沈阳地区不同人群HCV感染及HCV基因型分布研究

应用酶联免疫检测技术 ,检测沈阳地区 390 2例不同人群血清的抗 - HCV,并应用引物特异 PCR法对其中 10 0例血清标本进行 HCV基因分型。结果 :正常人群抗 - HCV阳性率为 0 .4 2 %～ 1.66% ;输血后及散发性肝炎 (除外 HAV、HBV、EBV、CMV感染 )、乙型肝炎、肝炎后肝硬化 (除外 HBV感染 )、原发性肝癌等组抗 - HCV阳性率显著高于无输血史的非肝病病人组 ( P<0 .0 1) ;10 0例血清标本中 HCV- 型感染占 58%、HCV- 型 2 7%、 / 混合型 14%、未分型 1% ,正常人群HCV感染者中 HCV基因型以 型为主 ( 80 % ) ,丙型肝炎后肝硬化病人 HCV基因型以 型为主( 91.7% )。提示 :各类肝病病人是 HCV感染的高危人群 ;沈阳地区 HCV感染以 型为主 ,其次为 型及 / 混合型 ,HCV基因型可能与丙型肝炎病情轻重有关。     

Nosocomial hepatitis C in a thoracic surgery unit; retrospective findings generating a prospective study

We describe the transmission of hepatitis C virus (HCV) to two patients from a thoracic surgeon who was unaware of his hepatitis C infection. By partial sequencing of the non-structural 5B gene and phylogenetic analysis, the viruses from both patients were found to be closely related to genotype 1a strain from the surgeon. Two further hepatitis C cases were found in relation to the thoracic clinic. Their HCV sequences were related to each other but were of genotype 2b and the source of infection was never revealed. To elucidate the magnitude of the problem, we conducted a prospective study for a period of 17 months in which patients who were about to undergo thoracic surgery were asked to participate. Blood samples were drawn prior to surgery and at least four months later. The postoperative samples were then screened for anti-HCV and, if positive, the initial sample was also analysed. The only two patients (0.4%) identified were confirmed anti-HCV positive before surgery, and none out of 456 evaluable cases seroconverted to anti-HCV during the observation period. Despite the retrospectively identified cases, nosocomial hepatitis C is rare in our thoracic unit. The study points out the risk of transmission of hepatitis C from infected personnel and reiterates the need for universal precautions.     

湖南省美沙酮门诊就诊者感染丙型肝炎病毒基因型特征分析

目的 了解湖南省美沙酮门诊就诊者感染丙型肝炎病毒(HCV)基因型特征。 方法 收集湖南省内14个市州18岁以上、未接受抗病毒治疗、既往HCV抗体阳性的美沙酮门诊患者的血浆样本,每市州样本15份,共210份。对收集到的血浆样本分别进行HCV抗体ELISA复检、荧光PCR法定量HCV-RNA检测和基因分型检测。 结果 在210名调查对象中,ELISA法复检HCV抗体阳性标本202例,阳性率96.19%;荧光PCR法检出HCV- RNA病毒载量>15 IU/ml标本181例,阳性率86.19%。HCV基因型分别为1型18例(9.94%),2/3型51例(28.18%),1型混合2/3型47例(25.97%),其他型别65例(35.91%)。区域分布以非1型为主,2/3型普遍分布。 结论 湖南省HCV基因型比较复杂,有待深入研究。     

