抗—HEV免疫吸印法的建立及应用

应用ＨＥＶ基因结构区的重组融合蛋白，建立了免疫吸印法（Ｗｅｓｔｅｒｎｂｌｏｔ，ＷＢ）检测抗－ＨＥＶＩｇＧ并与现行的酶联免疫试验（ＥＩＡ）进行了比较，结果表明，ＷＢ检出戊型肝炎暴发点急性肝为病人血清抗－ＨＥＶＩｇＧ的阳性率（６８／７３，９３．２％）高于现行的ＥＩＡ（５１／７３，７０．０％），对实验感染猕猴抗－ＨＥＶＩｇＧ检出率前者高于后（分别为７／７和５／７），且检出抗－ＨＥＶＩｇＧ时间较长，滴度也     

抗－HEV免疫吸印法的建立及应用

应用ＨＥＶ基因结构区的重组融合蛋白，建立了免疫吸印法（ＷｅｓｔｅｒｎＢｌｏｔ．ＷＢ）检测抗－ＨＥＶＩｇＧ，并与现行的酶联免疫试验（ＥＩＡ）进行了比较。结果表明，ＷＢ检出戊型肝炎暴发点急性肝炎病人血清抗－ＨＥＶＩｇＧ的阳性率（６８／７３，９３．２％）高于现行的ＥＩＡ（５１／７３，７００％），对实验感染猕猴抗－ＨＥＶＩｇＧ检出率前者也高于后者（分别为７／７和５／７），且检出抗－ＨＥＶＩｇＧ时间较长，滴度也较高。对多种对照血清检测结果表明，除５０％（３／５８）的丙型肝炎血清呈阳性外，甲型、乙型、ＥＢＶ、ＣＷＶ肝炎及健康人血清均为阴性，说明该法具有良好的灵敏度和特异性，可望用于流行病学调查和基础研究，也可用于疑是戊型肝炎病例的确诊     

66例慢性非甲非乙型肝炎患者的丙型肝炎病毒感染研究

以ＨＣＶ－Ｔ３序列为引物，结合ＲＴ－ＰＣＲ和寡聚核甘酸探针Ｓｏｕｔｈｅｒｎ杂交，检测６６例慢性非甲非乙型肝炎（ＮＡＮＢＨ）患者的血浆ＨＣＶ－ＲＮＡ，阳性４２例（６３．６％）。同样病例以相当于ＨＣＶＣ区基因编码和ＮＳ３区编码的人工合成肽抗原检测抗ＨＣＶ，阳性４９例（７４．２％）。这６６例慢性ＮＡＮＢＨ病例，抗ＨＣＶ和ＨＣＶ－ＲＮＡ双阳性者３８例（５７．６％）；抗ＨＣＶ阴性而ＨＣＶ－ＲＮＡ阳性者４例（６．１％）；抗ＨＣＶ阳性而ＨＣＶ－ＲＮＡ阴性者１１例（１６．７％）。其中诊断为散发型ＮＡＮＢＨ者３５例，检出ＨＣＶ－ＲＮＡ者１７例（４８．６％），为输血后ＮＡＮＢＨ者３１例，检出ＨＣＶ－ＲＮＡ者２５例（８０．７％）。     

急性丙型肝炎患者抗－HCV－IgM检测的临床意义

采用重组ＨＣＶ抗原片段Ｃ２２和３３ｃ包被酶标板孔，以间接ＥＬＩＳＡ方法，检测４０例输血后急性丙型肝炎患者血清抗－ＨＣＶ－ＩｇＭ。４０例患者均在起病后４０天内出现抗－ＨＣＶ－ＩｇＭ阳性，抗－ＨＣＶ－ＩｇＭ阳性与ＨＣＶＲＮＡ阳性密切相关，抗体阳性持续时间因病程是否转为慢性而不同。２３例自限性急性丙型肝炎（丙肝）患者，在起病后６个月内抗－ＨＣＶ－ＩｇＭ全部阴转并伴有ＨＣＶＲＮＡ阴转，而１７例转慢的急性丙肝患者中１５例抗－ＨＣＶ－ＩｇＭ持续阳性，其ＨＣＶＲＮＡ亦持续阳性或间断阳性。提示急性丙肝检测抗－ＨＣＶ－ＩｇＭ，可作为抗－ＨＣＶ－ＩｇＧ和ＨＣＶＲＮＡ检测的一个补充，在反映病情和判断预后方面有一定作用     

