乙,丙型肝炎病毒重叠感染临床研究

目的 了解徐州地区慢性乙型肝炎（ＣＨＢ）患者中乙型肝炎病毒（ＨＢＶ）、丙型肝炎病毒（ＨＣＶ）重叠感染情况。方法 对徐州地区２４７例慢性乙型肝炎患者（ＣＨＢ）进行血清丙型肝炎抗体（抗－ＨＣＶ）及丙型肝炎病毒（ＨＢＶ、ＨＣＶ）重叠感染与单纯ＨＢＶ感染患者的临床资料进行比较。结果 （１）徐州地区ＨＢＶ、ＨＣＶ重叠感染率为１２．９６％（３２／２４７）。（２）重叠感染者的年龄、血清丙氨酸氨基转移酶（ＡＬＴ）     

乙型和丙型肝炎病毒重叠感染的研究

目的：我国是乙型肝炎和丙型肝炎发病率较高的国家。而HBV和HCV有着相同的传播途径，为了解乙型肝炎病毒携带者和乙型肝炎患者重叠感染丙型肝炎病毒（HCV）状况，并探讨乙型肝炎病毒（HBV）、HCV重叠感染相互之间的影响。方法：应用ELISA法对726例HBV携带者和乙型肝炎患者进行了血清抗-HCV检测和HBV标志物检测。结果：726例HBV携带者和乙型肝炎患者血清抗-HCV阳性率为10．47％，男性阳性率为15．78％，女性阳性率为1．87％，年龄组以31—40岁阳性率最高为24．64％，不同人群以吸毒人员阳性率最高为78．89％。结论：HBV、HCV重叠感染通过注射是主要感染途径；HBV、HCV重叠感染者血清抗-HBe阳性率高于HBV携带者，显示HBV、HCV重叠感染使HBV的复制受到抑制。     

甲乙丙型肝炎病毒重叠感染检测分析

目的　了解甲型肝炎病毒 (HAV)、乙型肝炎病毒 (HBV)、丙型肝炎病毒 (HCV)重叠感染情况。方法　应用ELISA法分别对 2 83重叠感染者检测血清抗 -HAV、抗 -HCV和HBV -M ,并比较各型临床类型各型病毒的感染情况。结果　肝炎病毒感染者中HBV的感染率最高 86.9% ,HAV和HBV的重叠感染最多 42 8% ,HBV和HCV重叠感染次之 3 2 9%。结论　甲、乙、丙型肝炎病毒可以重叠感染 ,以HBV的感染为主 ,重叠感染加重病情。     

乙型肝炎病毒与丙型肝炎病毒重叠感染重症化探讨

目的:探讨HBV、HCV重叠感染时,病毒之间的相互关系及对病情转归的影响。方法:用ELISA法检测180例患者乙肝病毒血清学指标(HBV-M)和丙肝病毒抗体(抗-HCV),用PCR和RT-PCR体外扩增法检测HBV-DNA和HCV-RNA。结果:HBV、HCV重叠感染LC和HCC的发生率远远高于单纯HBV或HCV感染,HBV、HCV重叠感染患者中HBV-DNA和HBsAg的阳性率明显低于单纯HBV感染者。结论:HBV重叠感染HCV后,对肝细胞的损害加重,重叠感染患者病情的发展及转归可能主要与HCV有关,是HBV、HCV作用相互叠加的结果。     

乙,丙两型肝炎病毒重叠感染的临床探讨

自1989年建立了抗-HCV检测技术,为临床诊断丙型肝炎提供了证据。我们在临床中注意到乙型肝炎患者重叠感染丙型肝炎病毒或丙型肝炎患者重叠感染乙型肝炎病毒是存在的。由于国内外对乙型肝炎病毒(HBV)与丙型肝炎病毒(HCV)重叠感染时病毒间有无相互干扰、以及对     

196例乙,丙型肝炎病毒混合感染的临床分析

分析ＨＢＶ合并ＨＣＶ感染的慢性肝炎３２例的临床表现、肝功能和病毒标示物的检测结果，提示ＨＢＶ合并ＨＣＶ感染的慢性肝炎病情重、并发症多、易复发、重型肝炎和肝硬化发生率高、肝功能损害严重和病死率高，与冱ＨＢＶ或ＨＣＶ感染的慢性肝炎的病例比较，有非常显示性差异（Ｐ〈０．０１）。未提示ＨＣＶ干扰ＨＢＶ复制现象。     

39例庚型肝炎与乙型肝炎病毒或丙型肝炎病毒重叠感染的临床分析

庚型肝炎病毒（ＨＧＶ）是近年来发现的新型肝炎病毒。１９９６年１１月,Ｌｉｎｎｅｎ等在Ｓｃｉｅｎｃｅ上发表了它的基因组全序列〔１〕。我国学者也相继报道,从不同来源的血清标本中,检出了ＨＧＶＲＮＡ〔２～４〕。我们采用ＲＴ－ＰＣＲ的方法,从各类肝病患者中,...     