成都市男男性行为人群艾滋病及其关联检测结果的分析

[目的]了解成都市男男性行为人群(MSM)人类免疫缺陷病毒(HIV)、梅毒、乙型肝炎病毒(HBV)及丙型肝炎病毒(HCV)的感染状况。[方法]收集成都市MSM人群血液样本469份,进行HIV抗体、HBV标志物、HCV抗体及梅毒抗体测定,HIV抗体确珍阳性者,作CD4+、CD8+T淋巴细胞及CD4+/CD8+比值测定。[结果]469份样本HIV、梅毒、HBV及HCV感染率分别为14.93%(70/469)、8.53%(40/469)、67.16%(315/469)、0.64%(3/469);HIV合并梅毒感染3例,HIV合并HBV感染43例,HIV合并HCV感染1例,HIV合并梅毒及HBV感染5例;70例HIV感染者CD4+T淋巴细胞绝对值计数明显下降,CD4+/CD8+比值均呈倒置,单纯HIV感染组CD4T淋巴细胞计数值与HIV/HBV感染组比较差异无统计学意义(t=0.73,P=0.23),其余各组因样本量太小,与单纯HIV感染组CD4+计数均值比较不具统计学意义。[结论]成都市MSM人群HIV感染呈严重之势,HIV合并HBV、HIV合并梅毒的感染也较普遍,本次检测到的HIV感染者已基本进入艾滋病期,对他们的抗逆转录病毒治疗需要引起足够重视。     

HCV genotyping by combination of the Cobas Amplicor HCV 2.0 test and the reverse hybridization Versant HCV Genotype Assay

Genotyping of hepatitis C virus (HCV) is of relevance to scheduling the treatment of patients with chronic hepatitis C (VHC), making their prognosis and monitoring the treatment efficacy. A set of 62 sera testing HCV RNA positive in Cobas Amplicor HCV 2.0 test (CA) were genotyped using Versant HCV Genotype Assay (LiPA) Bayer, i.e. the reverse hybridization method, with the CA amplified product being directly used in the assay. Fifty-six out of 57 samples reactive in reverse hybridization (92%) were genotyped. One sample showed a profile differing from any genotype, five samples were not reactive and one sample was not tested within this study design. Two out of five non-reactive sera and one non-tested serum could be genotyped by nested PCR based reverse hybridization. It can be concluded that the CA product resulting from one-step HCV RNA amplification is suitable for use in genotyping by reverse hybridization. The CA product based genotyping procedure is easier to perform, less time-consuming and less costly. The nested PCR based procedure could be used for typing of sera with lower HCV concentrations nontypeable with the combination of CA and Versant HCV Genotype Assay. Forty-eight selected samples were typed not only by reverse hybridization but also by a serological kit Murex HCV Serotyping 1-6 Assay (Abbot Murex). Thirty-seven (77%) of these sera, including all of three sera negative in reverse hybridization, appeared typeable by this kit. Although less sensitive, serotyping may be of relevance to typing of sera with low HCV levels or not containing detectable viral NA which are nontypeable by reverse hybridization. Thirty-three sera appeared genotypeable by both of the methods tested with the results being in good agreement. In two cases only the serotyping method revealed one more type of virus (mixed genotype) compared to the reverse hybridization.     

High prevalence of hepatitis C virus infection and genotype distribution among general population, blood donors and risk groups.

The prevalence of hepatitis C virus (HCV) infection in the general population and in various high risk groups in south India was assessed. A total of 258 out of 3589 (7.1%) subjects (both general and risk groups) tested positive for HCV RNA by RT-PCR, while the third generation ELISA detected only 6.1% (221/3589). This suggests that a number of cases go unreported, as screening of blood and blood products is done primarily by ELISA. Among 124 chronic renal failure (CRF) patients with a history of renal transplant or haemodialysis, 37% were found to be positive for HCV RNA by RT-PCR. We also found a significantly higher rate of transmission of HCV among people exposed to tattooing (2.8%) and pilgrims (5.8%) (slashing a cultural practice in one sect of Muslims). In addition, our studies also reveal a high prevalence of HCV infection (44%) among patients with Lichen planus. The most prevalent genotype observed in our population was 1b (43.4%) followed by 3b (30.2%). The other genotype 1a was observed in 16.6% of patients followed by 3a observed in 3.4% of the patients. Our findings suggest that HCV may be the major cause of post-transplant hepatitis in Indian patients with CRF and indicate the necessity for stringent screening procedures for these viral infections.     

