血透患者乙、丙、庚型肝炎病毒感染检测的临床意义

目的:研究血透患者(HDP)乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)、庚型肝炎病毒(HGV)的感染状况、相关因素及防治措施。方法:对68例血透患者用ELISA法检测HBsAg、抗HBs、HBeAg、抗HBe、抗HBc、抗HCV、抗HGV;用逆转录聚合酶链反应(RT-PCR)检测HBVDNA、HCVRNA。结果:输血组肝炎病毒感染率明显高于单纯血透组(P<0.01)。血透患者的HCV、HGV感染率明显高于对照组(P<0.01),HBV感染率高于对照组(P<0.05)。结论:血透患者HCV、HGV、HBV感染率高,输血和血制品是主要因素,其次与透析器及管路的交叉使用有关。应尽量减少输血,加强透析过程中的消毒隔离措施。     

输血后肝炎病例中丙型肝炎的分析

７３例输血后肝炎经血清学检测，乙型肝炎病毒表面抗原和／或抗ＨＢｃ阳性２１例，抗丙型肝炎病毒抗体阳性６２例，显示输出后肝炎以丙型肝炎为主，在６２例输后血丙肝中，８２．２６％的患者输血或输血浆后６个月血清抗ＨＣＶ阳转；输血血组与输血浆组比较，输注量与输血后丙型肝炎的发生无关。提示血浆比全血更易传播丙型肝炎。部分随访病例说明丙型肝炎慢性化趋势较高。     

5031例精神病患者乙型肝炎血清学标志物检测结果分析

对我院精神病患者乙型肝炎病毒（HBV）血清学标志物检测结果进行分析,估计其传染性程度,为精神病患者乙肝预防、诊断和治疗提供实验室依据。用ELISA方法检测我院三年来门诊及住院精神病患者乙肝五项指标,并对所有数据进行统计与分析。结果显示,5031例血清标本中检出HBV血清学标志物3023例,总感染率60.1%。血清学标志物模式可分为感染期模式组和恢复期模式组,两组共20种模式。结论：乙肝五项指标检测结果显示,精神疾病患者较同类人群血清总感染率偏高,HBV血清学标志物模式也较为复杂,除HBsAg阳性、抗-HBs阴性、HBeAg阳性、抗-HBe阴性、抗-HBc阳性组具有传染性外,其他模式也存在一定的传染性。建议对住院精神疾病患者注射乙肝疫苗,以减少乙肝的传染率。     

Clinical and Virological Characteristics of Chronic Hepatitis B Patients with Hepatic Steatosis

Objective: This study aimed to explore clinical and virological characteristics of chronic hepatitis B (CHB) patients with hepatic steatosis in order to provide a theoretical basis for the prevention and control of hepatic steatosis.Methods: A total of 360 CHB inpatients were recruited from Affiliated Dongnan Hospital of Xiamen University and divided into hepatic steatosis group and non- hepatic steatosis group. The body mass index (BMI), waist-to-hip ratio (WHR), fasting blood glucose (FBG), triglyceride (TG), total cholesterol (TC), aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (GGT), hepatitis B e antigen (HBeAg), hepatitis B virus DNA (HBV DNA) and hepatic histological changes were detected and compared between the two groups. The association of these factors with hepatic steatosis was evaluated in CHB patients.Results: BMI, FPG, TG, TC, GGT, AST and HBV DNA showed statistically significant differences between two groups (P<0.01). The patients with hepatic steatosis had markedly higher BMI, FBG, TG and TC than those without steatosis did. No significant differences were found in ALT and HBeAg between two groups (P>0.05). In male patients, there was marked difference in the WHR between two groups (P < 0.01), which was not found in female patients (P > 0.05). The severity of hepatic steatosis increased in patients with hepatic steatosis, compared to those without steatosis (P < 0. 01), but the severities of inflammation and fibrosis in the non-hepatic steatosis group were dramatically higher than those in the hepatic steatosis group (P < 0. 01).Conclusions: BMI, WHR, FBG, TG and TC appeared to be influencing factors of CHB combined with hepatic steatosis. Hepatic steatosis in CHB patients was closely related to changes in anthropometric indices and metabolic factors but not HBV. It is necessary to improve these factors to effectively prevent hepatic steatosis in CHB patients.     

