周口市无偿献血人群HBV、HCV和HIV的感染情况

目的分析周口市无偿献血人群乙型肝炎表面抗原(HBsAg),丙型肝炎病毒(HCV)、人类免疫缺陷病毒(HIV)感染情况,从而探讨周口市公民HBV、HCV、HIV感染者的感染率、分布及流行趋势。方法对2009—2010年11月无偿献血人群35 707例进行回顾性调查分析。结果无偿献血人群HBV、HCV、HIV感染率分别为6.29%、0.25%和0.008‰。结论该市应加强献血者的筛选以及对健康人群的预防接种和艾滋病危险性的宣传教育,从而减少HBV、HCV、HIV的感染。     

Epidemiological and clinical aspects of hepatitis C virus infection in the Russian Republic of Daghestan

Hepatitis C virus (HCV) is a leading cause of chronic liver disease. The prevalence in blood donors in the USA and West Europe is around 0.3%. However, there are few studies performed in East Europe. We have studied the prevalence of hepatitis C virus infection and risk factors associated with it in the Russian Republic of Daghestan. Population and methods: We included 10,682 volunteer blood donors, 267 commercial blood donors, 97 high risk patients (22 haemophiliacs, 41 in haemodialysis program and 34 parenteral drug addicts), and 87 patients with chronic liver disease (61 chronic hepatitis, 20 cirrhosis and 6 hepatocellular carcinoma). Antibodies against HCV were detected by second generation ELISA. Results: 0.93% of volunteer blood donors were found to be HCV reactive. Factors with stronger association with seropositivity were previous blood transfusion and parenteral drug addiction. 66% of seropositive blood donors had an elevated level of ALT. Alcohol use correlated with more marked deterioration in liver function tests. 7.5% of commercial blood donors were seropositive. Prevalence in high risk patients and in patients with chronic liver disease was very high (50–80% and 40–50%, respectively). Conclusion: the Russian Republic of Daghestan has one of the lowest rates of HCV infection in East Europe. Commercial blood donors have a very high prevalence of HCV infection. The risk factors associated with HCV infection are similar to those found in other epidemiological studies.     

Incidence of hepatitis C virus antibodies in blood donors, high risk patient groups, liver diseases and health professionals. Multicenter study of the ABBOT ELISA method, comparison with the ORTHO test

Serum samples from 1185 individuals (blood donors, health care workers, patients on haemodialysis or from other high risk groups or with non-A, non-B [NANB] hepatitis and other liver diseases) were examined for antibody to a recombinant antigen of hepatitis c virus (anti-HCV). A new ABBOTT HCV EIA system was used and a parallel study with ORTHO HCV ELISA was also done for 380 samples to compare the two anti-HCV tests. A confirmatory neutralizing ABBOTT ELISA probe was also performed in 45 cases. Anti-HCV seropositivity was found in 1.60% of accepted healthy blood donors, while among subjects excluded from donation for elevated aminotransferase the rate was 8.95%. In patients on haemodialysis 47.15% anti-HCV prevalence was found, in other high risk group subjects 32.5%. Patients with acute post-transfusion (PT) NANB hepatitis showed 40% prevalence, this rate in chronic PT-NANB was 77.8%. The two ELISA tests revealed 95% agreement in the parallel determinations. Serial dilution studies of anti-HCV positive sera showed that ABBOTT test was of superior sensitivity. The results of the confirmatory test suggest that reactive (positive) samples of low optical density near to the cut-off value require a confirmation with the neutralization test. In conclusion HCV infection in Hungary seems to be a common aetiologic factor in PT-NANB hepatitis and the screening of blood donors for anti-HCV may be useful. However, because of financial difficulties, cost/benefit calculations are recommended before the introduction of this preventive measure.     