抗-HCV阳性血清HCV RNA检测与基因分型的研究

目的 检测抗-HCV阳件血清巾的HCV RNA并进行HCV基因分型.方法 采用荧光定量PCR法检测85例大连地区抗-HCV阳性患者血清中HCV RNA,应用型特异性引物逆转录套式PCR法对HCV RNA阳性样本进行基因分型.结果 85例的抗-HCV阳性患者中,HCV RNA阳性65例(76.5%),其中基因分型1b型32例(49.2%),2a型29例(44.6%),未分型4例(6.2%).结论 抗-HCV阳性并非HCV直接标志,大连地区HCV基冈1b型和2a型基本相等.     

Assessment of the occurrence and basic determinants of hepatitis C virus (HCV) infection among medical students in Silesian voivodeship

HCV infection may result in serious health consequences such as chronic hepatitis C and liver cancer. In Poland, the data on the prevalence of HCV infection is limited and available information suggests an increased risk among young males. The aim of the study was to assess the prevalence of hepatitis C virus (HCV) infection between medical and non medical students, and to explore probable routes of HCV transmission. The project was conducted as a cross-sectional study. The study group included medical students (IV, V and VI year) and non medical students as a control group. The subjects were examined in the period from November 2002 to January 2003, (study group: n = 221; control group: n = 129). Serum samples were tested for antibody to HCV by ELISA method and anti-HCV positive samples were verified using Western Blot Line technique. Probable routes of infection were assessed by questionnaire. Preliminary results obtained in 29% of the target group suggested, that the prevalence of positive anti-HCV among students was 2.6% (95% PU: 1.2%-4.8%). It was higher among non medical than medical students (4.7% vs 1.4%). Anti-hepatitis C virus seropositivity was associated with a history of hepatitis. Verification of 9 positive anti-HCV cases proved only 1 HCV infection. Results presented in this paper are preliminary and will be verified after obtaining data for 600 medical students and for 600 subjects in the control group.     

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。     

A Healthcare-Associated Outbreak of HCV Genotype 2a at a Clinic in Seoul

ObjectivesAn epidemiological investigation was conducted into a hepatitis C virus (HCV) outbreak at an outpatients clinic in Seoul (2011–2012). The aim of the study was to analyze the scale of infection, identify the source of infection, and route of transmission to prevent hepatitis C transmission in the future.MethodsA retrospective study of the outpatients and health care workers (n = 7,285) in the target outpatient clinic during 2011–2012 was conducted. The history of the study population infection with hepatitis C, electronic medical records, field visits, and health care worker interviews were examined for the period between March 1^st, 2006 and March 25^th, 2016. The blood samples were collected and tested for anti-HCV antibodies, HCV RNA and HCV gene in 2016.ResultsThe rate of anti-HCV positive results was 4.4% in the study population. The risk factors associated with an anti-HCV positive result were ≥ 10 clinic visits, and receiving an invasive procedure including a nerve block and a block of the peripheral branch of the spinal nerve (p < 0.05). There were 112 HCV RNA positive cases out of 320 anti-HCV positive test result cases, amongst which 100 cases had the dominant HCV genotype 2a which formed either 1 cluster (n = 56) or 2 clusters (n = 25). This result indicated exposure to a high-association infection source.ConclusionAnti-HCV antibodies and genotypic analysis showed an epidemiological association between the outbreak of HCV and invasive procedures performed (2011–2012) at an outpatients clinic in Seoul.     