广州市应用乙型肝炎疫苗免疫22年人群血清学效果研究

目的评价广州市长期应用乙型肝炎疫苗（hepatitis B vaccine,HepB）对乙型肝炎（乙肝）免疫防病效果。方法在广州市全市12个区、县级市按照多阶段分层整群抽样法,以家庭为单位对1～59岁人群进行横断面调查分析,包括检测HBsAg、抗-HBs,对HepB接种史及主要乙肝感染危险因素进行问卷调查,评估人群HepB接种率,分析和比较不同年龄组、不同家庭感染状况下接种与未接种HepB人群乙型肝炎病毒感染指标,评价HepB免疫防病效果。结果 1～16岁年龄组乙肝疫苗全程接种率为88.11%（2535/2877）,17～59岁人群有乙肝疫苗免疫史为20.75%（470/2113）。在推行新生儿HepB接种纳入计划免疫管理后出生的1～16岁人群,HBsAg阳性率为1.29%,而出生时尚未开展HepB接种的20～59岁人群HBsAg阳性率为13.72%。1～16岁人群中有HepB接种史人群HBsAg阳性率0.99%,无接种史人群为5.56%,疫苗保护率为82.19%。20～59岁人群接种HepB,基本都不是在新生儿时期,疫苗保护率为52.01%。新生儿接种HepB,母婴乙肝传播阻断率为94.16%,并能有效阻断家庭内水平传播。结论长期实施新生儿接种HepB能控制、消除受种人群乙肝病毒感染,非新生儿人群接种HepB也能显著降低乙肝病毒感染率。     

Changes in Hepatitis C Virus Genotype Distribution in Chronic Hepatitis C Infection Patients

Purpose: Identification of hepatitis C virus (HCV) genotypes is very important in the selection of antiviral treatment, dose adjustment of antiviral agents, determining the treatment duration and following-up of treatment response. We aimed to determine the distribution pattern of HCV genotypes in chronic hepatitis C infection (CHC) patients. Materials and Methods: We have included 106 CHC patients who were positive in the anti-HCV and HCV-RNA tests performed in our hospital during the 16-month period. Anti-HCV assays were performed on device using a chemiluminescent microparticle immunoassay, while HCV-RNA tests and HCV genotyping assays were performed by real-time polymerase chain reaction. Results: Of the 106 cases; genotype 1b was detected in 67.0%, genotype 3 was detected in 16.0%, genotype 1a was detected in 14.2% and genotype 2 was detected in 2.8% patients. Genotypes 4, 5 and 6 were not detected in our study group. There were no statistically significant differences between the gender and age groups according to the HCV genotype distribution. The genotype 3 detection rate (16%) was the highest rate among the studies compared with the other studies in our country. Conclusions: Events that cause social changes such as war and immigration and intense commercial and touristic activities affect and alter the HCV genotype distribution in HCV-infected patients. For this reason, further multicentre studies are required reflecting all the regions in order to determine the genotype distribution in HCV-infected patients at regular intervals.     

HBV-LP与HBV-DNA联检的临床应用

目的：探讨血清乙型肝炎病毒大蛋白与HBV-DNA联检在乙型肝炎患者诊治中的意义。方法：对162例HBV感染者及47名健康对照组血清采用ELISA检测乙型肝炎病毒大蛋白及乙型肝炎病毒标志物;FQ-PCR定量检测HBV-DNA。结果：162例HBV感染者血清中,HBV-LP浓度与HBV-DNA拷贝数间具有良好的正相关性（rs=0.64,P〈0.001）,不同HBV-DNA拷贝数组别间HBV-LP浓度存在差异显著性（P〈0.01）;HBV-LP与HBV-DNA、HBeAg间均关联显著（P〈0.01）。HBV-LP与HBV-DNA、HBeAg间阳性率均存在差异显著性（P〈0.05）,HBV-LP阳性率为84.57%,较HBV-DNA、HBeAg均敏感。其中HBV-LP在HBV-DNA阳性组中阳性率为91.18%（93/102）,DNA阴性组中阳性率为73.33%,均较HBeAg高;在58例HBV-DNA和HBeAg共同阴性的HBV感染血清中,HBV-LP检出42例阳性。结论：血清HBV-LP浓度与HBV-DNA联检有利于提高HBV感染者体内病毒复制、疾病进程、疗效与预后判断的血清学诊断与监测水平。     

Hepatitis C virus infection in 2,744 hemodialysis patients followed regularly at nine centers in Hiroshima during November 1999 through February 2003

Patients on maintenance hemodialysis (HD) are at increased risk of infection with hepatitis C virus (HCV). A prospective follow-up study on HCV infection from November 1999 to February 2003 was conducted in nine hemodialysis (HD) units in Hiroshima. A total of 2,744 HD patients were surveyed regularly for HCV RNA in serum. The prevalence of HCV RNA decreased from 15.7% (262/1,664) on the first survey to 12.9% (242/1,882) in the last one (P<0.05). This decrease may be attributed to the inclusion of patients with a lower prevalence of HCV RNA compared to patients leaving dialysis centers (111/1,080 [10.3%] vs. 132/862 [15.3%], P<0.01). During the 40 months of this study, 16 de novo HCV infections were documented in the nine HD units corresponding to an incidence of 0.33% per year. These cases included eight new HCV infections, three re-infections, and five infections that presumably occured in the window period when tested during the first survey. Our study shows that the annual incidence of de novo HCV infection during HD was 0.33%, and emphasizes the need for frequent serum HCV RNA testing and for stringent disinfection procedures in order to prevent the transmission of HCV in these settings.     

