Incidence and risk factors for community-acquired hepatitis C infection from birth to 5 years of age in rural Egyptian children

A prospective study in three Egyptian villages (A, B and C) having a high prevalence of hepatitis C virus (HCV) infection examined incidence of community-acquired HCV infection in children; 2852 uninfected infants were prospectively followed from birth for up to 5.5 years. Fifteen seroconverted for either HCV antibodies and/or HCV-RNA (incidence of 0.53%). Ten had both anti-HCV and HCV-RNA; four had only anti-HCV; and one had HCV-RNA in the absence of antibody. The incidence rate at all ages was 2.7/1000 person-years (PY). It was 3.8/1000 PY during infancy and 2.0/1000 PY for the 1-5-years age group. Hospitalization and low birth weight increased the risk of infection; while living in village B, the family having a higher socioeconomic status, and advanced maternal education were protective. Six of eight HCV-infected infants reported iatrogenic exposures (e.g. hospitalization, therapeutic injections, ear piercing) prior to infection whereas only 2/7 children older than 1 year reported these exposures. Having an HCV-positive mother was the only other reported risk in two of these older children. The virus cleared in six (40%) children by the end of follow-up. Health education targeting iatrogenic exposures and focusing on risk factors could reduce HCV infection in children in high-risk populations.     

Vertical transmission of hepatitis C Virus: An epidemiological study on 2,980 pregnant women in Italy

The risk of mother-to-infant transmission of hepatitis C virus (HCV) varies according to the population studied and the tests used. Aim of the current study was to investigate HCV vertical transmission rate in children born to 30 HCV positive/HIV negative pregnant women in Italy. We investigated the potential vertical transmission of HCV by identifying HCV antibody seropositive pregnant women, by analyzing HCV-RNA in the peripheral blood using PCR and by prospectively following their offspring until 24 months of age. During the third trimester, 2,980 consecutive pregnant women were examined for anti-HCV antibodies by a second generation Enzyme-Linked Immunosorbent Assay (EIA2) and re-assayed by a second generation Recombinant Immunoblot Assay (RIBA2). A total of 32 mothers (1.07%) were positive for EIA2 test; 30 out of 32 had a reactive confirmatory RIBA2 test for HCV All anti-HCV positive mothers were negative for HIV. These 30 mothers and their 30 babies formed the study cohort. Of the 30 anti-HCV positive mothers, 10 were also positive for serum HCV-RNA by PCR. All the babies born to the 30 anti-HCV positive mothers were initially negative for HCV-RNA (cord blood specimens), but three babies became positive at three months of age and remained positive thereafter. These babies had been born to 3 of the 10 mothers with viremia during the third trimester of pregnancy. These results suggest that HCV vertical transmission is possible in 10% of anti-HCV positives and in about 33% of the HCV-RNA seropositive mothers.     

HBV、HCV和HDV混合感染在慢性肝病中的意义

采用酶联免疫法(ELISA)检测127例慢性肝病患者血清中的HBV、HCV和HDV感染标志,并采用逆转录—聚合酶链反应(RT-PCR)技术检测部分患者血清HCV-RNA。HBV、HCV和HDV混合感染共37例(29.1%)。混合感染者发生慢重肝的频率明显高于单独HBV感染者(P<0.05),混合感染占慢重肝病因的74.2%。混合感染所致慢重肝患者的凝血酶原时间、血清总胆红素及病死率明显高于单独HBV感染者。结果表明:HBV、HCV和HDV混合感染可能是慢性肝病重型化的主要原因,所致慢重肝患者的病情重、预后差。     