乙型与丙型肝炎病毒重叠感染的血清学检测结果分析

乙型病毒性肝炎(以下简称乙型肝炎)和丙型病毒性肝炎(亦称非甲非乙型病毒性肝炎，以下简称丙型肝炎)多以散发形式流行，二者有共同的传播途径。为了探讨二者病毒重叠感染状况，我们对齐齐哈尔市传染病院住院的乙型肝炎、丙型肝炎、肝炎后肝硬化患者(共168例)，进行了血清学调查．现将结果报告如下。     

乙型肝炎病毒和丙型肝炎病毒重叠感染对乙肝标志的影响及其临床特点

对43例乙型肝炎病毒和丙型肝炎病毒重叠感染的病例进行了临床观察及分析。现报告如下：[第一段]     

丙型肝炎与乙型肝炎病毒重叠感染的初步观察

对210例乙型肝炎患者和52例非肝病患者进行了血清丙型肝炎病毒抗体（抗-HCV）检测，在慢性迁延性肝炎的阳性率为11．1％，慢性活动性肝炎为17．2％，肝硬化为34．0％。丙型肝炎病毒（HCV）与乙型肝炎病毒（HBV）重叠感染率为17．1％（36／210）。抗-HCV阳性者80．5％有输血史。未发现HCV感染对HBV复制有抑制的现象．HCV和HBV重叠感染肝硬化患者肝功生化指标与单纯HBV感染肝硬化患者比较无明显差异，但重叠感染的肝硬化患者的并发症较多见。     

原发性肝癌患者乙型肝炎病毒与丙型肝炎病毒感染标志物的分析

了解原发性肝癌患者乙型肝炎病毒和丙型肝炎病毒的感染状况,并探讨原发性肝癌与乙型肝炎病毒和丙型肝炎病毒的关系。用酶联免疫吸附法对８２例肝癌患者、８０例肿瘤对照组和１０３例健康对照组进行了乙型肝炎病毒和丙型肝炎病毒感染标志物的检测。     

不明原因肝炎患者隐匿性乙型肝炎病毒感染检测分析

目的探讨不明原因肝炎患者隐匿性乙型肝炎病毒（HBV）感染情况及隐匿性感染的机制。方法采用巢式聚合酶链反应（PCR）检测103例不明原因肝炎患者血清HBVDNA。用电化学发光免疫技术对检测出的隐匿性HBV感染者血清HBsAg进行定量测定。结果隐匿性乙型肝炎病毒感染率为17．5％。电化学发光免疫技术检测隐匿匿性HBV感染者血清HBsAg,未检出有3例,在0．05～0．1ng／ml有8例,0．1～0．5ng／ml有6例,3．5ng／ml有1例。隐匿性HBV感染者血清HBVDNA水平为10^3～10^6copies／ml。结论隐匿性HBV感染是不明原因肝炎的病因之一。隐匿性HBV感染者血清HBsAg阴性的机制主要是HBV复制和基因表达的严重抑制,以及HBV基因突变。     

Allele polymorphisms of interleukin-lO and hepatitis B,C virus infection

Background Interleukin 10 （IL-10） is an important cytokine with anti-inflammatory, anti-immune and anti-fibrotic functions. This study aimed at evaluating the relationship between allele polymorphisms in the IL-10 promoter region and hepatitis B virus （HBV） or hepatitis C virus （HCV） infection. Methods The odds ratios （ORs） of IL-10 allele distributions in patients with HBV or HCV infection were analyzed against healthy controls. All the relevant studies in PubMed were identified, and poor qualified studies were excluded. The meta-analysis software REVMAN 4.2 was applied for investigating heterogeneity among individual studies and summarizing all the studies. The publication bias was also evaluated. Results This study demonstrated a significant association between the IL-10-592 A/C polymorphism and HBV infection in the Asian population under the overall effect size of allele A versus C. In our subgroup meta-analysis, we found a significant association of IL-10-592 A/C polymorphism to HCV infection susceptibility in Asian populations, although sensitivity analysis showed that the combined result was not associated with the worldwide population. Other IL-10 allele polymorphisms were not associated with HBV or HCV infection. Conclusion IL-10-592 A/C allele might be a risk factor for HBV or HCV in Asians but not in Europeans.     

