north-eastern Poland.     

Prevalence of hepatitis B,hepatitis C,syphilis and HIV in Georgian blood donors

Prevalence of human immunodeficiency (HIV), hepatitis B (HBV), hepatitis C (HCV) virus and syphilis in the population of blood donors in Georgia has been investigated. Out of 4970 donors 7.3% had anti-HCV (6.9% confirmed), HbsAg was positive in 4.1% (3.4% confirmed), Seroprevalence of Syphilis was 2.3%. Three individuals had HIV. Prevalence of HCV and HBV in Georgia is higher than national prevalence estimates of viral hepatitis in neighboring countries.     

山西省原发性肝癌丙型肝炎病毒、乙型肝炎病毒感染状况分析

目的　探讨山西地区原发性肝癌（ＰＨＣ） 中丙型肝炎病毒（ＨＣＶ） 和乙型肝炎病毒（ＨＢＶ） 感染状况。方法　选择以山西省肿瘤医院为主的省级４ 所医院ＰＨＣ患者９８ 例,检测抗－ＨＣＶ、ＨＢｓＡｇ、抗－ ＨＢｓ、ＨＢｅＡｇ、抗－ ＨＢｅ、抗－ ＨＢｃ、抗－ ＨＢｃＩｇＭ 等指标,均采用ＥＬＩＳＡ 法进行测定。结果　ＰＨＣ 组抗－ ＨＣＶ 阳性率８．１６ ％ ,ＨＢＶ 感染率６８ ．３７％ ,均显著高于对照组的阳性率（ Ｐ＜０ ．０５） 。两者的病因分值（ＡＲＰ） 分别为９４％ 和９１ ％ 。经１∶２ 条件ｌｏｇｉｓｔｉｃ 多元回归分析,抗－ ＨＣＶ、ＨＢｓＡｇ 和抗－ ＨＢｃ 均作为独立的危险因素进入了回归方程,其ＯＲ值分别为５５ ．０６、１０ ．１８ 和９．８５ 。叉生分析结果表明,抗－ ＨＣＶ和ＨＢｓＡｇ 双阳性的ＯＲ值为６１ ．３７,较两指标单一阳性的ＯＲ值明显为高,亦高于两者单独阳性的ＯＲ值之和。结论　ＨＣＶ 和ＨＢＶ 感染均是ＰＨＣ发生的主要病原学因素。ＨＣＶ感染在致肝癌作用中,是当地不可忽视的重要因素,ＨＢＶ 仍是肝癌发生的主要因素。ＨＢＶ和ＨＣＶ双重感染对肝癌的发生具有协同作用。     

Decline of hepatitis B infection in Greece

Hepatitis B has long been a serious public health problem in Greece. In recent years, a decline in hepatitis B infection is observed ascribable to many factors such as demographic and socioeconomic changes, medical precautions, use of disposable medical equipments, screening of blood donors and vaccination. We studied the prevalence of HBV infection in a sample of 1050 Greek male Navy recruits. 343 subjects (32.6%) had previously been vaccinated and were anti-HBs positive. We observed that during the last decade, the prevalence of immunes declined to 1.33% and the prevalence of any HBV marker declined to 2.28%. The HBsAg carrier rate declined from 3.9% in 1973 to 0.9% in 1986. Since then, it is stable at 0.95% because perinatal and vertical transmissions are still responsible for the majority of HBV chronic infections. Universal prenatal screening and infant immunization will contribute to a further decline of HBV infection.     

Prevalence and incidence of hepatitis C virus infection among male prison inmates in Maryland

To identify incidence of antibody to hepatitis C virus among 265 male prison inmates, we assayed paired serum specimens obtained at intake in 1985–1986 with follow-up specimens in 1987. Intake prevalence was 38 percent. Seroincidence was 1.1/100 person years in prison. This finding might reflect saturation of high-risk subgroups or possibly reduced frequency of exposures following incarceration.     