天津市医院丙型肝炎检测和诊断能力研究

目的 了解天津市二级及以上医院开展丙型肝炎病毒抗体(抗-HCV)及核酸(HCV-RNA)检测情况,结合临床医生诊断结果评估医院诊断能力。 方法 2015年从天津市全市二级及以上医院的实验室检测记录中获得2014年抗-HCV和HCV-RNA检测结果,分析二级及以上医院抗-HCV检出阳性率、HCV-RNA检测率和阳性率;采用按比例系统抽样方法对住院病例进行调查,通过查阅病案资料获得住院病例的丙型肝炎诊断情况及相关病例诊断依据,对信息不详者经征得患者同意后进行电话随访,依据《丙型病毒性肝炎诊断标准》(WS 213-2008)对病例诊断逐一进行核查和判定,分析医院诊断正确率。从2014年疾病监测信息系统中获得报告的丙型肝炎病例基本资料,将医院已诊断病例与报告病例进行信息匹配,分析医院病例报告率,计算丙型肝炎校正报告发病率。 结果 在2014年天津市共88家二级以上医院中, 80家具备抗-HCV检测能力,占90.91%; 其中22家医院具备检出或外送检测HCV-RNA能力。天津市二级以上医院丙型肝炎抗-HCV 检出率为1.09%,传染病类医院抗-HCV阳性率(1.38%)要高于非传染病类医院(1.05%)(χ²_{M-H Summary}=401.052,P<0.001)。2014年天津市22家具备HCV-RNA检测能力医院有7 129例抗-HCV阳性者,HCV-RNA检测比例为15.72%(1 121/7 129),HCV-RNA阳性率为77.88%。根据1 031例抗-HCV阳性住院患者出院登记结果显示,丙型肝炎相关疾病诊断比例为58.29%。对住院病例核查诊断后,有953例可诊断为丙型肝炎(包括临床诊断和确诊病例),已报告率为31.90%(304/953),计算2014年丙型肝炎校正报告发病率是实际报告发病率的3.13倍,丙型肝炎校正报告发病率为10.60/10万。 结论 2014年天津市医院HCV-RNA实验检测项目比例较低,大部分病例未经核酸检测病毒复制情况,未能得到实验室确诊。抗-HCV阳性者住院病例漏诊和漏报比例较高,严重影响疫情报告数据的准确性,因此需进一步研究疫情报告质量。     

HCV prevalence in pregnant women in the UK

The objective of the study was to assess the prevalence and epidemiology of hepatitis C virus (HCV) infection in pregnant women in the North Thames region, and in the UK in general. Demographic data were linked to neonatal samples prior to anonymization and testing by anti-HCV EIA, and with RIBA 3 confirmation. Risk factors for maternal infection were explored. Area-specific seroprevalence rates were multiplied into population sizes to estimate HCV prevalence in pregnant women in the UK. A total of 241/126,009 samples were confirmed anti-HCV positive, and a further 40 were indeterminate, representing a seroprevalence of 0.19-0.22%; 51% of maternal HCV infections were in UK-born women (71% of the population), and 22% in women from continental Europe (5% of the population). Among European-born women, HCV prevalence was associated with birth in continental Europe, partner not being notified at birth registration, partner born in a different region to the mother, and inner city residence. Four of the 241 anti-HCV positive samples (1.7%) were also anti-HIV-1 positive. It was estimated that each year an estimated 1150 out of 730,000 pregnancies in the UK would involve a woman infected with HCV (uncertainty range 660-1850), a prevalence of 0.16% (0.09-0.25%). On the basis of reported rates of mother-to-child transmission of HCV, this would represent approximately 70 paediatric HCV infections per year.     

