老年病毒性肝炎病因学分析

总结１６０例６０岁以上老年性病毒性肝炎的病毒类型，并与１００例２０～３５岁年龄组肝炎进行对照。近年老年性肝炎组有以下特点：①仍以乙型肝炎为主（占３３．８％）；丙型及戊型肝炎各占２３．２％及１６．３％，较青年组多见；②重叠肝炎病毒感染多（２８／１６０例，占１７．５％），占老年组重症肝炎３２．１％。重叠感染中慢性肝炎基础以乙型肝炎为主，丙型肝炎少见，重叠感染中急性肝炎以戊型及丙型多见；③临床类型以急性肝炎、慢性重症肝炎、肝炎肝硬化多见；急性肝炎中以戊型肝炎为主，而慢性重症肝炎、肝炎肝硬化以乙型肝炎为主。④丙型肝炎中８６．４％及重叠感染中４２．９％有输血制品或（和）手术史。     

艾滋病合并丙肝的分析

目的:探讨艾滋病病毒重叠丙型肝炎病毒感染相互之间对疾病的进程的影响。方法:选择2015年12月至2016年12月期间我院收治的50例艾滋病合并丙型肝炎患者作为观察组,另选同期50例未合并艾滋病的丙型肝炎患者作为对照组,对两组患者的临床资料进行回顾分析。结果:观察组中50例艾滋病合并丙型肝炎患者,经吸毒感染38例(占76.0%)、经输血或献血感染9例(占18.0%)、经性途径传染3例(占6.0%);两组患者的肝损伤情况比较具有统计学意义(P0.05);观察组患者的ALT、AST、TBIL等指标高于对照组,组间差异具有统计学意义。结论:艾滋病病毒重叠丙型肝炎毒感染可能会进一步促使丙肝发展,增加患者的肝损伤几率。     

老年病毒性肝炎病因学分析

总结１６０例６０岁以上老年性病毒怀肝炎的病毒类型，并与１００例２０～３５岁年龄组肝炎进行对照。近年老年性肝炎组有以下特点：（１）仍以乙型肝炎为主（占３３．８％），丙型及戊型肝炎各占２３．２％及１６．３％，较青年组多见；（２）重叠肝炎病毒感染多（２８／１６０例，占１７．５％）占老年组重症肝炎３２．１％，重叠感染中慢性肝炎基础以乙型肝炎为主，丙型肝炎少见，重叠感染中急性肝炎以戊型及丙型多见；（３）临床     

甲乙丙型病毒性肝炎合并感染的临床调查

甲乙丙型病毒性肝炎合并感染的临床调查张慧群，孔祥寰（铜陵市人民医院传染科２４４０００）我国是病毒性肝炎高发区，甲、乙型肝炎发病率很高，随着近几年丙型肝炎抗体１ｇＧ检测的普及，发现三型肝炎重叠感染亦很多。乙、丙两型肝炎重叠，往往可使病程延长、病情加重。...     

妊娠合并病毒性肝炎37例临床分析

目的探讨肝炎与妊娠的关系。方法分析37例妊娠合并病毒性肝炎病例，甲型肝炎1例，乙型肝炎25例，丙型肝炎2例，戊型肝炎5例，乙、丙型肝炎病毒重叠感染1例，乙、戊型肝炎病毒重叠感染1例，病原未明2例。早期妊娠7例，中期妊娠12例，晚期妊娠18例。结果妊娠合并病毒性肝炎以乙型肝炎居多，随着妊娠周数增加，肝炎发病率、重型肝炎发生率及病死率增加。结论对妊娠合并肝炎患者的处理，需视不同的病程、病情采取相应的措施。     

HIV感染孕妇合并乙肝和丙肝的患病率

目的：本研究旨在评估到医疗机构接受产前检查的HIV感染孕妇合并乙肝和丙肝的患病率。研究设计：回顾去标识研究产科HIV资料库中患者的人口统计学特点、感染的危险因素、性传播疾病史和最初的CD4计数。结果：11年中，455例HIV感染妇女中有572次妊娠和分娩，这些患者中有6．3％合并乙型肝炎病毒感染或丙型肝炎病毒感染。更确切地说，有1．5％的患者合并乙型肝炎病毒感染，4．9％合并丙型肝炎病毒感染。合并肝炎病毒感染的患者中吸毒（52％13518％，P〈0．01）和酗酒（38％体5％，P〈0．01）的比例更高。出现合并感染的患者年龄较大（28岁vs25．6岁，P=0．04），但无种族差异。合并乙型肝炎病毒感染患者的CD4计数中位基线值（310个细胞／μl）显著低于合并丙型肝炎病毒感染患者（453个细胞／μl）及单纯HIV感染的患者（414个细胞／μl）。结论：约1／16的HIV感染孕妇合并乙型肝炎病毒或丙型肝炎病毒感染。本研究还发现，免疫功能降低的患者似乎更易合并乙型肝炎病毒感染。     