IL-2-330基因多态性与慢性乙型肝炎病毒和/或丙型肝炎病毒感染及不同临床转归的关系

目的 研究乙型肝炎病毒(HBV)和/或丙型肝炎病毒(HCV)感染及其不同临床转归者IL-2基因多态性(SNP).方法 对河北省赵县某农村HBV和/或HCV感染者及对照共277人采集空腹静脉血.用ELISA检测抗-HBV、抗-HCV生物标志物,筛出HBV重叠HCV感染79例、单纯HBV感染69例、HCV感染55例和对照74例.用RT-nPCR检测HCVRNA,BeckmanLX-20全自动生化仪检测肝功能丙氨酸氨基转移酶(ALT),RFLP-PCR技术检测IL-2-330 SNP,分析IL-2-T330G SNP与HBV和/或HCV感染、不同临床转归、ALT和HCVRNA表达的关系.结果 (1)不同感染类型即单纯HBV、HCV感染和重叠感染者IL-2-330 TT频率明显高于对照,-330 GG频率明显低于对照(χ2=14.24,P=0.03),OR值(95%CI)分别是7.14(2.13～23.81)、3.46(1.17～10.02)、2.93(1.15～7.46),各感染类型间差异无统计学意义(χ2=2.09,P=0.72);各感染组-330T频率明显升高,-330G频率明显降低(χ2=12.33,P=0.01),OR值(95%CI)分别是2.26(1.39～3.69)、1.82(1.09～3.03)、1.73(1.10～2.73)倍.(2)不同临床转归即轻型、中重型肝炎和肝硬化组IL-2-330 TT频率明显高于对照组、-330 GG频率明显低于对照组(χ2=13.52,P=0.04),OR值(95%CI)分别是3.33(1.75～6.32)、3.31(1.75～6.26)、11.23(3.09～40.76).不同临床转归组-330T频率明显升高,-330 G频率明显降低(χ2=12.32,P=0.01);OR值(95%CI)分别是1.86(1.32～2.63)、1.71(1.27～2.31)、2.77(1.57～4.89)倍.(3)IL-2-330基因型和等位基因频率与HCV的病毒复制无统计关联(χ2=0.83,P=0.66;χ2=0.20,P=0.66),与ALT水平亦无统计关联(χ2=1.10,P=0.58;χ2=0.08,P=0.78).结论 IL-2-330 T/G SNP与HBV和/或HCV感染者慢性化及不同临床转归有一定关联,IL-2-330TT/T能增加HBV和/或HCV感染及其临床转归的危险,-330 GG/G则减低其感染和临床转归风险.     

启东乙型肝炎干预研究:2013年随访人群HBV感染及慢性肝病现患调查

目的 分析新生儿接种乙型肝炎(乙肝)疫苗人群在达到婚配年龄后罹患慢性乙肝、肝硬化的远期保护作用。方法 2013年1-10月采用横断面调查方法,对启东乙肝干预研究(QHBIS)的研究对象分层随机抽样,并行ALT、HBV感染血清学标志物(HBsAg、HBeAg、抗-HBs、抗-HBc、抗-HBe)检测及肝胆B超检查。计算HBV感染血清学标志物各指标的阳性率,慢性乙肝及肝硬化的患病率,疫苗组及对照组人群按性别分层后, χ²检验比较各组间率的差异。结果 共获得新生儿乙肝疫苗接种组(疫苗组)4 421人和对照组3 880人,平均年龄分别为(25.59±1.84)岁和(26.61±2.24)岁。疫苗组HBsAg、单独抗-HBs、抗-HBc、HBeAg、抗-HBe阳性率分别为2.38%、37.73%、3.78%、0.57%、2.15%,对照组分别为9.02%、29.41%、16.83%、2.73%、8.87%,两组间血清学标志物各指标的差异均有统计学意义(P <0.05)。疫苗组慢性乙肝活动期、肝纤维化及肝硬化患病率分别为0.45%和0.16%,对照组分别为1.29%和0.39%,组间差异均有统计学意义(P <0.05)。按性别分层后,疫苗组男性慢性乙肝活动期患病率高于女性,差异有统计学意义(P <0.05);在对照组,不管是慢性乙肝活动期患病率还是肝纤维化及肝硬化患病率,男性均高于女性,差异有统计学意义(P <0.05)。结论 新生儿接种乙肝疫苗对慢性HBV感染的保护作用可延长至婚配年龄后,而不同性别人群慢性乙肝与肝硬化现患保护作用的差异值得进一步研究。     

Prevalence of HIV,syphilis, hepatitis B,and hepatitis C among entrants to Maryland correctional facilities