马鞍山市既往有偿献血人员戊型肝炎检测分析

目的了解马鞍山市既往有偿献血人员中戊型肝炎感染状况,为此类传染病防治提供依据。方法采集有偿献血人员及农村正常人群的血清,通过酶联免疫吸附试验检测血清中戊型肝炎病毒的IgG抗体。结果共检测标本992例,其中既往有偿献血人员492例,检测出抗HEV-IgG抗体阳性病例数126例,阳性率25.6%;正常农村人群500例,检测出40例阳性,阳性率8%。结论既往有偿献血人员戊型肝炎感染率显著高于一般人群,戊型肝炎经血传播的危险是一个客观存在和值得关注的问题。     

Seroprevalence for Hepatitis E and Other Viral Hepatitides among Diverse Populations,Malawi

Data on prevalence of hepatitis E virus (HEV) in Malawi is limited. We tested blood samples from HIV-uninfected and -infected populations of women and men enrolled in research studies in Malawi during 1989–2008 to determine the seroprevalence of HEV, hepatitis A virus (HAV), hepatitis B virus (HBV), and hepatitis C virus (HCV). Samples were tested for IgG against HEV, total antibodies against HAV and HCV, and presence of HBV surface antigens. Of 800 samples tested, 16.5% were positive for HEV IgG, 99.6% were positive for HAV antibodies, 7.5% were positive for HBV surface antigen, and 7.1% were positive for HCV antibodies. No clear trends over time were observed in the seroprevalence of HEV, and HIV status was not associated with hepatitis seroprevalence. These preliminary data suggest that the seroprevalence of HEV is high in Malawi; the clinical effects may be unrecognized or routinely misclassified.     

Risk Factors for Hepatitis C Virus Infection among Blood Donors in Georgia

BACKGROUND: Growing awareness about the importance of blood safety for controlling the transmission of hepatitis C virus (HCV) has helped to decrease the spread of this virus in many settings. This study was conducted in order to evaluate potential risk factors for HCV infection among blood donors in Georgia. METHODS: The study population consisted of 553 blood donors in three major Georgian cities: Tbilisi, the capital city and Batumi and Poti, naval port cities. Risk factors were examined using a behavior questionnaire. All blood samples were initially tested using 3rd generation anti-HCV enzyme-linked immunosorbent assays and confirmed using recombinant immunoblot assays and nucleic acid testing. RESULTS: Forty-three blood donors, 7.8%, were confirmed HCV positive. Significant risk factors included: drug injection ever (OR: 42; 95% CI: 3.2-550.7); history of hepatitis (OR: 25.9; 95% CI: 4.6-145.5); history of a previous surgical procedure (OR: 148.4; 95% CI: 26.9-817.4); blood transfusion (OR: 25.9; 95% CI: 3.2-210.9). CONCLUSIONS: This study found a very high prevalence of HCV among blood donors in Georgia. The main risk factor for HCV infection in this population of blood donors was previous contact with contaminated blood or blood products. Reliable screening of donors and their blood is critical for controlling the further spread of HCV in Georgia.     

郑州市无偿献血者乙肝流行病学调查分析

目的 了解郑州市无偿献血者乙肝感染率,为做好乙肝防控提供科学依据。 方法 采用乙肝金标试纸条对661 184名无偿献血者进行初筛,并按献血次数、种类、年龄、性别、职业、文化程度进行分类统计。 结果 初次献全血和单采血小板的献血者乙肝感染率分别为1.044%和1.894%,两者差异有统计学意义(χ²=97.795,P＜0.001);初次和多次献血者乙肝感染率分别为1.082%和0.012%,两者差异有统计学意义(χ²=3 405.968,P＜0.001)。初次献血者乙肝感染率男性(1.334%)显著高于女性(0.687%)(χ²=314.594,P＜0.001);多次献血者男女之间差异无统计学意义(χ²=0.010,P＞0.05);初次献血者乙肝感染率随年龄增大而上升,18～25岁男女较低,26～35岁男性明显升高;多次献血随着年龄增高变化不大。初次献血者商贸、农民、工人以及自由职业者以及服务人员乙肝感染率均较高,医生、公务员以及军人乙肝感染率较低;多次献血者乙肝感染率较低且变化不大。初次和多次献血者乙肝感染率均随学历升高而降低。 结论 郑州市无偿献血者乙肝感染率较低,26～35岁年龄段男性感染率明显升高,农民及中专学历以下乙肝感染率较高,在加强乙肝免疫的同时,应加大乙肝传染病防治知识的宣传。     

Hepatitis E Virus Infections in Blood Donors,France

We screened plasma samples (minipools of 96 samples, corresponding to 53,234 blood donations) from France that had been processed with solvent–detergent for hepatitis E virus RNA. The detection rate was 1 HEV-positive sample/2,218 blood donations. Most samples (22/24) from viremic donors were negative for IgG and IgM against HEV.     

