2009年甲型及戊型肝炎病毒IgM抗体检测结果分析

目的 分析2009年甲型和戊型肝炎病毒IgM抗体(抗HAV-IgM和抗HEV-IgM)检测情况.方法 收集血清3169份,采用捕获法测抗HAV-IgM和抗HEV-IgM.结果 3169份中,检测抗HAV-IgM者1593份,抗HAV-IgM阳性118份(7.4%);检测抗HEV-IgM者1576份,抗HEV-IgM阳性82份(5.2%).甲型肝炎高发于第二季度和第四季度,戊型肝炎高发于第一季度和第二季度.甲型肝炎和戊型肝炎均好发于30岁以上的成年人,以男性居多.结论 在非流行年份中,尽管抗HAV-IgM和抗HEV-IgM的阳性率相对较低,两型肝炎在一年中均有发病高峰,应引起泛关注.     

戊型肝炎患者血清抗HEVIgM消长的临床研究

目的探讨戊型肝炎患者血清抗HEVIgM在肝炎病程中的消长和临床意义.方法应用酶联免疫方法(ELISA)检测患者系列血清抗HEVIgM.结果住院第一周抗HEVIgM检测均为阳性,住院第三周抗HEVIgM阳性数明显下降,至第五周大部分血清抗HEVIgM检测均为阴性.结论散发性戊型肝炎患者血清抗HEVIgM急性早期出现,肝功能恢复期阳性率明显下降并逐渐转阴.抗HEVIgM阳性持续时间短,是戊型肝炎早期诊断的重要指标.     

内蒙古地区庚型肝炎病毒感染分析

目的:分析内蒙地区不同民族,不同年龄人群庚型肝炎病毒感染及致病情况.方法:采用EUSA方法对298例健康人群和111例肝炎患者中进行抗-HGV检测.结果:健康人群HGV感染率为2.5%.汉族为1.69%.在肝炎患者中蒙古族HGV感染率38.7%,汉族为18.75%.健康人群HGV感染率为2.01%.肝炎患者为24-32%.结论:蒙古族HGV感染在健康人群或肝炎患者中都明显高于汉族人群.肝炎患者HGV感染明显高于健康人群.     

急性散发性戊型肝炎患者戊肝抗体分析

急性散发性戊型肝炎 (戊肝 )在我国广泛存在。目前检测戊肝的实验方法有戊肝抗体 (抗＿ＨＥＶ) ,免疫电镜检测病毒颗粒和检测ＨＥＶ＿ＲＮＡ。但由于病毒颗粒在体内降解 ,进入肠道的ＨＥＶ不易检测到。而应用ＲＴ＿ＰＣＲ方法虽较为灵敏 ,但病毒血症高峰期出现于丙氨酸氨基转移酶 (ＡＬＴ)顶峰及临床症状前［１］,因此 ,戊肝的实验室检测仍以抗体检测为主。笔者对９２例戊肝患者及９０例健康体检者血中戊肝抗体ＩｇＭ(抗＿ＨＥＶ＿ＩｇＭ）及戊肝抗体ＩｇＧ（抗＿ＨＥＶ＿ＩｇＧ）测定 ,以期探讨戊型肝炎患者抗体出现特点。１资料与方法１ …     

自身抗体在自身免疫性肝病中的表达及临床价值

目的研究自身抗体在自身免疫性肝病患者中的表达及临床价值。方法间接免疫荧光法检测自身免疫性肝病患者血清中的自身抗体。结果 36例AIH患者抗平滑肌抗体（ASMA）阳性率58.33%,抗肝肾微粒体抗体Ⅰ型（LKM-1）阳性率5.56%,抗可溶性肝抗原抗体（SLA）阳性率2.78%和抗线粒体抗体Ⅱ型（AMA-M2）阳性率8.33%;48例PBC患者抗线粒体抗体Ⅱ型（AMA-M2）阳性率97.92%,其他抗肝抗原自身抗体均阴性。AIH和PBC患者抗核抗体（ANA）阳性率分别为77.77%、100%。5例PSC患者ANA阳性率60%,抗肝抗原自身抗体均为阴性。31例健康体检者ANA只检测1例阳性,抗肝抗原自身抗体均为阴性。自身免疫性肝病各组阳性检出率与健康对照组之间比较差异具有统计学意义（P〈0.01）。结论抗核抗体（ANA）及抗肝抗原自身抗体的检测对自身免疫性肝病的诊断和分型具有重要价值。     