Viral hepatitis amidst COVID-19 in Africa: Implications and recommendations

Hepatitis, a significant cause of mortality worldwide, results in around 1.34 million deaths each year globally. Africa is not exempt from the plague of Hepatitis. Around 100 million estimated individuals are infected with Hepatitis B or C. Egypt has the highest prevalence of cases of Hepatitis followed by Cameroon and Burundi. The continent is severely affected by the onset of the COVID-19 pandemic, as the virus has added an additional burden on the already fragile continent. With the pandemic, it is presumable that Hepatitis like other viral diseases will pose a threat to collapsing healthcare system. Therefore, for Africa to become more resilient in the face of such menaces, including Hepatitis, further prevention policies are required to be implemented     

e抗原阳性慢性乙型肝炎患者血清HBV-DNA与HBsAg、HBeAg的相关性分析

目的 研究e抗原阳性慢性乙型肝炎患者外周血中HBV-DNA载量与乙型肝炎病毒表面抗原（HBsAg）、乙型肝炎病毒e抗原（HBeAg）的相关性,及其在不同性别、年龄群体中的差异.方法 收集319例e抗原阳性慢性乙肝患者血清,采用实时荧光定量PCR法检测HBV-DNA载量,用时间分辨免疫荧光法检测HBsAg和HBeAg的浓度,利用SPSS软件做统计分析.结果 HBV-DNA载量与HBsAg含量有良好的相关性（r=0.514,P〈0.001）;与HBeAg含量有相关（r=0.337,P〈0.001）;女性的HBeAg水平要高于男性患者（P〈0.05）;年龄（31～50）岁组、〉50岁组的HBV-DNA、HBsAg 及HBeAg值皆高于年龄 〈30岁组 （P〈0.001）.结论 e抗原阳性慢性乙型肝炎患者血清中HBV-DNA载量与HBsAg、HBeAg定量水平皆有相关性,其中与HBsAg相关性更佳.     

105例乙型病毒性肝炎肝阻抗血流图分析

目的:了解不同病期乙型病毒性肝炎的肝血液循环变化.方法:将105例乙型病毒性肝炎患者分为:急性(21例)、慢性轻度(22例)、慢性中度(22例)、慢性重度(20例)及肝硬化(20例)五组.正常对照组20例为本院健康职工.空腹、平卧、平静呼气末屏气检测,存盘分析.结果:与对照组比较,各病期肝炎形态异常率和各定量指标由急性、慢性轻度、慢性中度、慢性重度、肝硬化,差异逐渐明显(P＜0.05,P＜0.01).结论:乙型病毒性肝炎由急性肝炎到肝硬化,随着病情进展,肝阻抗血流图异常渐明显,表明肝脏血液循环障碍渐加重.     

丙型病毒性肝炎患者血清瘦素的检测

研究丙肝患者血清leptin水平的变化。采用RIA检测65例丙肝组患者,80名对照组血清leptin水平,以及各种生化指标,比较各组的leptin水平以及leptin与各生化指标的相关性。结果显示慢性丙肝患者血清leptin水平较对照组明显升高(P<0.01);血清leptin水平与谷丙转氨酶(ALT)、谷草转氨酶(AST)呈显著性正相关(P<0.05);而与血糖(Glu)、总胆固醇(TC)无明显相关性(P>0.05)。慢性丙肝患者血清leptin水平升高且与肝脏炎症病变严重程度有关,leptin可以作为一个判断肝脏炎症严重程度的指标。     

Virological and Immunological Studies in Patients with Acute Viral Hepatitis

One hundred and seven patients with acute viral hepatitis (AVH) were studied prospectively regarding the viral aetiological agent HAV, HBV and NANB (by exclusion) using radioimmunoassay. Acute HAV infection occurred in 43 patients, and acute HBV infection in 34 patients, while HDS occurred in two patients only. Acute, presumably NANB, infection occurred in 28 patients. Ten out of 28 sera of patients with AHBV infection were positive for smooth muscle antibody by immunofluorescence. Important findings include: (1) presence of delta superinfection in the absence of HBsAg; (2) HBsAg as the only marker in two patients with AHBV infection; (3) concurrent presence of HBsAg and anti-HBsAg in three patients with AHBV infection.     

