新疆地区各型病毒性肝炎中的HGV感染及临床初步观察

为了解新疆各型病毒性肝炎病人感染庚型肝炎病毒情况,我们用合成多肽抗原制备的试剂检测了78例各型病毒性肝炎患者血清和5例ALT升高的产妇及其所生新生儿血清抗HGV,并对HGV感染者的部分临床表现初步观察,检测结果表明,在34例非甲～戊型肝炎中检出抗HGV阳性12例(37.5％),17例乙型肝炎中检出5例(29.4％),29例丙型肝炎中检出11例(37.9％),2例ALT升高产妇及其所生新生儿抗HGV阳性。     

重庆地区肝胆疾病患者中A～G型病毒性肝炎血清标志初步分析

目的：探讨重庆地区肝胆疾病患者中A～G型肝炎病毒感染状况。方法：EIA法检测12种A～G型病毒性肝炎血清标志。结果：总阳性数为320／455例(70．18％)，其中抗HAV IgM阳性率为8．99％(41／456例)，HBVM53．07％(242／456例)，抗HCV5．48％(25／456例)，HDVM24．12％(110/456例)，抗HEV和抗HGV分别为12．5％(57／456例)和12．28％(56／456例)。在320例A～G型肝炎病毒感染者中，仅146例(35.63%)检测出一种肝炎：病毒感染标志，其余均为混合感染，计两种肝炎病毒血清感染标志阳性，113例(35.31％)，三种混合感染者41例(12.81％)，四种的18例(563％)，还有2例同时检出五种肝炎病毒感染标志，结论：重庆地区肝胆疾病患者中存在A～G型肝炎病毒感染者，以HBV最高，HBV最低，HDV约占四分之一，但仍可能存在A～G型型以外的其他肝炎病毒感染者。几种肝炎病毒混合型感染可能是造成，肝炎重型化重要因素之一。     

各型肝炎病毒单纯及重叠感染的研究

目的 探讨病毒性肝炎患者甲～戊，庚型肝炎病毒(HAV-HEV，HGV)单纯感染及重叠感染情况。方法 采用EIA法检测病毒性肝炎患者血清抗-HAV IgM，HBV标志物、抗-HCV IgM、抗-HDV IgM、抗-HEV IgM、抗-HGV IgM。结果 共检测210例病毒性肝炎患者HAV-HEV、HGV血清标志物，20例未检出(9．5％)，190例患者检出标志物阳性(90．5％)。HBV感染率89，5％(188／210，其中有34例为既往感染，占16．2％，现症感染154例，占73．3％)；HAV感染率29．0％(61／210)，HCV、HDV感染率均为8．1％(17／210)、HEV、HGV感染率依次为10．0％(21／210)、7．1％(15／210)。各临床类型中单纯感染占61．4％(129／210)，二重感染占32．4％(68／210)，以HAV HBV、HBV HDV、HBV HEV感染模式最常见，三重感染占6．2％(13／210)，以HAV HBV HDV感染模式最常见；临床上以肝炎肝硬化、重型肝炎重叠感染常见，急性肝炎最少见。结论 病毒性肝炎中HBV感染最常见，其次为HAV感染；单纯感染、二重感染多见，三重感染少见；重叠感染发生率随病情加重而增加。     

庚型病毒性肝炎17例的临床和病原学分析

目的:对南京地区庚型病毒性肝炎的临床和病原学特点进行分析。方法:用反转录聚合酶链反应(RT-PCR)法检测血清HGV-RNA。从274例病毒性肝炎患者中检测出17例庚型病毒性肝炎,观察其临床表现及血清病原学标志,并分析庚型肝炎病毒(HGV)部分核酸序列。结果与结论:17例患者男性成年人多见,全年散发,经输血感染为重要传播途径。HGV可以单独感染,也可重叠(混合)其它肝炎病毒感染。少数为急性肝炎,多数为慢性肝炎或肝硬化,尤其在重叠(混合)感染。单纯HGV感染者症状轻,多隐匿发病,肝功能损害较轻。重叠(混合)感染者多有慢性肝炎的症状,与HBV重叠(混合)感染时有形成重型肝炎的趋势。核酸序列分析表明HGV南京株部分核苷酸序列与HGV美国株HGU 44402、HGU 45966、HGU 36380及HGV河北株在对应位置的核苷酸同源性从87.27%~93.94%,可能HGV有不同的基因型。     

丙型肝炎病毒与甲乙型肝炎病毒重叠感染的研究

对485例病毒性肝炎患者进行了抗HCV、抗HAV-IgM、HBV-M检测.各型病毒性肝炎患者中抗HCV阳性率15.05％,慢性肝炎、肝硬变和重型肝炎阳性率高于急性肝炎;抗HCV阳性者中,27.40％有输血或血浆史;57.53％HBV-M阳性,其中HBsAg阳性占54.76％,抗HBc阳性达88.10％;既往有HBV感染者占33.33％.HBV与HCV重叠感染中慢性肝炎占58.06％,IAV与HCV重叠感染以急性肝炎多见(94.44％),HCV与甲乙型肝炎病毒三重感染可加速肝炎重症化的进程。     