杭州地区妊娠晚期孕妇病毒性肝炎感染的调查研究

目的:调查杭州市2958例妊娠晚期孕妇乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)、丁型肝炎病毒(HDV)、戊型肝炎病毒(HEV)的感染状况。方法:对杭州市2958例妊娠晚期孕妇的血清乙型肝炎标志物、HCV抗体、HDV抗体、HEV抗体的检测结果进行统计分析。结果:2958例妊娠晚期孕妇中乙型肝炎总感染率40.16%,HCV抗体阳性率0.40%,HDV抗体阳性率0.20%,HEV抗体阳性率2.60%。结论:杭州地区妊娠晚期孕妇病毒性肝炎的感染以乙型肝炎位居第一、戊型肝炎次之,丙型肝炎及丁型肝炎感染率较低。应加强育龄女性易感人群乙肝疫苗的预防接种,开展和实施有效的预防措施来防止病毒性肝炎的感染,提高新生人口的素质。     

Risk factors for hepatitis C virus infection. A case-control study of blood donors in the Trent Region (UK).

The introduction of screening for hepatitis C virus (HCV) by the National Blood Transfusion Service identified donors who had acquired HCV infection. We undertook a case-control study amongst blood donors in the Trent Region to determine risks for HCV infection. A total of 74 blood donors confirmed positive for hepatitis C infection and 150 age, sex and donor venue matched controls were included in the study. Fifty-three percent of hepatitis C infected blood donors reported previous use of injected drugs compared to no controls; relative risk (RR) not estimatable (lower limit 95% CI = 20). Other risk factors were a history of: receipt of a blood transfusion or blood products RR = 3.6 (95% CI 1.5-8.3), having been a ''health care worker'' RR = 2.8 (95% CI 1.1-7.6), tattooing RR = 3.3 (95% CI 1.2-8.7), and an association with having been born abroad RR = 3.2 (95% CI 1.1-9.5). No risk was shown for a history of multiple sexual partners, ear piercing or acupuncture. Injecting drug use explains more than 50% of hepatitis C infections in blood donors, a group who are less likely to have injected drugs than the general population.     

Effect of Hepatitis E Virus RNA Universal Blood Donor Screening,Catalonia, Spain, 2017‒2020

Hepatitis E virus (HEV) is the major cause of acute viral hepatitis in several countries in Europe. HEV is acquired mainly by consumption of contaminated pork but can also be transmitted through blood transfusion. HEV infection is usually self-limited but can become persistent in immunocompromised persons. During the first 30 months of HEV RNA universal screening of blood donations in Catalonia, Spain, we identified 151 HEV RNA–positive donations (1/4,341 blood donations). Most infected donors reported consumption of pates and sausages, and 58% were negative for HEV IgM and IgG. All HEV isolates belonged to genotype 3. All infected donors spontaneously resolved the infection, and no neurologic symptoms and reinfections were observed after 1 year of follow-up. Since the implementation of HEV RNA universal screening, no new cases of transfusion-transmitted HEV infection were reported. Our data indicate HEV screening of blood donations provides safer blood for all recipients, especially for immunosuppressed persons.     

山西省某既往有偿献血地区18～59岁村民丙型肝炎病毒感染的横断面研究

目的估计山西省某农村既往有偿献血地区18～59岁村民丙型肝炎病毒（HCV）感染的流行率并分析HCV感染的可能危险因素。方法选择山西省某县12个村庄随机抽取660名18～59岁村民开展以社区为基础的横断面研究。采用标准化问卷收集研究对象的人口学、医疗史、危险行为等信息，采集7ml静脉血用于检测HCV感染。结果该既往有偿献血地区18～59岁村民总的HCV感染率为8．2％，献血人群HCV感染率为27．7％。多因素logistic回归分析提示，曾经献过血（调整OR=14．28，95％CI：6．83～29．87）和输过血（调整OR=8．66，95％CI：2．31～32．47）是该地村民感染HCV的主要危险因素。对献血亚人群分析发现，曾经献过血浆（调整OR=8．56，95％CI：2．87～25．54）是献血者感染HCV的最主要危险因素；1994年及以后停止献血的村民感染HCV的危险性较1994年之前停止献血的低（调整OR=0．32，95％CI：0．11～0．93）；女性献血者感染HCV的危险性较男性为低（调整OR=0．28，95％CI：0．10～0．83）。结论该献血地区HCV流行水平较高，既往有偿献血（浆）是该地区HCV流行的最主要原因。应采取有效措施预防该地区居民HCV的二代传播及为阳性患者提供治疗刻不容缓。     