肝炎病人和健康人群乙型肝炎病毒感染三项标志检测结果的分析

本文报告肝炎病人和健康人群HBV感染三项标志检测结果的分析。抗HBc、HBsAg的和抗HBs分别用ELISA、R-PHA和PHA检测。肝炎病人是从住院确诊为肝炎的患者中随机抽样,共检测98例:其中男性87例,女性11例;年龄17～64岁。健康人群共检测333名(男性290名,女性43名);年龄18～42岁。98例肝炎病人的抗HBc、ABsAg和抗HBs阳性数分别为70、59和23例,阳性率为71.4%、60.2%和     

公共场所从业人员甲、戊型肝炎IgM阳性率的调查分析

目的调查分析公共场所从业人员甲、戊型肝炎IgM阳性率。方法对40182名公共场所从业人员进行甲肝、戊肝检查,分析甲、戊型肝炎IgM阳性率情况及与性别的关系。结果 2017年公共场所从业人员甲型肝炎IgM阳性率为0.40%(159/40182),其中女性占59.12%(94/159),男性占40.88%(65/159);戊型肝炎IgM阳性率为0.8%(33/40182),其中女性占49.23%(32/65),男性占50.77%(33/65)。甲型肝炎IgM阳性率显著高于戊型肝炎IgM阳性率(χ~2=13.284,P <0.05),女性甲型肝炎IgM阳性率显著高于男性(χ~2=6.253,P <0.05),女性与男性戊型肝炎IgM阳性率比较无显著差异(χ~2=0.612,P> 0.05)。结论公共场所从业人员中甲型肝炎IgM阳性率较高,且女性多于男性,而戊型肝炎IgM阳性率相对低,且无明显的性别差异,应加强对公共场所从业人员的健康教育以及卫生管理,使甲型肝炎与戊型肝炎的流行得到有效的控制。     

大理地区不同血清学检测试剂对鸡血中HEV的检测

目的：了解大理地区鸡中戊型肝炎病毒（HEV）感染情况及比较两家公司生产的HEV检测试剂对鸡血清HEV抗体的检测效果。方法分别采集大理古城和下关菜市场鸡血92份和91份,应用两家公司生产的HEV抗体试剂盒检测鸡血清中HEV抗体。结果183份鸡血清中用试剂A1、A2、B1和B2检测,分别检出2份、2份、2份和3份阳性结果,阳性率分别为1.09%、1.09%、1.09%和1.64%。两家公司生产的戊型肝炎病毒IgM抗体诊断试剂和戊型肝炎病毒IgG抗体诊断试剂对同一份鸡血清检测,没有相同的阳性结果,阴性结果符合率很高。结论大理地区鸡中存在HEV,同时两家公司生产的HEV抗体检测试剂可以作为研究鸡群中HEV的流行病调查,但检测灵敏度不高,需研制更灵敏的检测试剂。     

贵州存在戊型病毒性肝炎

对180例病毒性肝炎患者进行了血清抗-HEV的检测,并对急性肝炎进行了病原学分型研究。抗-HEV总阳性率为11.11％(20/180)。亚急性重型肝炎患者血清抗-HEV阳性率最高达33.33％(2/16),急性肝炎和慢性活动性肝炎血清抗-HEV的阳性率分别为11.13％(17/154)与7.14％(1/14)。17例抗-HEV阳性的急性肝炎患者血清学上无甲、乙、丙、丁肝炎病毒、CMV和EBV感染标志。戊型肝炎在急性肝炎中的比例为11.03％。结果提示贵州存在有戊型肝炎。     