A study on hepatitis D virus infection in liver tissues of patients with hepatitis B in China

Summary 2346 liver samples from 17 areas in China were investigated for intrahepatic hepatitis D antigen (HDAg) by direct enzyme-labelled technique. HDAg was detected in 167 out of 1764 samples of HBsAg positive individuals with the detection rate of 9.47%. Hepatitis D virus (HDV) infection existed in all the examined areas without any significant difference regarding HDAg detection rate. A relationship of intrahepatic HDAg to the pathologic type of the liver disease was observed. The HDAg detection rate in chronic liver diseases and severe hepatitis was higher than in other liver diseases. It suggested that HDV infection was associated with the progression and chronicity of the liver disease. Studies on the relationship between HDV infection and HBV replication showed that HBV replication might be suppressed by HDV infection. Both HDV and HBV, however, could replicate in the same hepatocyte simultaneously.     

Allele polymorphisms of interleukin-10 and hepatitis B, C virus infection

Background Interleukin 10 (IL-10) is an important cytokine with anti-inflammatory, anti-immune and anti-fibrotic functions. This study aimed at evaluating the relationship between allele polymorphisms in the IL-10 promoter region and hepatitis B virus (HBV) or hepatitis C virus (HCV) infection.
Methods The odds ratios (ORs) of IL-10 allele distributions in patients with HBV or HCV infection were analyzed against healthy controls. All the relevant studies in PubMed were identified, and poor qualified studies were excluded. The meta-analysis software REVMAN 4.2 was applied for investigating heterogeneity among individual studies and summarizing all the studies. The publication bias was also evaluated.
Results This study demonstrated a significant association between the IL-10-592 A/C polymorphism and HBV infection in the Asian population under the overall effect size of allele A versus C. In our subgroup meta-analysis, we found a significant association of IL-10-592 A/C polymorphism to HCV infection susceptibility in Asian populations, although sensitivity analysis showed that the combined result was not associated with the worldwide population. Other IL-10 allele polymorphisms were not associated with HBV or HCV infection.
Conclusion IL-10-592 A/C allele might be a risk factor for HBV or HCV in Asians but not in Europeans.

     

有偿献血员人类免疫缺陷病毒合并乙型、丙型肝炎病毒感染及生化指标分析

目的: 探讨有偿献血员中人类免疫缺陷病毒(HIV)合并乙型、丙型肝炎病毒(HCV、HBV)感染情况及其肝、肾功能指标的变化。方法: 选取125例曾有偿献血HIV感染者,进行HCV、HBV血清学标志物及肝、肾功能各项指标检测。结果: 125例中,合并HCV感染率为92.0%,合并HBV感染率为5.6%,合并HCV感染组AST、ALT与对照组和单纯HIV感染组差异均有统计学意义。HIV合并HCV、HBV感染组及单纯HIV感染组β₂微球蛋白与对照组差异有统计学意义,合并HCV组与单纯HIV感染组β₂微球蛋白差异有统计学意义(P < 0.01)。结论: HIV合并HCV可加重HIV患者的肝脏损害,对肾功能未造成影响,β₂微球蛋白升高可能是机体免疫过度活化的表现。     

RANTES gene single nucleotide polymorphisms and expression in patients with chronic hepatitis B virus infection

Background Regulated on activation, normal T-cell expressed and secreted (RANTES) plays a critical role in T-lymphocyte activation and proliferation. The process is involved in both acute and chronic phases of inflammation. The present study was to ascertain the possible correlations between chronic hepatitis B virus (HBV) infection and the RANTES gene polymorphisms and their expression. Methods The study included 130 HBV negative healthy donors and 152 patients with chronic hepatitis B (CHB) virus infection. The polymerase chain reaction (PCR) and restriction fragment length polymorphisms (RFLPs) were used to detect RANTES gene single nucleotide polymorphisms (SNPs). RANTES levels in the platelet depleted plasma were detected by enzyme linked immunosorbent assay (ELISA). Results RANTES alleles -403G, -28C and In1.1T were the predominant alleles in the subjects studied. No significant correlation was found between CHB infection and the RANTES alleles, while a significant correlation was found between CHB infection and increased RANTES expression in platelet depleted plasma (P&lt;0.05). Conclusions SNPs in RANTES gene do not affect chronic HBV infection or the outcome of interferon-α treatment in patients positive for HBV “e” antigen (HBeAg+). However, patients with CHB infection express the higher levels of plasma RANTES, which is thus associated with CHB infection.     