187例维持性血液透析患者肝炎病毒感染的随访研究

目的 :了解维持性血液透析患者肝炎病毒的感染率及其有关因素。方法 :回顾分析 187例行维持性血液透析的慢性肾功能衰竭患者的实验室资料。结果 :维持性血液透析患者肝炎病毒感染率分别为乙型肝炎病毒 12 .3%、丙型肝炎病毒 46 .0 %、戊型肝炎病毒 3.4% ,感染率的高低与透析年限呈正相关。结论 :在 CHD患者肝炎病毒感染中 ,以丙型肝炎病毒感染率最高 ,同时应注意戊型肝炎病毒感染的动向。     

贵阳地区性乱者血清抗HCV的调查

对208例性乱、107例献血员作血清丙型肝炎病毒抗体(抗HCV)、部分乙肝病毒标志(HBVM)检测。结果献血员抗HCV阳性率1.87%,性乱者8.65%,其中伴性病者为12.7%,不伴性病者4.1%。性乱者抗HCV阳性率在男、女各年龄组间无明显差异,HCV合并HBV感染率达72.2%。结果提示,性乱者中有着不可忽视的HCV感染率,感染率高低与伴发性病或HBV感染有关。     

Detection of HGV in serum and peripheral blood mononuclear cells of maintenance haemodialysis patients.

The aim of the present study was to investigate the prevalence of hepatitis G virus (HGV) and also hepatitis C virus (HCV) infections in maintenance haemodialysis patients, and to identify extrahepatic sites as HGV reservoirs. HGV RNA was detected in the serum of 6/61 (10%) patients and in the peripheral blood mononuclear cells of 2/61 (3%) patients (one of whom was serum negative). These findings suggest that lymphoid cells constitute an extrahepatic HGV reservoir. HCV RNA was detected in 7/61 (11%) patients. Five of these patients (71%) were identified as carrying HCV genotype 1b. Co-infection with HCV and HGV was detected only in one patient. Haemodialysis patients are at risk for HGV infection, by nosocomial routes or via transfusions. HGV itself does not seem to be an important cause of hepatitis since all six HGV RNA positive patients not co-infected by HCV or HBV showed normal ALT values.     

Increased all-cause, liver, and cardiac mortality among hepatitis C virus-seropositive blood donors

Hospital-based studies suggest that hepatitis C virus (HCV) infection causes frequent cirrhosis, hepatocellular carcinoma, and mortality, but epidemiologic studies have shown less morbidity and mortality. The authors performed a retrospective cohort study of 10,259 recombinant immunoblot assay-confirmed, HCV antibody-positive (HCV+), allogeneic blood donors from 1991 to 2002 and 10,259 HCV antibody-negative (HCV-) donors matched for year of donation, age, gender, and Zone Improvement Plan Code (ZIP Code). Vital status through 2003 was obtained from the US National Death Index, and hazard ratios with 95% confidence intervals were calculated by survival analysis. After a mean follow-up of 7.7 years, there were 601 (2.92%) deaths: 453 HCV+ and 148 HCV- (hazard ratio (HR) = 3.13, 95% confidence interval (CI): 2.60, 3.76). Excess mortality in the HCV+ group was greatest in liver-related (HR = 45.99, 95% CI: 11.32, 186.74), drug- or alcohol-related (HR = 10.81, 95% CI: 4.68, 24.96), and trauma/suicide (HR = 2.99, 95% CI: 2.05, 4.36) causes. There was also an unexpected increase in cardiovascular mortality among the HCV+ donors (HR = 2.21, 95% CI: 1.41, 3.46). HCV infection is associated with a significant, threefold increase in overall mortality among former blood donors, including significantly increased mortality from liver and cardiovascular causes. High rates of mortality from drug/alcohol and trauma/suicide causes are likely due to lifestyle factors and may be at least partially preventable.     