云南省1991—1992年丙型肝炎监测报告（摘要）

本文报告了1991.5—1992.4对我省高危人群进行了丙型肝炎监测的结果。通过对878份人血清及17份血制品检测抗—HDV结果表明:云南省有HCV感染存在,各类人群感染状况不同,医院职工抗—HCV阳性率0.65%;现症肝炎病人阳性率为14.49%,其中肝硬化33.33%,慢性肝炎27.5%;急性肝炎11.66%,有2份丙种球蛋白检出阳性;但检测献血员230人(含献浆员)全部阴性。通过对过去排除性诊断为NANB(非甲非乙)型肝炎及其它型别肝炎     

戊型病毒性肝炎32例临床分析

目的 了解戊型病毒性肝炎在五型病毒性肝炎中的构成比及其临床特点。方法 应用ELISA法和PCR法对1996－1999年诊治338例病毒性肝炎病人进行了甲、乙、丙、丁、戊型肝炎病原体检测和临床特点的统计分析。结果 共检出戊型病毒性肝炎32例,占受检人数的8．2％。其中单纯HIE、HEV＋HAV、HEV＋HBV、HEV＋HAV＋HBV、HEV＋HCV感染率分别占46．9％、18．8％、15．6％、9．4％、9．4％。临床分型主要是急性黄胆型,其次是急性无黄胆型及瘀胆型。戊型病毒性肝炎主要症状为：纳差、厌油（93．8％）,乏力（81．3％）,发热、头痛（71．9％）,恶心、呕吐、黄胆（59．4％）,肝肿大（53．1％）,腹胀（37．5％）,可有心肌损害（12．5％）,ALT几乎均有升高（96．9％）。结论 HEV可单纯感染,也可与HAV、HBV、HCV混合感染,总混合感染率为53．1％,混合感染较单纯感染病情重、黄胆深,且病情恢复慢。     

Risk of hepatitis E infection to travelers

Hepatitis E virus (HEV), previously referred to as enterically transmitted non-A, non-B hepatitis, is a major cause of epidemic hepatitis and acute, sporadic hepatitis in endemic areas of the world. The existence of HEV was suspected based upon epidemiological grounds for many years. However, it was only in the early 1990s that confirmation occurred when two prototype strains of HEV from Burma and Mexico were sequenced.1-3 Outbreaks of HEV infection as well as sporadic transmission commonly occur in Asia, Africa, Central and South America, the Middle East, and the Republics of the former USSR. Southeast Asia seems to be a particularly high HEV endemic region. HEV is transmitted via the fecal-oral route, and contaminated drinking water is a common source of infection.4 Many of the large outbreaks have occurred after heavy rains and flooding.4 During interepidemic periods sporadic infections occur frequently. This suggests a constant environmental reservoir, allowing for transmission between epidemics. The existence of a zoonotic reservoir for the virus is likely. HEV has been detected in a number of species, including swine, rats, and chicken.     

山西地区病毒性肝炎2263例病原学和临床类型分布研究

目的研究山西地区病毒性肝炎的病原和临床特征,为制定病毒性肝炎防治方案提供依据。方法对2000—2007年在山西医科大学第一医院住院的2263例病毒性肝炎患者资料进行回顾性临床流行病学调查,并运用描述性统计学方法进行分析。结果在2263例病毒性肝炎病例中,病原学以乙型肝炎病毒占绝对优势,感染构成比达73.8%,其次是未定型肝炎,为10.3%;临床分型以慢性肝炎和肝硬化比例为高,分别为44.1%和32.9%。在急性病毒性肝炎中,以乙型病原比例最高,约35.0%,戊型其次,为30.1%,而甲型相对较少,仅13.4%;慢性肝炎、肝硬化和重型肝炎的病原也均以乙型为主。病原未定型在急性和重型病毒性肝炎中比例较高,分别为20.8%和31.3%。结论山西地区病毒性肝炎病原学以乙型为主,但病原未定型的比例高于全国平均水平;临床类型以慢性肝炎和肝硬化为主。在急性病毒性肝炎中,甲型肝炎比例显著下降,乙型和戊型比例增高。病原学未定型在急性和重型病毒性肝炎中比例较高,提示我们应提高对病毒性肝炎病原的检测手段,并加强对新型肝炎病毒的关注。另外,需要加强对戊型肝炎的监测,警惕其暴发流行。     