Prevalence and incidence of hepatitis C virus infection in the US military: a seroepidemiologic survey of 21,000 troops

Because of a high prevalence of hepatitis C virus (HCV) infection (10-20%) among veterans seeking care in Department of Veterans Affairs (VA) hospitals, current US military forces were evaluated for HCV infection. Banked serum samples were randomly selected from military personnel serving in 1997 and were tested for antibody to HCV (anti-HCV). Overall prevalence of anti-HCV among 10,000 active-duty personnel was 0.48% (5/1,000 troops); prevalence increased with age from 0.1% among military recruits and active-duty personnel aged <30 years to 3.0% among troops aged >/=40 years. Prevalence among 2,000 Reservists and active-duty troops was similar. Based on sequential serum samples from 7,368 active-duty personnel (34,020 person-years of observation), annual incidence of infection was 2/10,000. Of 81 HCV RNA-positive troops for whom genotype was determined, genotypes 1a (63%) and 1b (22%) predominated, as in the civilian population. These data indicate that HCV infection risk among current military forces is lower than in VA studies and the general civilian population aged <40 years. The low level of HCV infection may be attributed to infrequent injection drug use in the military due to mandatory testing for illicit drugs prior to induction and throughout military service.     

Prevalence of hepatitis C virus infection in north-eastern Brazil: a population-based study

In general, the prevalence and genotype distribution of hepatitis C virus (HCV) are estimated based on the ambulatory clinic or hospital population. In the present work, a population-based study was conducted to estimate the prevalence of HCV infection in Salvador, Brazil. A total of 1308 serum samples were collected from 30 "sentinel areas", and the prevalence of HCV infection was determined by ELISA and confirmed by recombinant immunoblot assay and RT-PCR. The overall prevalence of HCV infection was 1.5% (20/1308). Prevalence was greater among those aged 35 years or older and those with more education. Genotype 3 was the most common (53.3%), followed by genotypes 1 (40%) and 2 (6.7%). These observations are different from those found in a prior survey of hospital and ambulatory patients in Salvador, who were most frequently infected with genotype 1, followed by genotypes 3 and 2, respectively.     

Hepatitis virus and HIV infections in inmates of a state correctional facility in Mexico

We sought to determine the prevalence and associated characteristics of hepatitis A, B, C and D viruses and HIV infections in a prison in Durango, Mexico. Sera from 181 inmates were analysed for HAV antibody, hepatitis B core antibody (HBcAb), hepatitis B surface antigen (HBsAg), HCV antibody, HDV antibody, HIV antibody and HCV genotypes. Prevalence of HAV antibody, HBcAb, HBsAg, HCV antibody, HDV antibody and HIV antibody were 99.4, 4.4, 0.0, 10.0, 0.0 and 0.6% respectively. HCV genotype 1a predominated in HCV-infected inmates (62.5%), followed by HCV genotype 1b (25%) and HCV genotype 3 (12.5%). An association between HBV infection and age > 30 years was found. HCV infection was associated with being born in Durango City, history of hepatitis, ear piercing, tattooing, drug abuse history, intravenous drug use and lack of condom use. We concluded that the prevalence of HAV, HBV, HDV and HIV infections in inmates in Durango, Mexico were comparable to those of the Mexican general population and blood donors, but lower than those reported in other prisons around the world. However, HCV infection in inmates was higher than that reported in Mexican blood donors but lower than those reported in other prisons of the world. These results have implications for the optimal planning of preventive and therapeutic measures.     

Hepatitis C virus infections in the Democratic Republic of Congo exhibit a cohort effect

The prevalence and genetic diversity of hepatitis C virus (HCV) and human pegivirus (HPgV) in many regions of sub-Saharan Africa is poorly characterized, including in the Democratic Republic of Congo – the largest country in the region and one of the most populous. To address this situation we conducted a molecular epidemiological survey of HCV and HPgV (previously named GB Virus C or hepatitis G virus) in samples collected in 2007 from 299 males from the DRC, whose ages ranged from 21 to 71 years old. Samples were tested for the presence of HCV antibodies by ELISA and reactive samples were subsequently tested for HCV RNA using RT-PCR in which both the HCV Core and NS5B genome regions were amplified. Remaining samples were tested for HPgV RNA and the HPgV NS3 genome region of positive samples was amplified. For HCV, 13.7% of the samples were seropositive (41/299) but only 3.7% were viremic (11/299). HPgV RNA was found in 12.7% (33/259) of samples. HCV viremia was strongly associated with age; the percentage of samples that contained detectable HCV RNA was ∼0.5% in those younger than 50 and 13% in those older than 50. Our study represents the first systematic survey of HCV genetic diversity in the DRC. HCV sequences obtained belonged to diverse lineages of genotype 4, including subtypes 4c, 4k, 4l and 4r, plus one unclassified lineage that may constitute a new subtype. These data suggest that HCV in the DRC exhibits an age ‘cohort effect’, as has been recently reported in neighbouring countries, and are consistent with the hypothesis that HCV transmission rates were higher in the mid-twentieth century, possibly as a result of parenteral, iatrogenic, or other unidentified factors. Different HCV subtypes were associated with individuals of different ages, implying that HCV infection in the DRC may have arisen through multiple separate HCV epidemics with different causes.     