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。     

海南澄迈县在押吸毒人员丙型肝炎病毒检测分析

目的了解澄迈县高危人群中丙型肝炎病毒感染情况。方法用酶联免疫吸附试验（EusA法）检测澄迈县戒毒所715名在押吸毒人员血清标本中的丙型肝炎病毒IgG抗体。结果715例标本中检测出HCV抗体阳性标本388例,阳性率为54．27％,其中301例曾经共用针具的吸毒者256例HCV抗体阳性率为85．04％,90例单独使用针具吸毒者中阳性率为38．89％,324例单纯12I吸的吸毒者阳性率为29．73％。三组比较差异有统计学意义（χ2=14．31,P〈0．05）结论丙型肝炎病毒已在共用针具的吸毒者中广泛传播,在该人群中开展预防丙型肝炎病毒感染工作非常必要,应积极采取措施杜绝共用针具吸毒。     

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。     

乌鲁木齐吸毒人群HBV、HCV感染状况的调查

目的调查乌鲁木齐吸毒者乙、丙型肝炎病毒感染状况。方法以ELISA法对乌鲁木齐125例吸毒者乙、丙型肝炎病毒进行血清流行病学调查。结果125例吸毒者中HBsAg携带率（12．08％）汉族高于维族和回族；HBV感染率维、汉、回族分别是53．85％、85．71％和100％，显然回族高于汉族和维族（P均〈0．05）；并且HBV感染率和抗-HCV以静脉吸毒最高，混合吸毒其次，口吸最低。结论吸毒者中的HBsAg携带率高于一般人群且汉族高于维族和回族，该吸毒中HBV感染亦高，应采取防治措施。     

Update on chronic viral hepatitis

Many recent and significant advances in the field of chronic viral hepatitis, including therapy, suggest that an update on chronic hepatitis is timely. Chronic hepatitis B virus infection remains a significant worldwide cause of liver cirrhosis and hepatocellular carcinoma, despite the wide availability of a long established and effective vaccine. Transmission occurs via perinatal, sexual, and parenteral routes (particularly intravenous drug abuse and although blood products still carry a risk, this is now extremely low in Western countries). Only a minority of infected adult cases develop chronic hepatitis but in children under 1 year, 90% develop chronic hepatitis. The clinical spectrum of chronic liver injury ranges from mild inflammation to end stage liver cirrhosis. Interferon alfa has been the mainstay of treatment for patients with active disease but nucleoside analogues (lamivudine and adefovir) are now available with similar efficacy. Patients with end stage liver disease and hepatocellular carcinoma can be offered transplantation but infection in the graft is commonplace. The combination of hepatitis B immunoglobulin and newer antiviral drugs reduce the incidence and severity of graft infection significantly. The hepatitis C virus epidemic of the latter half of the 20th century now affects more than 1% of populations worldwide. This RNA virus is spread parenterally and is becoming the leading indication for liver transplantation. The majority of patients develop chronic hepatitis, which may be progressive, evolving to significant liver disease (cirrhosis or hepatocellular carcinoma) in about 20% cases after decades. Treatment with the combination of interferon alfa and ribavirin is successful in up to 40% cases. Liver transplantation is a therapeutic option for some but graft infection is universal and often complicated by progressive liver fibrosis. A vaccine remains a remote prospect so that prevention is crucial. Hepatitis D virus infection occurs on a background of hepatitis B virus infection and can also cause liver damage. The response to antiviral therapy is poor. The newer "hepatitis" viruses G and TT do not cause significant liver injury.     

Hepatitis C virus in intravenous drug users

Sera from 172 intravenous drug users were tested for the presence of antibodies to hepatitis C virus (anti-HCV). The results were analysed in relation to aspects of the history of drug use and evidence of liver disease. The presence of anti-HCV was strongly associated with duration of intravenous drug use. Two-thirds of patients were anti-HCV seropositive within two years of commencing regular intravenous drug use, and there was 100% seropositivity among people injecting drugs for more than eight years. Seropositivity for hepatitis C virus closely paralleled exposure to hepatitis B virus, which was also endemic in this population. In contrast, only one patient tested positive for antibodies to the human immunodeficiency virus. The presence of anti-HCV correlated poorly with biochemical markers of hepatitis. About half the patients with anti-HCV had normal serum levels of alanine aminotransferase, whereas an abnormal liver biochemistry was frequently observed in anti-HCV seronegative subjects. Previous studies of non-A, non-B hepatitis that have used abnormal liver biochemistry as a marker have underestimated the prevalence of chronic hepatitis among intravenous drug users; the use of a specific screening test reveals that infection with hepatitis C virus is very common in this population.     