Although high prevalence of hepatitis C virus (HCV) in correctional institutions has been established, data are sparse regarding the comorbidities of hepatitis B virus (HBV), HCV, and human immunodeficiency virus (HIV), all of which may complicate the management of HCV. This study sought to estimate the prevalence and correlates associated with HCV prevalence among entrants into the Maryland Division of Correction and the Baltimore City Detention Center. Participants included all newly incarcerated entrants between January 28 and March 28, 2002. Excess sera with identifiers removed from samples drawn for routine syphilis testing were assayed for antibodies to HIV and HCV and for HBV surface antigen and surface and total core antibodies. Separately, all HIV-positive specimens were tested using the serological testing algorithm for recent HIV seroconversion. Of the 1,081 immates and 2,833 detainees, reactive syphilis serology was noted in 0.6% of the combined population; HIV seroprevalence was 6.6%; HCV prevalence was 29.7%; and 25.2% of detainees and prisoners had antigen or core or surface antibodies to HBV. A multivariate analysis of predictors of HCV positivity indicated that detainees, women, whites, older age groups, those who were HIV seropositive, and individuals with past or present infection with HBV were significantly more likely to be positive for HCV. These data indicate that hepatitis C remains an important public health concern among entrants to jail and prison and is complicated with coinfections that need to be addressed for effective treatment.     

Trend in incidence of hepatitis B virus infection during a decade of universal childhood hepatitis B vaccination in Saudi Arabia

Since 1990, the national strategy to eliminate hepatitis B virus (HBV) infection in Saudi Arabia has included universal administration of HBV vaccine to all infants. From 1990 to 1995 this vaccine was also routinely administered to children at school entry. The prevalence of hepatitis B surface antigen (HBsAg) among children before this programme was reported to be 6.7%. The objective of this study was to describe the trend in incidence of HBV infection over a decade of surveillance following the introduction of this programme. From January 1990 to December 1999 a total of 30,784 cases of HBV infection (positive for HBsAg) were reported. The total number of HBV infections among children <15 years of age was 4180 cases, with a prevalence of 0.05%. The total number of HBV infections among adults was 26,604 cases, with a prevalence of 0.22%. The prevalence varied by region, ranging from 0.03% to 0.72% with a mean prevalence of 0.15%. There was a clear decline in incidence among children whereas the incidence in adults slightly rose, perhaps owing to population growth estimated to be 3.3% annually. This study showed that the universal childhood HBV vaccination programme had an enormous positive impact on HBsAg seroprevalence among children in Saudi Arabia.     

Prevalence of hepatitis C virus infection in Nanjing, Southern China

There is little information on the prevalence of hepatitis C virus (HCV) infection in China. The prevalence of HCV infection was determined in 998 subjects (398 with liver disease and 600 without) in the city of Nanjing in southern China. Subjects were tested for anti-HCV antibodies by a second generation assay. We also determined serological HCV genotypes and HCV RNA sequences. Among the 600 subjects without liver disease, 3 (0.5%) were seroreactive for anti-HCV. All were less than 12 years of age and had a history of transfusion. Of the 398 liver disease patients, 20 (5.0%) were seroreactive for anti-HCV. Of 16 patients in whom serological HCV genotype was determined, 10 (62.5%) were infected with HCV type 1, 5 (31.3%) with type 2 and 1 (6.3%) undetermined. HCV genomes sequenced from 2 patients belonged to genotype 2 and were closely related to strains in Beijing and Japan by molecular evolutionary analysis. These results suggest that HCV infection is rare and not a major cause of liver disease in southern China.     

山西有偿献血地区某村HBV、HCV、HIV感染现状分析

目的了解山西省农村有偿献血地区HBV、HCV、HIV感染状况及有偿献血对其分布的影响.方法对某村的946名20～65岁居民进行调查,采用ELISA法分别检测血清中HBsAg、HBsAb、HBeAg、HBeAb、anti-HCV和HIV抗体.结果HIV抗体全为阴性,HBsAg、HBsAb、HBeAg、HBeAb、anti-HCV的阳性率分别为5.3%、54.5%、2.5%、22.5%、1.7%;其中有偿献血人员108名,相应的阳性率分别为0.9%、63.9%、0.9%、18.5%、4.6%,从未有偿献血人员838名,相应的阳性率分别为5.8%、53.3%、2.7%、23.0%、1.3%.与未有偿献血的研究对象相比,曾经有偿献血的研究对象HBsAg、HBsAb和anti-HCV的阳性率差异有显著性.结论该村未发现HIV感染者,HBV、HCV感染与其他地区无明显不同,有偿献血人员HCV感染率较高.     