入境外籍人员抗-HCV、HCV-RNA 与ALT相关性及监测分析

摘要:目的　掌握四川口岸入境外籍人群HCV感染情况及流行病学特征。探讨广东、深圳、云南、四川、辽宁口岸2010-2012年入境外籍人员抗-HCV阳性人员的抗-HCV、HCV-RNA载量及ALT三者的相关性,对口岸入境外籍人员更科学合理有效地开展丙肝传染病监测起好指导作用。方法　对2010-2012年监测的四川口岸入境外籍人群HCV阳性检出者流行病学资料进行统计学分析。收集五大国境口岸保健中心筛查的235例抗-HCV阳性的入境外籍人员血清样本,用酶联免疫吸附测定（ELISA）法进行抗-HCV复检,用实时荧光定量PCR法检测HCV-RNA,同时收集其丙氨酸氨基转移酶（ALT）检测数据。数据采用SAS 9.13处理。结果　2010-2012年监测的四川口岸入境外籍人群HCV感染率是2.8‰,51～60岁年龄组,来华留学人员感染率最高。收集的235例抗-HCV阳性入境外籍人员血清标本复检后231例阳性,4例阴性。检出HCV-RNA阳性131例（占56.7%）,其中ALT异常89例（占67.9%）。100例HCV-RNA阴性中ALT异常25例（占25.0%）。随着HCV-RNA载量的升高,ALT异常率有增高趋势（χ2＝44.75,P＜0.01）。同时,ALT的均值随HCV-RNA载量的增加而升高（r＝0.973,P＜0.01）。结论　HCV-RNA检出率与方法学敏感性、HCV感染所处的临床阶段、抗病毒药物的应用密切相关。HCV-RNA载量与ALT水平呈明显相关性。入境外籍人群中51～60岁年龄组,来华留学人员阳性检出率最高,提示在今后口岸HCV防控与分子流行病学分析工作中,可考虑将其作为重点监测对象。     

HCV单克隆抗体的制备及其应用的初步研究

目的:丙型肝炎病毒(Hepatitis C Virus,HCV)感染已成为全球公认的健康难题,目前并没有很好的疫苗和特效药,尽早检出HCV感染者是实现丙型肝炎早期诊断、阻断传播的重要途径。方法:研究通过免疫Core-NS4B融合重组蛋白,制备抗HCV单克隆抗体,并获得5H5和4E7-HRP最优的抗体配对组合,检测120例血清,同时与HCV-RNA检测做比较。结果:阴性血清均未测出阳性,HCV阳性标测出23例阳性,检出率77%,HCV-RNA测出26例,检出率87%;HCV可疑标本测出15例阳性,HCV-RNA测出17例;单项ALT增高的标本测出2例阳性,HCV-RNA测出1例。结论:研究所获得的抗体能够用于HCV抗原检测,具有巨大的潜力,为建立HCV抗原检测试剂盒奠定了基础,为临床检测提供了实验依据。     

血透患者中丙型肝炎病毒感染的流行病学研究

目的了解血透患者中丙型肝炎病毒的感染情况,并探讨相关的危险因素。方法对150例维持性血透患者应用逆转录聚合酶链反应及酶联免疫吸附法检测血清中HCV-RNA及抗HCV-IgG的水平。结果HCV-RNA的阳性率为26.7%(40/150例);抗HCV-IgG的阳性率为24%(36/150例);HCV感染率(总阳性率)为35.3%(52/150例)。结论提示血透患者中HCV感染率明显高于普通人群。输血及血制品是其第一位的危险因素,而透析器及管路的交叉使用也是不容忽视的危险因素之一。     

Incidence and cofactors of hepatitis C virus-related hepatocellular carcinoma: a prospective study of 12,008 men in Taiwan

In a community-based prospective study, the authors examined the independent and interactive effects of hepatitis C virus (HCV) infection and cofactors, including hepatitis B virus (HBV) infection and lifestyle habits, on the incidence of hepatocellular carcinoma (HCC) in Taiwan. At baseline recruitment, subjects were evaluated with regard to second-generation HCV antibody (anti-HCV), hepatitis B surface antigen, and serum alanine aminotransferase, as well as cigarette smoking, alcohol drinking, and betel quid chewing habits. A total of 12,008 male residents aged 30-64 years without a history of HCC were included in the study. Between July 1990 and June 2001, 112 incident cases of HCC were identified among the subjects and included in the analysis. Persons with anti-HCV positivity alone had a 20-fold increased risk of developing HCC in comparison with those who were negative for anti-HCV. In statistical assessment of additive interaction, HCV and HBV tended to act independently in the pathogenesis of HCC. The results of this study suggest that HCV plays a significant role in hepatocarcinogenesis in an area endemic for chronic HBV infection.     