TTV在急性黄疸性肝炎中的感染状态研究

就ＴＴＶ在各型急性黄疸性肝炎患者中的感染状况进行初步探讨。门诊及住院患者 80例 ,男 4 9例 ,女 31例 ,年龄 9～ 54岁。血清标本包括首次就诊和发病后 3个月 ,标本 -70°Ｃ冰箱保存备检。ＴＴＶ检测采用套式ＰＣＲ法 ;抗 ＨＡＶＩｇＭ、ＨＢｓＡｇ、抗 ＨＢｃＩｇＭ、抗 ＨＣＶ、抗 ＨＤＶＩｇＭ、抗 ＨＥＶＩｇＧ和抗 ＨＧＶＩｇＭ检测采用ＥＬＩＳＡ法。结果表明 ,ＴＴＶ在各型急性黄疸性肝炎患者中的总检出率为 2 8.75% ( 2 3/ 80 ) ,在非甲～庚型肝炎患者中ＴＴＶ阳性率高达 50 % ( 6/ 12 ) ,以下依次为庚型肝炎 33.3% ( 3/ 9)、…     

抗戊型肝炎病毒IgG和IgM抗体对诊断急性戊型肝炎的意义

目的 探讨抗戊型肝炎病毒（ＨＥＶ）ＩｇＧ和ＩｇＭ抗体对诊断急性戊型肝炎（ＨＥ）的意义。方法 应用酶联免疫法（ＥＩＡ）检测我国７个城市共计１４３例散发性ＨＥ病人急性期血清和其中５６例病人的３５９份系列血清,以及４只实验感染ＨＥＶ猕猴的６８份系列血清的抗－ＨＥＶＩｇＭ和ＩｇＧ。结果 ７个城市１４３例散发性ＨＥ病人急性期血清抗－ＨＥＶＩｇＧ阳性率为１００．０％,明显高于抗－ＨＥＶＩｇＭ（７３．４％）,９     

抗－HAV IgM阳性血清乙、丙、丁、戊型肝炎标志物分析

抗－ＨＡＶＩｇＭ阳性血清乙、丙、丁、戊型肝炎标志物分析周佳彦，王崇国，周才仁，缪松毅应用山东３Ｖ诊断技术公司提供的放射免疫试剂盒，对抗－ＨＡＶＩｇＭ阳性血清，同步检测ＨＢＶ、ＨＣＶ、ＨＤＶ、ＨＢＶ感染标志物（ＨＢＶＭ）１０项，结果分析如下：一、观察对...     

病毒性肝病患者庚型肝炎病毒感染状况研究

为了解庚型肝炎病毒（ＨＧＶ）在各型病毒性肝病中的感染状况,我们对１０５５例病毒性肝病患者开展了相应研究．１　材料和方法１．１　材料　各型病毒性肝病患者１０５５例,系１９９６０６／１９９９０２的住院患者．其中ＨＧＶ感染者１７９例,男１２８例,女５１例,年龄２７岁±３岁．临床及血清病原学分型诊断标准按１９９５年５月北京会议修订的诊断标准．１．２　方法　抗ＨＡＶＩｇＭ,ＨＢＶＭ（ＨＢｓＡｇ,ＨＢｓＡｂ,ＨＢｅＡｇ,ＨＢｅＡｂ,ＨＢｃＡｂ及ＩｇＨＢｃＡｂ）,抗ＨＣＶ,抗ＨＤＶ及抗ＨＥＶＩｇＭ…     

急性丙型肝炎患者抗—HCV—IgM检测的临床意义

采用重组ＨＣＶ抗原片段Ｃ２２和３３Ｃ包被酶标板孔，以间接ＥＬＳＩＡ方法，检测４０例输血后急性丙型肝炎患者血清抗－ＨＣＶ－ＩｇＭ。４０例患者均在起病后４０天内出现抗－ＨＣＶ－ＩｇＭ阳性，抗－ＨＣＶ－ＩｇＭ阳性与ＨＣＶ ＲＮＡ阳性密切相关，抗体阳性持续时间因病程是否转为慢性而不同。２３例自限性急性丙型肝炎（丙肝）患者，在起病后６个月内抗－ＨＣＶ－ＩｇＭ全部阴转并伴有ＨＣＶ ＲＮＡ阴转，而１７例转慢的急     

乙肝病毒标记物的胃腔释放

为探讨乙肝病毒粪－口途径传播的可能，用ＥＬＩＳＡ法检测１６０例胃病患者胃液ＨＢｓＡｇ和抗ＨＢｃ，发现各型患者之胃液均可检出－－“腔释放。因ＨＢｓＡｇ为乙肝病毒囊膜，不受胃液和肠液破坏，经口而入的ＨＢＶ既可使人受染，又可随粪－口途径传染他人。胃癌（Ｇａ）、慢性浅表性胃炎（ＣＳＧ）合并十二肠肠球部溃疡（ＤＵＡ）和慢性萎缩性胃炎（ＣＡＧ）、ＣＳＧ／ＣＡＧ、ＣＳＧ／ＤＵＡ和ＣＳＧ之ＨＢｓＡｇ检出率分别为３     

Hepatitis A to E: what's new?