重型病毒性肝炎中丁型肝炎病毒的检测

为了探讨丁型肝炎病毒（ＨＤＶ）感染在重型病毒性肝炎中的作用，对北京佑安医院１９８０年至１９８９年收治的５４例急性和亚急性重型肝炎和３８例急性乙肝患者血清，应用国产ＨＤＶＥＬＩＳＡ试剂测定抗－ＨＤ、抗－ＨＤＩｇＭ和ＨＤＡｇ，应用斑点杂交技术测定ＨＤＶＲＮＡ。结果发现重型肝炎组ＨＯＶ－Ｍ检出率明显高于急性乙肝组（２７．８％比５．３％．Ｐ＜０．０５）。单独ＨＢＶ感染和ＨＤＶ／ＨＢＶ混合感染的重型肝炎患者均有较高的病死率。提示ＨＤＶ感染是重型肝炎中重要的病原学因素之一，ＨＤＶ与ＨＢＶ具有协同作用加重肝损害，导致肝衰竭。     

慢性乙型肝炎病人结肠粘膜淋巴细胞亚群分析

本文用组织学和免疫组织化学方法对１５例经肝穿刺证实的中、重度慢性乙型病毒性肝炎病人的结肠粘膜进行了免疫病理学研究。发现该组病人结肠粘膜固有层淋巴细胞增多，上皮间淋巴细胞减少；ＣＤ３＋、ＣＤ８＋细胞增多，ＣＤ４＋细胞变化不大；少量上皮细胞有ＨＬＡ－ＤＲ的表达。提示有轻度炎症反应，但炎症程度远不如非特异性结肠炎，且有质的不同。这种轻度炎症反应与中、重度慢性肝炎病人结肠粘膜机械屏障受损、抗原刺激粘膜免疫系统导致局部免疫状态发生改变有关。     

962例外来工的乙型肝炎表达模式分析

目的了解来东莞工作的外来工的乙肝感染状况，分析其乙型肝炎的表达模式，为乙肝防治提供参考。方法收集了到某院体检的962份外来工的血清，检测乙肝五项：表面抗原（HBsAg）、表面抗体（HBsAb）、e抗原（HBeAg）、e抗体（HBeAb）、核心抗体（HBcAb），并对结果进行分析。结果在检测的962人中，HBsAg阳性335人，阳性率34．82％。其中男性受检者527人，HBsAg阳性204人，阳性率38．71％；女性受检者435人，HBsAg阳性131人，阳性率30．11％。乙肝五项标志物全阴者217人，占总受检人数的22．56％。结论必须加强对来莞工作的外来工的乙肝监测，及时为乙肝五项全阴者注射乙肝疫苗，同时加强外来工的健康教育，提高他们的卫生知识水平。     

从基因分型看血液透析及肾移植患者丙型肝炎病毒感染状况

采用国产和美国Ｏｒｔｈｏ公司第２代抗丙型肝炎病毒（ＨＣＶ）试剂对１００例维持性血透及肾移植患者进行血清丙型肝炎病毒抗体（抗－ＨＣＶ）对比检测。阳性标本用聚合酶键反应（ＰＣＲ）法检测ＨＣＶＲＮＡ并采用型特异的ＨＣＶ亚基因探针对其非结构蛋白ＮＳＳ区扩增产物进行了杂交基因分型。结果表明，这组病人中抗－ＨＣＶ阳性率为４１％，肾移植术后再透析者达５６．５２％，且与透析时间、输血次数、受血量成正相关；国产抗－ＨＣＶ试剂同美国Ｏｒｔｈｏ公司试剂比较阳性符合率达９１．４３％；抗－ＨＣＶ阳性患者中有３１．４３％（１１／３２）血清ＨＣＶＲＮＡＮＳ５阳性；透析患者中，ＨＣＶ基因型各型均有，以混合型为主，占６３．６４％。     

Hepatitis C virus genotypes in hemodialysis patients in Angola

To our knowledge, there are no published data on hepatitis C virus (HCV) genotypes in Angola. This study aimed at assessing the distribution of HCV genotypes in seropositive hemodialysis patients in Luanda. Among 51 HCV-positive subjects included, viremia was detected in 27 (53%). HCV genotyping was performed by bidirectional sequencing of the 5'-untranslated region by the Sanger method. HCV genotype 4 was largely predominant (20 cases; 74%), followed by genotypes 1b (5 cases; 18.5%), 1a and 2 (one case each; 3.7%). These results suggest that the distribution of HCV genotypes in Angola is similar to that reported from other Central African countries.