血清中HCV抗体与HCV-RNA检测在临床中的应用

目的探讨丙型肝炎病毒抗体与RNA在临床中的应用价值。方法用ELISA法检测934例丙型肝炎可疑患者病毒抗体,用实时荧光定量PCR检测379例丙型肝炎可疑患者病毒RNA。结果934例患者HCV抗体阳性率为19.16%,379例HCV-RNA阳性率为43.01%。53例为两者均做的病人,RNA和Ab均阳性的占52.8%(28/53),均阴性占15.1%(8/53),两者的一致率达67.9%,Ab的阳性率为81.1%(43/53),RNA的阳性率为56.6%(30/53)。结论HCV抗体联合HCV-RNA检测对丙型肝炎的临床诊断有一定的价值。     

Sexual transmission of hepatitis C virus infection

The role of sexual transmission in the diffusion of HCV infection, was studied through the seroprevalence of anti-HCV antibodies in the heterosexual habitual partners of 83 anti-HCV positive subjects. The index cases were represented by 10 dialysed subjects, 31 patients with chronic liver disease and 42 healthy carriers. Seroprevalence of anti-HCV positivity reported in partners was 8.43%, with a higher rate in cohabitants of patients with chronic liver disease (16.12% vs 4.76% of carriers); no case was found among partners of dialysed subjects. Laboratory and ultrasonograph signs of chronic hepatitis were reported in 3 cases (3.61%). Control on 70% of the cohabitants' relatives, was negative for HCV infections. These data suggest a possible sexual transmission of HCV infection, even if its prevalence resulted modest, undoubtedly lower than in other disease sexually transmitted.     

河南省2012－2014年新报告HIV感染者中HCV抗体流行状况分析

目的 了解河南省2012－2014年新报告HIV感染者中HCV抗体的流行情况。方法 通过艾滋病综合防治数据信息管理系统对河南省2012年7月1日至2014年6月30日新报告的HIV感染者进行信息整理、HIV-1 BED新发感染检测和HCV抗体检测。结果 4 267例新报告HIV感染者中HCV抗体阳性率为13.19%(563/4 267),感染途径为注射吸毒者的HCV抗体阳性率最高(77.27%),采血浆/输血、异性性传播、同性性传播和母婴传播人群的HCV抗体阳性率分别为15.06%、15.81%、3.74%和8.96%。开封(32.04%)、驻马店(25.00%)、商丘(25.00%)、周口(18.86%)和南阳(14.67%)为HCV抗体阳性率最高的前五个省辖市。BED阳性者(HIV新近感染者)中HCV抗体阳性率为7.50%(86/1 146)。多因素logistic回归分析发现:BED阴性、年龄>40岁、农民、HIV感染途径为注射吸毒以及报告地区为开封市、南阳市、商丘市、驻马店市和周口市为HCV感染的危险因素。结论 2012－2014年河南省新报告HIV感染者中HCV抗体流行率有降低的趋势,但是部分地区和重点人群仍存在较高的HCV抗体流行率。     

Sexual behaviour and multiple infections in drug abusers

We have studied the prevalence and the serological profile of HBV, HCV, HDV and HIV infections in 137 Italian subjects addicted to the intravenous use of heroine and correlated the virological findings with sexual behaviour. HBV and HCV viremia were also measured in 114 patients. Anti-HCV was detected in 81% of the addicts, and one or more markers of HBV infection were detected in 62.8% (4.4% were carriers of HBsAg, 58.4% had evidence of past HBV infection and 13.1% of the latter also had HDV markers). Anti-HIV was positive in 23.4%; 26% of those positive for anti-HCV and 4.6% of those positive for HBV markers had no other viral marker: none had only anti-HIV. HBV-DNA was negative in the carriers of HBsAg, and HCV-RNA was not detected in any of the HBsAg carriers who also had circulating anti-HCV Overall, 34% of the anti-HCV positive addicts had HCV-RNA in their blood. The prevalence of the virus infection correlated with the duration of drug addiction but not with sexual behaviour, and sexual behaviour did not influence the acquisition of any virus. HCV infection was most frequent and probably the first infection to occur, but exposure to HBV was also common despite a low rate of HBsAg carriage. The prevalence of HDV infection was high (50%) in the HBsAg carriers, while the overall prevalence of HIV was lower (23%) than expected. Lack of HBV-DNA and HCV-RNA in carriers of HBV with anti-HCV in serum may indicate that HBV and HCV mutually inhibit their own replication.     