丙型肝炎病毒核心抗原在丙肝检测中的应用分析

目的探讨丙型肝炎病毒核心抗原在丙肝感染诊断中的临床应用价值。方法采用荧光定量聚合酶链反应(FQ-PCR)对162例疑似HCV感染者血清进行HCV RNA检测,同时用ELISA法对其进行HCV核心抗原和抗-HCV检测。结果 162例样本中,抗-HCV阳性率64.20%(104/162),HCV RNA阳性率51.85%(84/162),HCV核心抗原阳性率35.19%(57/162);HCV RNA和HCV核心抗原均阳性样本57例,二者符合率为67.86%;HCV核心抗原和HCV RNA阳性而抗-HCV阴性者1例。结论 HCV核心抗原是HCV早期感染的标志之一,检测HCV核心抗原有利于HCV感染的早期诊断。     

The occurrence of hepatitis B and C viruses in Pakistani patients with chronic liver disease and hepatocellular carcinoma.

To study the occurrence of hepatitis B virus (HBV) and hepatitis C virus (HCV) in patients with chronic liver disease (CLD) and hepatocellular carcinoma (HCC) in Pakistan, blood samples from 105 sequential patients with biopsy-proven CLD (n = 82) and HCC (n = 23) were tested for HBV and HCV markers. Of the 105, 87 (83%) had evidence of hepatitis B exposure, 58 (55%) were positive for hepatitis B surface antigen (HBsAg), 23 (22%) had hepatitis C antibodies and 25 (24%) had detectable HCV RNA. Significantly more patients with HCC had evidence of HBV exposure in the absence of HCV markers (49/82 vs. 20/23, odds ratio 4.49, 95% CI 1.17-25.16). The proportion of patients positive for HBsAg with no HCV markers was also significantly higher in the HCC group (34/82 vs. 18/23, odds ratio 5.08, 95% CI 1.59-18.96). There were more patients with only HCV markers in the CLD group than the HCC group but the difference was not statistically significant (19/82 vs. 1/23, odds ratio 6.63, 95% CI 0.93-288.01). A modified non-isotopic restriction fragment length polymorphism study on PCR products was used to investigate the epidemiology of HCV genotypes in Pakistan. Due to depletion of the initial samples, a second series of specimens collected one year afterwards was used. Fifteen out of 40 samples had amplifiable product and all were identified as type 3. A commercial serological typing method on the same samples also confirmed that type 3 was the predominant HCV genotype in Pakistan.     

我国部分地区丙型肝炎病毒基因分型研究

目的：研究中国丙型肝炎病毒（HCV）基因型分布。方法：应用AmplicorPCR试剂盒检测北京、青岛、固安和周口等地27例抗－HCV阳性的单采浆供血员和36例慢性丙型肝炎病人血清HCV RNA,并对其中36例HCV RNA阳性者用INNO－LiPA^TMHCV II试剂进行HCV基因分型。结果：抗－HCV阳性的单采浆供血员和慢性丙型肝炎病人HCV RNA检出率0分别为48.15％（13／27）和69.44%(25／36）,平均为60.32％（38／63）。对13例HCV RNA阳性的单采浆供血员和23例慢性丙型肝炎病人HCV基因分型结果表明,29例（80.55％）为1b型,5例（13.89％）为2型,另2例（5.56％）不能被分型。结论：上述调查地区流行的HCV基因型以1b型占优势。     