Endemic hepatitis B virus infection and chronic liver disease mortality in the Republic of Palau, 1990-2002

In the Republic of Palau, a Pacific island nation, approximately 20% of the population is chronically infected with hepatitis B virus (HBV) and is at risk of developing chronic liver disease (CLD), including cirrhosis and hepatocellular carcinoma (HCC). To examine the consequences of HBV infection, we sought to quantify HBV-related CLD mortality in this population. The cause of death was abstracted from death certificates of all persons who died in Palau during 1990-2002. CLD deaths were categorised as cirrhosis or HCC. HBV serological status was determined by review of a hospital database. The cause of death was determined for 1,366 (85%) of 1,608 deaths. CLD was the fifth most common cause of death, accounting for 102 (7%) deaths with a known cause. Of deaths due to CLD, 55 (54%) were from cirrhosis and 47 (46%) were from HCC. Sixty-five percent of CLD decedents and 19% of non-CLD decedents were chronically infected with HBV (P<0.01). The attributable fraction of HBV-related CLD was 54% (58% for cirrhosis and 53% for HCC). CLD mortality rates were approximately twice the worldwide CLD rate. HBV-related CLD is a common cause of death in the Republic of Palau, highlighting the importance of routine infant hepatitis B vaccination, especially in countries with high endemicity.     

近期ALT升高史单采浆供者乙型肝炎和丙型肝炎病毒感染现状的调查

对一组一年内一次以上ALT升高史的单采浆供者血清中多项乙肝与丙肝病毒感染标志进行了检查,并与本地区无ALT升高史供浆者进行比较。两组检测结果分别为抗HCV:14.03%和6.45%;抗HCV-IgM:3/8和2/13;HBsAg:2.82%和0.46%;抗HBs:32.39%和25.35%;抗HBc:45.07%和33.18%;其检出率前者均高于或显著高于后者,并与ALT升高次数有显著的伴随关系。     

联合检测丙肝病毒核心抗原和抗体在丙型肝炎早期诊断中的价值

目的:通过检测丙型肝炎抗体(HCV-Ab),同时对其进行丙型肝炎病毒核心抗原(HCV-cAg)和丙肝病毒RNA(HCV-RNA)两项指标进行检测,探讨HCV-cAg检测在丙型肝炎早期诊断中的意义。方法:对104例HCV-Ab阳性标本及108例高危人群但HCV-Ab阴性标本(包括血液透析患者55例、医务人员20例和丙型肝炎病人的家庭密切接触者33例)及健康对照组同时进行HCV-cAg和HCV-RNA的检测。结果:104例HCV-Ab阳性组中,HCV-cAg阳性25例,HCV-RNA阳性27例;108例HCV-Ab阴性组中,HCV-cAg阳性2例,HCV-RNA阳性1例;健康对照组全阴性。结论:HCV-cAg和HCV-RNA在丙型肝炎早期诊断上无显著性差异,但HCV-cAg检测在临床的应用前景上具有更大的优势,故可在临床推广HCV-Ab和HCV-cAg联合检测,有条件者可联合检测HCV-Ab、HCV-cAg和HCV-RNA。     

Coinfections by HIV, hepatitis B and hepatitis C in imprisoned injecting drug users

In order to know the prevalence and risk factors for coinfections by human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV) among injecting drug users (IDUs), a cross-sectional study was carried out in two prisons of the province of Cantabria, northern Spain. Three hundred and sixty-two IDU inmates were recruited. All inmates were interviewed and their blood tested for HIV, HBV and HCV. Crude and multiple risk factor adjusted for (by polychotomous logistic regression) odds ratios were calculated. Prevalence of HBV-HCV coinfection (42.5%) was higher than HIV-HBV-HCV coinfection (37.3%), whereas monoinfections were very uncommon (overall: 13%). Long-term injectors and reincarceration were the foremost risk factors for both coinfections, showing a trend between the degree of association and the number of viruses infecting a patient. No significant relationship between coinfection status and sexual practices was observed. The results related to coinfections are consistent with previous studies of prevalence and risk factors for HIV, HBV and HCV, in indicating that the high rates of coinfections among IDU inmates emphasise the need to harm-reduction policy across prisons in Spain.     