Demonstration of HCV-RNA and HBV-DNA in the serum of HBsAg negative patients with hepatocellular carcinoma

Forty patients with chronic liver disease and HCC were analyzed for infection with hepatitis C (HCV) and hepatitis B (HBV) viruses. All patients were negative for HBsAg, 16 were alcoholics, 6 had previous blood transfusions and 18 had sporadic chronic hepatitis. Antibodies to HCV were determined by EIA 2nd generation. HBV-DNA was detected by PCR using primers of the precore region. Analysis of HCV-RNA was done with nested PCR amplifying the 5 non-coding region of the HCV genome, using primers complementary to nucleotides 1–20 and 305–320 and nested primers complementary to nucleotides 21–31 and 271–286 of the HCV-J1. Anti-HCV were positive in 35/40 patients (87.5%). HCV-RNA was detected by PCR in 34 patients (85%) all of them positive for the anti-HCV. HCV-RNA was detected in 70.5% of the alcohol abusers, in 100% of patients with history of transfusion(s) and 94.1% of patients with cryptogenic chronic liver disease. HBV-DNA was detected in only 2 patients. In conclusion, there is a high rate of HCV and a low rate of HBV viremia detected by PCR in Spanish patients with HCC HBsAg negative. No patient without anti-HCV presents HCV-RNA. Our results suggest that persistent HCV replication may play a role in hepatic carcinogenesis, as HBV-DNA could be found in only 5% of our HCC patients.This work was presented in part at the Biennial Scientific Meeting of the IASL (Brighton 1992) and at the 27th EASL meeting (Vienna 1992)     

联合检测丙肝病毒核心抗原和抗体在丙型肝炎早期诊断中的价值

目的:通过检测丙型肝炎抗体(HCV-Ab),同时对其进行丙型肝炎病毒核心抗原(HCV-cAg)和丙肝病毒RNA(HCV-RNA)两项指标进行检测,探讨HCV-cAg检测在丙型肝炎早期诊断中的意义。方法:对104例HCV-Ab阳性标本及108例高危人群但HCV-Ab阴性标本(包括血液透析患者55例、医务人员20例和丙型肝炎病人的家庭密切接触者33例)及健康对照组同时进行HCV-cAg和HCV-RNA的检测。结果:104例HCV-Ab阳性组中,HCV-cAg阳性25例,HCV-RNA阳性27例;108例HCV-Ab阴性组中,HCV-cAg阳性2例,HCV-RNA阳性1例;健康对照组全阴性。结论:HCV-cAg和HCV-RNA在丙型肝炎早期诊断上无显著性差异,但HCV-cAg检测在临床的应用前景上具有更大的优势,故可在临床推广HCV-Ab和HCV-cAg联合检测,有条件者可联合检测HCV-Ab、HCV-cAg和HCV-RNA。     

Major decline of hepatitis C virus incidence rate over two decades in a cohort of drug users

Injecting drug users (DU) are at high risk for hepatitis C virus (HCV) and HIV infections. To examine the prevalence and incidence of these infections over a 20-year period (1985–2005), the authors evaluated 1276 DU from the Amsterdam Cohort Studies who had been tested prospectively for HIV infection and retrospectively for HCV infection. To compare HCV and HIV incidences, a smooth trend was assumed for both curves over calendar time. Risk factors for HCV seroconversion were determined using Poisson regression. Among ever-injecting DU, the prevalence of HCV antibodies was 84.5% at study entry, and 30.9% were co-infected with HIV. Their yearly HCV incidence dropped from 27.5/100 person years (PY) in the 1980s to 2/100 PY in recent years. In multivariate analyses, ever-injecting DU who currently injected and borrowed needles were at increased risk of HCV seroconversion (incidence rate ratio 29.9, 95% CI 12.6, 70.9) compared to ever-injecting DU who did not currently inject. The risk of HCV seroconversion decreased over calendar time. The HCV incidence in ever-injecting DU was on average 4.4 times the HIV incidence, a pattern seen over the entire study period. The simultaneous decline of both HCV and HIV incidence probably results from reduced risk behavior at the population level. Charlotte H.S.B. van den Berg and ColetteSmit contributed equally to this paper     