2010～2011年永济市吸毒人员艾滋病哨点监测结果分析

目的了解我市吸毒人群中艾滋病、梅毒和丙肝的感染率变化趋势以及吸毒行为的变化情况,以获得我市艾滋病流行趋势及危险因素,及时总结我市艾滋病哨点监测工作经验及监测工作中存在的问题,更好地有针对性地开展艾滋病宣传教育及防治工作。方法按照中国疾病预防控制中心性艾中心艾滋病哨点/丙肝哨点监测实施方案要求进行监测。结果 2010~2011年我市监测的吸毒人员均为男性,青壮年、已婚者居多,多数吸毒者为初中以下文化,吸毒人群的吸毒方式以口吸为主,大都吸食海洛因。2010年监测的421例吸毒人员中有商业性行为占14.01%,静脉注射吸毒者占16.15%,共用针具者占19.12%,HIV抗体阳性1例,阳性检出率为0.24%,梅毒抗体检测阳性8例,检出率为1.90%,丙肝抗体阳性46例,检出率为10.93%。2011年监测的411例吸毒人员中有商业性行为者占21.41%,静脉注射吸毒者占22.87%,共用针具者占37.23%,未检出HIV抗体阳性者,梅毒抗体检测阳性23例,检出率为5.59%,丙肝阳性56例,检出率为13.63%。结论我市被调查的吸毒人群中艾滋病感染率较低,梅毒、丙肝感染率较高,呈上升趋势;静脉注射吸毒、共用针具、商业性行为等危险行为发生率有所升高。在吸毒人群中加强艾滋病防治知识,进行健康教育和行为干预刻不容缓。     

Epidemiology of hepatitis D virus (delta) infection in Melbourne over a 15-year period

The prevalence of delta infection was studied in 3986 individuals seropositive for hepatitis B surface antigen (HBsAg), who were seen in Melbourne between 1971 and 1985. The group comprised 2004 patients with acute hepatitis B, 1820 asymptomatic HBsAg carriers, 139 HBsAg carriers with evidence of chronic liver disease, and 23 carriers who had suffered more than two separate attacks of acute hepatitis. Markers of delta infection were found almost exclusively among intravenous drug abusers and their close contacts. Studies of stored sera suggest that delta infection was introduced into this group about 1970. In carriers with no evidence of chronic liver disease, the prevalence of delta infection was highest among intravenous drug abusers (19.2%). In carriers with evidence of chronic liver disease, delta markers were present in 20.1% and all 23 carriers with recurrent acute hepatitis had evidence of infection with the delta virus.     

Hepatitis B in general practice: epidemiology, clinical and serological features, and control

In an outbreak of hepatitis B virus infection in a south Wales village 31 cases were identified over 16 months. Spread of the infection was by sharing needles and by sexual contact. Twenty seven patients were known to have symptoms, of whom nine had an anicteric illness. Generally the illness was mild with no deaths, and there was only one chronic carrier. Two patients were only transiently positive for hepatitis B surface antigen. The outbreak was controlled by vigorous contact tracing and counselling. Despite an enormous increase in workload for the general practitioner and problems including disposal of contaminated needles, outbreaks of hepatitis B virus infection may adequately be treated in the community.     

Intravenous drug users who present to the Albion Street (AIDS) Centre for diagnosis and management of human immunodeficiency virus infection

Intravenous drug users who presented to the Albion Street (AIDS) Centre for human immunodeficiency virus (HIV) antibody screening during the period March 1, 1985 to January 31, 1989, were included in this study. Information on medical history and HIV risk-related behaviour was collected by means of a standardized, computer-coded medical record. Of the 1222 intravenous drug users in this study, 72.3% were men, 26.9% were women and 0.8% were transsexual, with 60.1% of the total claiming exclusive heterosexuality. Of the sample, 40.2% were current intravenous drug users, and 86.8% recorded having shared needles and syringes. Among this sample, the over-all prevalence of HIV seropositivity was 14.5%. Of subjects who were diagnosed as HIV seropositive, 43.8% were homosexual men, 13.1% were bisexual men and 5.3% were heterosexual men. Of all intravenous drug users, 49.9% had a history of at least one sexually-transmitted disease, with 21.8% reporting a history of more than one. Fifty-two per cent of the sample reported that they had been infected with hepatitis B previously. There was no over-all increase in the annual rate of HIV infection among this population of intravenous drug users. The sexual activity and prevalence of hepatitis and other sexually-transmitted diseases among this group are suggestive of widespread, continuing risk behaviour.     