Therapeutic targets for the treatment of hepatitis E virus infection

Introduction: Hepatitis E virus (HEV) is one of the most common causes of acute viral hepatitis in the world with an estimated 20 million infections per year. Although the mortality rate is < 1% among the general population, pregnant women can have a fatality rate of up to 30%. Additionally, chronic hepatitis E has increasingly become a significant clinical problem in immunocompromised individuals. Effective antivirals against HEV are needed.

Areas covered: This review article addresses the current state of knowledge of HEV infections with regard to animal and cell culture model systems that are important for antiviral discovery and testing, our current understanding of the molecular mechanisms of virus replication, our understanding of how each viral protein functions, and areas that can potentially be exploited as therapeutic targets.

Expert opinion: Lack of an efficient cell culture system for HEV propagation, the limited knowledge of HEV lifecycle, and the inherent self-limiting infection within the normal populace make the development of new therapeutic agents against HEV challenging. There are many promising therapeutic targets, and the tools for identifying and testing potential antivirals are rapidly evolving. The development of effective therapeutics against HEV in immunocompromised and pregnant patient populations is warranted.     

The role of hepatitis E virus testing in drug-induced liver injury

BACKGROUND: Locally acquired hepatitis E is an emerging infection in developed countries and can be misdiagnosed as drug-induced liver injury. AIM: To study the role of hepatitis E virus (HEV) testing in drug-induced liver injury. METHODS: Retrospective review of a cohort of patients with suspected drug-induced liver injury (n = 69) and hepatitis E (n = 45). The standard criteria for drug-induced liver injury were applied. Patients with suspected drug-induced liver injury who met these criteria were retrospectively tested for HEV on stored sera taken at the time of presentation. The two cohorts were compared to determine variables that predicted either of the diagnoses. RESULTS: Forty-seven out of 69 patients had criterion-referenced drug-induced liver injury. 22/47 were HEV negative and thus had confirmed drug-induced liver injury. 19/47 were not tested for HEV, as there was no sera available from the time of presentation. 6/47 were HEV positive and thus did not have drug-induced liver injury, but had hepatitis E infection. Compared to patients with confirmed drug-induced liver injury, patients with hepatitis E were significantly more likely to be male (OR 3.09, CI 1.05-9.08); less likely to present in November and December (0.03, CI 0.01-0.52); have lower serum bilirubin (P = 0.015); and higher serum alanine aminotransferase (P < 0.001) and alanine aminotransferase/alkaline phosphatase ratio (P < 0.001). CONCLUSION: The diagnosis of drug-induced liver injury is not secure without testing for HEV.     

戊型病毒性肝炎的现状及治疗研究进展

戊型病毒性肝炎（HE）是由戊型肝炎病毒（HEV）引起的肝脏炎症病变。针对HEV感染应根据病情轻重和临床类型进行对症及抗病毒治疗,本文综述HE的流行病学特征、临床表现及治疗进展。     

重组戊型肝炎病毒P179-海藻酸钠/壳聚糖微球混悬制剂的制备及其免疫效果

目的 制备吸附重组戊型肝炎病毒(hepatitis E virus,HEV)P179抗原的海藻酸钠/壳聚糖微球混悬制剂,并观察其免疫效果。方法 乳化法制备海藻酸钠/壳聚糖微球,采用不同海藻酸钠浓度、混合乳化剂添加量、混合乳化剂亲水亲油平衡值设计正交试验,确定最佳制备工艺参数。将重组HEV P179抗原吸附在最佳工艺制备的微球表面,制备吸附重组HEV P179的海藻酸钠/壳聚糖微球混悬制剂,皮下多点免疫BALB/c小鼠,测定其诱导小鼠产生特异性IgG抗体的能力,与同剂量含弗氏佐剂的重组HEV P179免疫制剂对比。结果 经正交试验确定乳化最佳工艺参数为:海藻酸钠质量分数1%、混合乳化剂体积分数2%,混合乳化剂亲水亲油平衡值4。制备的微球平均粒径为6.73 μm(分布范围3.90~9.10 μm,方差1.78 μm),形态较为均一,透射电镜观察结果与双层球体及内部疏松多孔的微球结构特点相符。用此条件制备抗原质量浓度为500 μg/ml的混悬制剂,微球对抗原的吸附率为90.64%。免疫效果观察试验结果表明,皮下多点免疫试验中微球制剂诱导特异性IgG抗体的能力优于含弗氏佐剂抗原。结论 成功制备了吸附重组HEV P179的海藻酸钠/壳聚糖微球混悬制剂,且诱导产生特异性IgG抗体的能力优于含弗氏佐剂抗原,为其在新型实验动物超敏制剂中的应用奠定了基础。     