杭州市孕妇产前血液传染性标志物的分析研究

目的:探讨孕妇产前血液检测传染性标志物的临床意义。方法:采用微粒子化学发光技术检测乙型肝炎病毒标志物;酶联免疫法(ELISA)检测丙型肝炎病毒抗体(HCV)、梅毒螺旋体抗体(TP)、人类免疫缺陷病毒抗体(HIV)。结果:6170名孕妇中HBsAg阳性总人数593例,HBsAg阳性率9.61%;梅毒感染人数39例,梅毒抗体阳性率0.63%;丙肝感染人数18例,丙肝抗体阳性率0.29%;未检测出HIV阳性者。结论:孕妇产前血液传染性标志物的检测,能为阻断和降低母婴传播,确保母婴安全健康提供保障;减少和避免医疗纠纷、预防医院感染提供可靠的实验室依据。     

6 280例体检人员丙型肝炎病毒感染调查分析

目的了解普通（体检）人群HCV感染状况.方法应用酶联免疫法检测6 280例体检人员血清中HCV抗体;对HCV抗体阳性者,检测其血清中HCV RNA及肝功能,并进行流行病学史调查.结果6 280例体检人员HCV感染率为2.17%;男性感染率为2.58%,高于女性1.86%（P〈0.05）.HCV抗体阳性者肝功能及相关生化指标54%在正常范围;HCV RNA阳性率为47%;42%的人主诉有肝区不适等症状;曾有输血史、毒瘾史、手术史、献血史、血吸虫病史者分别占22%,6%,35%,3%,12%;确诊为肝硬化者占4%,肝癌1%.结论普通人群HCV感染率男性高于女性;其感染除与易感因素有关外,大多为不能诉述易感因素的“不明原因”感染.HCV抗体阳性者大多无症状,肝功能及相关生化指标多正常;易转化为肝硬化、肝癌.     

丙型肝炎病毒抗体光密度值与丙型肝炎病毒核酸的关系

［目的］了解抗ＨＣＶ的ＯＤ值与ＨＣＶ－ＲＮＡ的关系。为丙型肝炎的诊断提供科学依据。［方法］从太原市中心血站、太原市卫生防疫站、山西省妇女劳动教养所、本站性病门诊、山西医科大学第一医院采集抗ＨＣＶ阳性血清２９６份，筛选出抗ＨＣＶ阳性的血清２２８份，用逆转录巢式多聚酶链反应（ＲＴ－nestPCR)进行ＨＣＶ－ＲＮＡ的检测。［结果］２２８份抗ＨＣＶ阳性标本中，检出ＨＣＶ－ＲＮＡ阳性者１６１例，阳性率为７０.6%，在抗ＨＣＶ的效价增高到一定值（ＯＤ／ＣＯ≥8.0)时，ＨＣＶ－ＲＮＡ检出率增高较明显，结果还显示不同人群抗ＨＣＶ阳性者的ＨＣＶ－ＲＮＡ检出率有差别，献血员、丙型肝炎患者的ＨＣＶ－ＲＮＡ检出率较高（８５.25%和８１82%）。［结论 ］当抗ＨＣＶ阳性的血清ＯＤ／ＣＯ≥8.0时，ＨＣＶ－ＲＮＡ很可能也为阳性。     

Hepatitis C virus infection among pregnant women in Central-Western Brazil, 2005-2007

The study was aimed at estimating the prevalence of infection with and the genotype of hepatitis C virus (HCV), and to determine the extent of underreporting of HCV cases. A total of 115,386 pregnant women seen by the Program for Protection of Pregnancy [Programa Estadual de Prote??o à Gestante] of the state of Mato Grosso do Sul, Central-Western Brazil, were tested for anti-HCV antibodies between 2005 and 2007. Prevalence of HCV infection was 1.07 cases per thousand. Positive samples were tested for HCV RNA and genotyped. Genotype 1 was detected in 73% of samples, genotype 3 in 24.3%, and genotype 2 in 2.7%. Underreporting of hepatitis C cases was 35.5%.