Viral hepatitis contributes to significant morbidity and mortality worldwide. While acute infection may be self‐limiting, unrecognised chronic infection and under‐utilisation of guideline‐based approaches to therapy contribute to increasing rates of cirrhosis, hepatocellular carcinoma and death. Our aim was to review the current evidence for screening, diagnosis and treatment in hepatitis A to E. Evidence for this review was sourced from international and Australian guidelines and high‐quality clinical trials. MEDLINE was searched using structured key word strategy and retrieved articles were reviewed methodically to inform a brief and up‐to‐date synopsis of hepatitis A to E. We share some of the recent developments in viral hepatitis, specifically the new therapies for hepatitis C. Direct‐acting antiviral therapies are safe, well‐tolerated and effective. Subsidies allow access for all Australians with most strains of hepatitis C. We outline evidence underpinning efficacy and safety of treatment for hepatitis B, while clarifying some of the nuances in the setting of pregnancy and immunosuppression. We provide a simplified concept to facilitate understanding of the five phases of hepatitis B; practical for real‐world setting. Hepatitis A to E is a broad topic, not all aspects of these viruses can be covered in this short review. We provided suggestions for evidence based guidelines, which are a suitable supplement to this article.     

Fulminant hepatitis associated with hepatitis A virus superinfection in patients with chronic hepatitis C

There have been conflicting reports of the clinical outcome of acute hepatitis A virus (HAV) infection in patients with chronic hepatitis C virus (HCV) infection. A prospective study evaluated 432 patients with chronic hepatitis C (183 with cirrhosis) over a 7-year period. Of the 17 patients with concurrent HAV infection, seven developed fulminant hepatitis and six died. None of these patients had cirrhosis; however, the HLA phenotype (A1; B8:DR3) appeared to be a significant factor in the development of fulminant hepatitis. Patients with this phenotype had high titres of antinuclear antibodies, antismooth muscle antibodies and antiasialoglycoprotein-receptor antibodies, possibly reflecting the induction of autoimmune hepatitis in this group. The high frequency of fulminant hepatitis in patients with HAV/HCV coinfection contrasts with other surveys, although a large Centers for Disease Control and Prevention (CDC) survey demonstrated that HAV infection in patients with pre-existing chronic liver disease (CLD) is associated with increased mortality. It is likely that CLD has some importance as an underlying factor in the development of fulminant hepatitis following HAV infection. Further prospective studies are needed to clarify this issue.     

Histological evolution of chronic hepatitis C. Factors related to progression

We have evaluated the histological progression of liver disease in 29 untreated patients with chronic hepatitis C. All patients were positive to antibodies to hepatitis C virus by ELISA2 and RIBA2. Two liver biopsies were carried out for each patient, with an interval ranging between 12 and 126 months (mean 50.2±30.7). In all cases the usual histological classification was applied and the histological activity index scoring system according to Knodell et al. was determined. Fifteen cases worsened (51.7%), 12 cases showed no histological changes (41.4%) and two patients improved (6.9%). Cirrhosis was found in five patients (18.5%) in the second liver biopsy. Epidemiological, clinical, biochemical and histological parameters were compared between the group without histological progression and the group with impairment in liver histology. Factors related to histological worsening were: more advanced age (p=0.002), high levels of aspartate aminotransferase (p=0.04), high global histological activity index (p=0.03) and piecemeal necrosis and bridging necrosis scores (p=0.02) at first biopsy. The histological activity index can be applied to assess the natural history of chronic viral hepatitis, and is a good tool to evaluate the prognosis. Thus chronic hepatitis C virus infection is a histologically progressive disease in at least half the cases.     

病原未定型肝炎的临床研究

目的探讨病原未定型肝炎的临床特征。方法以43例慢性乙型肝炎和30例急性乙型肝炎为对照组,对62例病原未定型肝炎患者进行临床分析,比较病原未定型肝炎的流行病学、临床表现、实验室检查及肝组织学改变。结果62例病原未定型肝炎患者发病以冬末及春季多见;发病年龄以青、中年(18岁~50岁)占92.2%;临床表现有急性和慢性,多数症状轻、肝病体征少;血清转氨酶水平呈轻、中度升高;肝活检组织病理学显示炎症轻;绝大多数预后良好。结论病原未定型肝炎的致病因子仍不清楚。     

Viral hepatitis and the surgeon

BACKGROUND: Viral hepatitis is an infection of the liver caused by one or more of six known (HAV-HGV) hepatotropic viruses. It is a common problem among health care workers and their patients. Surgeons are at particular risk of both acquiring and transmitting some of these viruses from and to their patients. Unfortunately, specific immunoprophylaxis for viral hepatitis is presently limited to protecting against the spread of hepatitis A and B viral infections, leaving a high degree of vigilance and careful surgical technique as the only means available to prevent the transmission of other viruses relative to the surgeon. The purpose of this paper is to review the various forms of viral hepatitis including the nature of the virus, serologic testing, clinical features, epidemiology (with specific reference to those issues that arise in surgical practice), treatment and prevention.