Hepatitis E vaccines: progress and prospects

Hepatitis E accounts for the major part of enterally transmitted non-A, non-B hepatitis worldwide. Its agent, the hepatitis E virus (HEV), is a small, single-stranded RNA virus. Only one serotype of HEV is recognised. Infection results in protective immunity with long-lived neutralising antibodies. In developing countries with poor sanitary conditions and high population density, hepatitis E causes water-borne epidemics with substantial mortality rates in pregnant women. In addition, more than 50% of cases of acute hepatic failure and sporadic acute hepatitis are due to hepatitis E. The overall prevalence rates of antibodies to the HEV in populations native to these areas rarely exceed 25%. Hence, many individuals remain susceptible to hepatitis E infection, making hepatitis E an important public health concern.In this context, the development of an HEV vaccine is warranted. Because HEV does not grow adequately in cell cultures the development of a vaccine based on inactivated or attenuated whole-virus particles is not feasible. HEV vaccines currently under study are based on recombinant proteins derived from immunogenic parts of the HEV capsid gene. Other approaches such as DNA-based vaccines or transgenic tomatoes have also been developed. Several recombinant protein-based vaccines elicited neutralising antibodies and protective immunity in vaccinated non-human primates. One such vaccine has passed phase I trial and is currently under further evaluation in field trials. Even so, several questions remain to be answered before vaccination programmes could be implemented.     

安徽某三甲医院戊型肝炎流行病学特点分析简

目的 分析戊肝流行情况与趋势,探讨流行规律,为制定防治措施提供实验的依据.方法 回顾性收集安徽医科大学第一附属医院2010年1月1日-2012年12月31日戊肝资料并对其流行特征进行分析.结果 安徽医科大学第一附属医院2010年1月1日-2012年12月31日共检测血清戊肝抗体标本7 903份,其中抗-HEV-IgG阳性832份,检测阳性率为10.53%,抗-HEV-IgM阳性409例,检测阳性率为5.18%.2010、2011和2012年戊肝患者占病毒性肝炎患者的比例分别为2.39%、3.67%、3.14%.20岁以下人群血清抗-HEV-IgM阳性率〈1%.40～60岁年龄段患者占全部戊肝患者的61.8%.3年血清抗-HEV-IgM阳性男女比分别为3.93：1,4.00∶1,3.57：1.结论该研究资料提示20岁以下人群中戊肝阳性率极低,男性和40～60岁人群具有较高的HEV感染风险,应引起高度重视.     

输血传播病毒感染状况调查

目的　调查河南省不同人群输血传播病毒(TTV)的感染状况。方法　采用酶联免疫法 (ELISA)和套式聚合酶链反应(PCR)法对 321例正常人群、正常献血员、急性肝炎、慢性肝炎和肝癌患者血清进行了抗 -TTVIgG和TTVDNA检测。结果　以上人群TTV感染率分别为 5. 0%、0、11. 25%、17. 24%、26. 42%、34. 18%;混合感染中TTV合并HBV、HCV感染率最高,分别为 32. 20%和 30. 51%。结论　河南省不同人群均有TTV的感染;TTV与各型肝炎均有混合感染;ELISA法检测抗-TTVIgG与PCR法检测TTVDNA结果有较好的一致性。