HAV and HEV infection in hospitalised hepatitis patients in Alexandria, Egypt

A total of 202 serum and stool samples from acute hepatitis patients attending the Fever Hospital of Alexandria, Egypt, have been studied to reveal markers of hepatitis virus infection. Anti-HAV IgM were detected in 21 out of 202 sera (10.4%), whereas 201 sera (99.5%) had anti-HAV IgG. The first age attack was in the class-age 0–9 years with 64.7% of anti-HAV IgM positive sera. Among 202 patients, anti-hepatitis E IgG (sample/over cut off>1.0) was identified in 90 patients (44.5%). The anti-HEV seropositivity ranged from 17.6% to 60.0% in the different age groups, with the highest level in the class-age 20–29 years. Anti-hepatitis E IgM were identified in 49 patients with the first age attack in the class-age 10–19 years (39.4%). HAV RNA was identified by nested PCR in 7 samples out of 15, whereas HEV RNA was present in 4 out of 75 stool samples. Direct DNA sequence of the latter PCR products confirmed the presence of the HEV genome; comparison of the sequences of the isolates from Egypt with those in data banks revealed the highest homology to the Burma strain. Our data confirm that HAV and HEV are common causes of acute sporadic hepatitis in Alexandria but with different peak age positivity. Occasionally, but not infrequently, dual infections (HAV–HEV and HEV-enteric viruses) were also found. The risk analysis indicates that patients living in rural areas are exposed to a higher risk of hepatitis E infection compared to the urban population, whereas the presence of anti-HEV IgG was significantly associated with consumption of common village water and use of indoor dry pit and oral therapy for schistosomiasis.     

Protective role of humoral immune responses during an outbreak of hepatitis E in Egypt

Although the seroprevalence of hepatitis E virus (HEV) is approximately 80% in adult Egyptians living in rural areas, symptomatic HEV-caused acute viral hepatitis (AVH) is sporadic and relatively uncommon. To investigate the dichotomy between HEV infection and clinical AVH, HEV-specific immune responses in patients with symptomatic and asymptomatic HEV infection during a waterborne outbreak in Egypt were examined. Of 235 acute hepatitis patients in Assiut hospitals screened for HEV infection, 42 (17.9%) were acute hepatitis patients confirmed as HEV-caused AVH; 37 (88%) of the 42 patients were residents of rural areas, and 14 (33%) were from one village (Kom El-Mansoura). Another 200 contacts of AVH cases in this village were screened for HEV and 14 (7.0%), all of whom were family members of AVH cases, were asymptomatic HEV IgM-positive. HEV infections in this village peaked during the summer. Asymptomatic HEV seroconverters had significantly higher levels of epitope-specific neutralising (p=0.006) and high avidity (p=0.04) anti-HEV antibodies than the corresponding AVH cases. In conclusion, naturally acquired humoral immune responses appear to protect HEV-exposed subjects from AVH during an HEV outbreak in Egypt.     

Examination of hepatitis c virus antibody seropositive blood donors and their relatives

INTRODUCTION: 239 anti-HCV seropositive blood donors (132 male, 107 female, age: 19-61, mean: 40.59 y.) and 174 family members of them (74 male, 100 female, age: 4-65, mean: 23.67 y.) were studied for chronic hepatitis C virus infection and chronic liver disease. Detailed virus serology, ultrasonography, and 6 months follow-up and--in patients with HCV RNA--liver biopsy were made. RESULTS: HCV RNA was determined in 165 patients. 70% of them were HCV RNA positive. The ALT level was normal in 95 cases (57%), and lower, than twice of the normal was in 34 cases (20%) among them. Liver biopsy was made in 79 patients; chronic C hepatitis was proven in 75 cases (steatosis in 3 cases, alcoholic liver disease in 1 case was observed). Inflammatory activity was minimal (HAI < 3) in 17, mild (HAI: 3-6) in 41, moderate (HAI: 7-9) in 7, and severe (HAI > 9) in 10 cases. There was no correlation between the serum ALT levels and the severity of the histological activity of chronic C hepatitis. Authors stress the importance of the fact, that 2 patients had normal ALT and 5 patients ALT levels were lower, than the twice of the normal of the 17 patients with significant inflammatory activity (HAI < 6). Chronic C hepatitis need for antiviral therapy was occurred in 45% of patients who known themselves previously healthy. CONCLUSIONS: The necessity of the systematic examination of anti-HCV seropositive patients and of the importance of the liver biopsy in patients with HCV RNA positivity is stressed. 3 anti-HCV seropositive cases of 174 family members of the blood donors were observed, but none of them was HCV RNA positive. It seems to be, family members of the HCV infected patients have no increased risk for HCV infection.