干性CD44异常活化对脂肪积聚肝细胞恶性转化的影响*

非酒精性脂肪性肝病(nonalcoholic fatty liver disease, NAFLD)已成为最常见慢性肝病之一,并逐步成为继乙肝病毒(hepatitis B virus, HBV)和丙肝病毒(hepatitis C virus, HCV)感染外诱发肝细胞性肝癌(hepatocellular carcinoma, HCC)的主要致病因素,其发病机制复杂。新近发现,脂肪积聚肝组织中干性CD44(stemness CD44, CD44)异常活化,可能与肝细胞的恶性转化相关。本文综述了CD44异常激活影响脂肪积聚肝细胞恶性转化的研究进展。     

静脉注射毒品者的血源性感染

目的了解静脉吸毒者的血源性全身感染状况，以指导诊断和治疗。方法将2001年1月-2004年12月收治的18例静脉吸毒者的全身感染作回顾性分析。结果全部病例均有右心感染性心内膜炎和多发性肺脓肿，伴发肺栓塞4例、多发性脑脓肿2例、丙型肝炎3例、乙型肝炎1例。血培养结果：金黄色葡萄球菌阳性13例，其中1例同时白色念珠菌阳性；铜绿假单胞菌阳性2例；草绿色链球菌阳性3例。予青霉素、阿米卡星、头孢他啶、去甲万古霉素等治疗6周左右，除伴发脑脓肿的2例死亡、伴白色念珠菌感染1例自动出院外，余均治愈。结论静脉吸毒者血源性全身感染常见有右心感染性心内膜炎、多发性肺脓肿、肺栓塞、多发性脑脓肿、丙型肝炎、乙型肝炎等，其中脑脓肿尤具致命性。血培养阳性率高，经合理治疗后效果较好。     

上海市浦东新区HIV高危人群感染HBV和HCV的流行病学调查

目的 了解上海市浦东新区HIV高危人群的乙肝病毒（HBV）、丙肝病毒（HCV）感染状况,分析危险因素,建立更有针对性的HBV、HCV防制策略。方法 采用整群抽样和连续抽样等方法抽取2019—2020年浦东新区HIV高危人群,开展问卷调查、实验室检测,描述并比较HBV、HCV感染率的异同,采用Logistic回归分析HBV、HCV感染的危险因素。结果 共调查5 784人,HIV感染率为2.46%,HBV感染率为7.16%,HCV感染率为2.52%,HBV-HCV合并感染率为0.14%,HIV-HBV合并感染率为0.21%,HIV-HCV合并感染率为0.03%,无HIV、HBV、HCV合并感染者。HBV感染的危险因素为年龄45岁以上、男性、高中以上文化程度、肝炎家族史、手术治疗史、牙科诊疗史、静脉注射吸毒、针灸史、创伤性美容、修面或修足、不安全性行为。HCV感染的危险因素为年龄35岁以上、本市户籍、婚姻状况离异或丧偶、输血或血制品、静脉注射吸毒,婚姻状况已婚为保护因素。结论 浦东新区HIV高危人群HBV、HCV感染率高于一般人群,建议加强HIV高危人群的HBV、HCV筛查工作,通过接种乙肝...     

乙型肝炎合并HFRS与HFRS临床对比分析

目的探讨乙型肝炎合并肾综合征出血热（ＨＦＲＳ）对ＨＦＲＳ临床及乙肝病毒血清学标志（ＨＢＶＭ）的影响。方法采用Ａｕ－５６０全自动生化分析仪检测肝、肾功能，酶联免疫吸附试验（ＥＬＩＳＡ）检测ＨＢＶＭ，聚合酶链反应（ＰＣＲ）技术检测ＨＢＶＤＮＡ，并与３０例ＨＦＲＳ进行临床对比分析。结果合并感染肝、肾损伤轻，对乙肝病毒（ＨＢＶ）有短期抑制作用。结论两种嗜病毒合并感染并未加重病情及肝脏损伤。