乙型肝炎病毒X基因变异和慢性乙型肝炎患者临床与组织病理学指标的相关性

 目的 探讨慢性乙型肝炎患者肝组织内乙型肝炎病毒（HBV）X基因部分区段的变异与HBV相关各临床与组织病理学指标的关系。方法 以83例慢性乙型肝炎肝穿刺活检标本作为研究对象,20例HBV相关性肝细胞癌作为对照;HBV X基因变异的研究采用PCR扩增和直接双向测序。免疫组化二步法显示肝组织内四种病毒蛋白的表达;荧光实时定量PCR检测肝组织内HBV DNA含量。结果 HBV X基因nt1583～1793区段错义突变主要出现在对应的X蛋白aa87（nt1632、1633）、88（nt1635、1636）、116（nt1719）、118（nt1726、1727）、119（nt1730）、127（nt1752）、130（nt1762）和131（nt1764）位氨基酸。nt1725～1730（aa118/119）突变与肝组织内HBcAg显著低表达（P=0.006）,和HBV DNA低拷贝数（P=0.004）明显相关,尤以ACTGAC（TD）型突变最为明显;相反,nt1762/1764（aa130/131）位点突变则伴肝组织内HBcAg显著高表达（P=0.005）和高水平的HBV DNA含量（P=0.006）。同时,肝癌组中nt1725～1730 野生型所占比率明显高于慢性肝炎（P<0.05）,而nt1762/1764 突变型所占比率肝癌组与肝炎组相比显著增高（P<0.01）。结论 肝组织内,在nt1725～1730突变能显著降低HBcAg 的表达和HBV DNA水平,nt1762/1764突变则相反。肝组织内HBV的高负载可能与肝细胞癌的发生有关     

Detection of hepatitis G virus RNA in hepatitis C patients and hepatitis C virus infected hemodialysis patients

AlthoughsensitiveandspecificimmunoassayandmolecularbiologicaltechniquesforthedetectionofthehepatitisA--Evirusesareavailable,theetiologyofasubstantialfractionofpost--transfusionandcommunity--acquiredhepatitiscasesremainsundefined[1],suggestingtheexistenceofadditionalcausativeagents.Anewhumanhepatitisviruswasisolatedbytwoindependentgroups.ThenewvirusisprovisionallydesignatedashepatitisGvirus(HGV)[ZJorGBvirusC(GBV~C)[3'4),whichwasthoughttobetheagentofpartofthenon--A--Ehepatitispatients.Fro…     

Th细胞极化群体在慢性乙型肝炎病毒感染中的作用

目的　了解慢性乙型肝炎病毒（HBV）感染者外周血中辅助性T细胞（Th）内干扰素-γ（IFN-γ）、白细胞介素-4（IL-4）和转化生长因子-β（TGF-β）的表达情况,以测定Th1/Th2 /Th3细胞的百分数,探明Th细胞各极化群体在慢性HBV感染中的作用.方法　常规分离外周血单个核细胞（PBMC）,在佛波脂（PMA）、钙离子导入剂伊屋诺霉素Ionomycin、细胞内转运阻断剂莫能星Monensin的刺激下,采用流式细胞分析术（FACS）对慢性HBV感染者外周血单个Th细胞内IL-4、IFN-γ和TGF-β的表达进行分析.结果　正常对照组,2.3%-18.6%的CD4+T细胞为Th1细胞,0.9%-9.2%为Th2细胞；0.7%-7.1%的细胞仅表达TGF-β, 为Th3细胞.在慢性HBV感染者外周血单个CD4+T细胞中,以Th0细胞居多；而Th1细胞则随着慢性乙型肝炎肝脏炎症活动的加剧而明显增多,在炎症活动明显的慢性乙型肝炎,其Th1百分数明显高于炎症活动呈静止状态的慢性乙型肝炎；Th2细胞在慢性HBV感染的不同阶段则较为恒定(P>0.05),但明显高于对照组(P<0.05).Th3细胞的百分数则随着肝组织炎症活动的加剧,其比例也明显减少(P<0.05),在无症状携带者（AsC）组,Th3细胞的百分数远高于慢性乙型肝炎组及对照组(P<0.05) .Th3细胞重叠于Th2细胞之中.结论　Th1细胞类因子与炎症活动呈正相关,Th2细胞可能与HBV感染的慢性化相关联.而Th3细胞与Th2细胞协同发挥负性免疫调节作用,并可能与慢性HBV感染的免疫耐受状态相关联.