Prevalence of hepatitis A, B and C in the Flemish population

Viral hepatitis is a serious health problem throughout the world. No recent prevalence data on hepatitis A, B and C were available for the population in Flanders, Belgium. For this reason, a sero-epidemiological study was undertaken in 1993–1994 in a sample of the general population. The purpose of this study was to obtain a clear picture of the prevalence of hepatitis A, B and C. Between April 1993 and February 1994, 4,058 blood samples were drawn and collected in 10 hospitals in Flanders. The study group was representative for the Flemish population. For hepatitis A a seroprevalence of 55.1% was found. In the non-Belgian residents the HAV prevalence was significantly higher than in Belgians (62% versus 52%; ² = 8.05; p = 0.005). For hepatitis B, 9.9% of the study group showed serological evidence of hepatitis B markers: 6.9% of the participants was positive for anti-HBs/anti-HBc, 0.7% appeared to be HBsAg positive and 3.5% was solely anti-HBs positive. The prevalence of HBV markers in Belgians was 6.9%, significantly lower compared to the 13.4% among non-Belgians (² = 14.05; p = 0.00018). 4055 serum samples were analysed for hepatitis C serology by second generation anti-HCV tests. Anti-HCV was detected in 0.87% of the serum samples. No statistically significant difference was found in HCV prevalence between Belgians and non-Belgians. Results of this study should help policy makers in their decisions on the most appropriate hepatitis A and B vaccination strategy and on the most effective prevention strategy for hepatitis C.     

乙型肝炎病毒感染与心血管疾病的相关性

HBV感染可引起许多肝外疾病,如皮肤疾病和关节炎等,但对心血管病变的影响关注和研究较少,且有些研究结果存在矛盾.此文总结HBV感染对心肌疾病、心衰、冠状动脉性疾病和心脏移植等心血管疾病的影响,以及HBV感染与代谢综合征之间的关系.     

HIV对HIV/HCV共感染患者丙型肝炎病程进展的影响

目的 探讨HIV感染对HIV/HCV共感染患者病情进展的影响及免疫机制。方法 研究对象为28例HIV/HCV共感染者及12例HCV单独感染者。外周血生化检测及超声Fibro-Scan评估肝脏功能及纤维化程度,采用PCR-荧光探针法检测外周血HCV病毒载量,运用流式细胞技术检测外周血Treg/CD₄⁺T淋巴细胞百分率。结果 HIV/HCV共感染组ALT及碱性磷酸酶(ALP)水平分别为(76.16±81.248)U/L、(24.507 1±8.194)g/L,明显高于HCV单独感染组［(27.475 0±13.985) U/L、(16.966 7±7.189)g/L］,差异具有统计学意义,P值分别为0.012、0.009。HIV/HCV共感染组患者肝脏纤维化指标E值为5.950 0~5.825 0 Kpa,与 HCV单独感染患者(5.150 0~1.050 0 Kpa)相比有升高趋势,P=0.077。HIV/HCV共感染者、HCV单独感染者HCV载量及病毒清除率分别为(6.476 8~5.343 4)lg copy/ml及32.14%、(1.699 0~2.681 5)lg copy/ml及75.00%,HIV/HCV共感染组HCV载量明显高于HCV单独感染组,HCV清除率低于HCV单独感染组,P值分别为0.012及0.032。HIV/HCV 共感染组Treg/CD₄⁺T淋巴细胞百分率为(7.460 0%~2.287 5%),高于HCV单独感染组(5.965 0%~2.105 0%),差异有统计学意义(P=0.032)。并且Treg/CD₄⁺T淋巴细胞百分率与HCV载量具有明显相关性(ρ=0.350,P=0.027),而HCV载量与肝脏纤维化程度E值存在相关性(ρ=0.487,P=0.001)。结论 HIV/HCV共感染加速丙型肝炎病情进展,而Treg细胞与丙型肝炎病情进展相关。