2009-2011年重庆口岸出入境人群梅毒感染及梅毒与HIV/HCV/HBV合并感染分析

目的了解重庆口岸出入境人群梅毒感染状况及与梅毒、艾滋病病毒(HIV)、乙肝、丙肝共感染状况。方法对2009-2011年在重庆口岸出入境的人群开展HIV、梅毒、乙肝、丙肝检测,对个案资料进行统计学分析。结果 2009-2011年重庆口岸共监测出入境人员54100名,梅毒抗体阳性963例,检出率1.78%。合并感染情况为:963例梅毒阳性感染者中,乙肝合并感染91例;梅毒与HIV合并感染4例,占HIV感染总数的10%(HIV阳性40例);梅毒与丙肝合并感染10例;梅毒、乙肝、丙肝三种合并感染2例;梅毒、乙肝、HIV合并感染1例;总合并感染率0.20%。结论应加强我国国境口岸出入境人员梅毒监测工作,尤其是劳务人员的监测,制定有效的防控对策,以防止梅毒通过国境口岸传播。     

PCR-反向点杂交检测武汉地区丙型肝炎病毒的基因分型

目的了解武汉地区慢性丙型肝炎患者的HCV基因分型,为合理选择治疗方案及疗效预测提供理论依据。方法用PCR-反向点杂交技术对82份HCV-RNA阳性的血清进行基因分型,并对PCR产物测序验证,同时分析患者的性别、丙型肝炎临床类型与基因型分布相关性。结果 82份HCV感染样本共检出4种基因型,分别为lb、2a、3b和6a型,其中1b占73.1%,2a占14.6%,3b占7.3%,6a型占5.0%,各型测序结果与GenBank相应序列一致,1b型患者中重度型丙型肝炎发病率显著高于其他各型(P<0.05),基因型分布差异与性别无关。结论武汉地区HCV基因型主要为1b型,其次为2a型,与中国其他地区HCV基因型分布相一致,1b型患者临床症状较其他类型重,输血是丙型肝炎传播的主要途径,PCR-反向点杂交技术检测丙型肝炎病毒基因分型结果准确可靠、操作简便,具有临床推广和应用价值。     

Occult Hepatitis B Infection in the Immigrant Population of Sicily, Italy

In Italy, about 7 % of the resident population is represented by immigrants originating from geographic regions at high endemicity for hepatitis B virus infection. This study aims to assess the prevalence of occult HBV infection (OBI) including the identification of HBV-genotypes in a population of immigrants serologically negative for hepatitis B surface antigen (HBsAg). Between May 2006 and May 2010, 339 immigrants were tested for markers of HBV, hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infections. HBV-DNA was tested by using nested-PCR assays on three different genetic region. HBV-DNA was detected in plasma samples of 11/339 (3.2 %) patients. Most of them had no serological markers of HBV infection, 3/58 (5.2 %) were anti-HBc-alone, and 4/13 (30.8 %) were anti-HIV positive. HIV positivity was the only factor independently associated with the higher probability of observing OBI (OR = 16.5, p < 0.001). No HCV co-infected patients were found. Genotype D was detected in 9/11 (81.8 %) OBI cases, while the remaining two (18.2 %) were classified as genotype E. Although OBI was found at lower rate than expected among immigrants from highly endemic countries, anti-HBc alone positivity was confirmed as a sentinel marker of occult HBV infection. Nevertheless, a marked heterogeneity of HBV markers was found among HBV-DNA positive subjects. Our finding evidenced the predominance of HBV-genotype D viral strains among OBI cases, also in those from geographical areas where overt HBV infections are mainly sustained by viral genotypes other than D.