63例TTV单纯和重叠感染的临床探讨

为了探讨TT病毒(TTV)感染的临床特点,我们采用聚合酶链反应(PCR)方法检测了1998年11月～2000年1月215例住院肝炎患者血清TTV-DNA,发现63例TTV单纯和重叠感染者,现将结果报告如下。 1 材料与方法 1.1 对象 我们对215例病毒性肝炎住院患者血清进行了TTV-DNA检测,发现63例阳性。其中男性55例,女性8例,年龄14～72岁,平均年龄43岁。 1.2 方法 对入院病人次日清晨常规空腹抽血进行甲、乙、丙、丁、戊、庚型肝炎病毒免疫标志物及各项生化项目检测。 1.3 检测试剂与结果判断 抗HAVIeM,IgG,HBV-M是由     

柯萨奇B组病毒性肝炎56例

为探讨非嗜肝病毒在散发性病毒性肝炎病原学中的地位 ,我们于 1997年开始对 398例肝炎患者进行柯萨奇Ｂ组病毒 (ＣＶＢ)、巨细胞病毒 (ＣＭＶ)和甲～庚型肝炎病毒及输血传播病毒 (ＴＴＶ)等 9种病毒指标的检测 ,共检出抗ＣＶＢ ＩｇＭ阳性 5 6例 ,现将ＣＶＢ感染者情况分析如下。材料与方法一、研究对象5 6例多为肝炎住院患者 ,其中 6例系原因不明丙氨酸转氨酶升高门诊发现。男 39例 ,女 17例 ,年龄 8～ 73岁 ,平均 38.5岁。临床诊断标准参照第五次全国传染病和寄生虫病学术会议修订的病毒性肝炎防治方案[1] 。二、检测方法抗ＣＶＢ ＩｇＭ…     

各型病毒性肝炎患者庚型肝炎病毒感染状况

目的:了解武汉地区各型病毒性肝炎患者中庚型肝炎病毒(HGV)感染的情况。方法:用酶联免疫吸附试验(ELISA)及逆转录聚合酶链反应(RT-PCR)方法测定各型病毒性肝炎患者的抗HGV和HGV RNA,并对庚肝病毒感染者进行临床分析。结果:351例各型病毒性肝炎患者中抗HGV阳性者56例,占15.05％;此56例中HGV RNA阳性者21例,占37.50％。各型病毒性肝炎患者中抗HGV阳性率及庚肝抗体阳性者中HGV RNA阳性率分别为:甲肝14.29％(5/35)及20.00％(1/5);乙肝17.29％(37/214)及35.14％(13/37);丙肝14.52％(9/62)及55.56％(5/9);戊肝4.00％(1/25),0.00％(0/1);非甲～戊肝26.67％(4/15),50.00％(2/4)。56例抗HGV阳性者中43例有输血、使用血制品或静脉药癌史,占76.79％。HGV感染在肝炎各临床类型分布为急性、慢性和重型肝炎患者无明显差异,且无性别和年龄分布的差异。HBV重叠感染HGV患者的SALT及TBil水平明显高于单纯HBV感染者(P<0.05),而HGV和其它肝炎病毒((HAV、HCV、HEV)重叠感染患者与单纯其它肝炎病毒感染者的SALT及TBiL水平无明显差异(P>0.05)。结论:武汉地区各型病毒性肝炎患者均可存在HGV感染。HGV可单独感染或与其它病毒混合感染。血液传播是HGV感染的主要途径。乙型肝炎患者合并庚肝病毒重叠感染可加重病情,而甲、丙、戊型肝     

庚型肝炎病毒感染的初步调查

采用酶联免疫法(ELISA)检测94例病毒性肝炎患者血清中抗庚型肝炎病毒抗体(抗-HGV),阳性率为23.4％。其中急性肝炎、慢性肝炎、重型肝炎抗-HGV阳性率分别为21.4％、21.1％、30.4％,在22例抗-HGV阳性病人中,HBV与HGV重叠感染率为36.3％。39例非甲-戊型肝炎抗HGV的阳性率(35.5％)明显高于55例乙型肝炎的阳性率(14.5％、P<0.05),说明HGV感染主要存在于非甲-戊型肝炎病人中。23例重型肝炎中有16例死亡,抗HGV(+)7例全部死亡,而单纯HBV感染的死亡率为56.25％。结果显示:HGV感染系非甲-戊型肝炎的主要原因,HGV可以与HBV重叠感染,且可能影响重型肝炎的愈后。     

乌鲁木齐地区部分高危人群庚型肝炎病毒感染状况的研究

目的 了解新疆乌鲁木齐地区部分高危人群中庚型肝炎病毒的感染状况。方法 首先运用酶标法(ELISA)检测不同人群中庚型肝炎病毒抗体(抗-HGV),然后对抗-HGV阳性血清运用逆转录聚合酶链反应(RT-PCR)检测HGV RNA。结果 在各类高危人群中,抗-HGV阳性率分别是:手术受血者为35.59％(21/59),静脉吸毒者为38％(19/50),非甲～戊型肝炎病人为18％(9/50);均显著高于对照人群(2％,1/50,P<0.05);职业供血员抗-HGV阳性率也较高(13.79％,8/58),但与对照人群无显著性差异(P>0.05);58份抗-HGV阳性血清有18份血清HGV RNA阳性,其中手术受血者血清1份,静脉吸毒者血清12份,职业供血员血清2份,非甲～戊型肝炎病人血清3份。结论 (1)本研究首次在乌鲁木齐地区部分高危人群中证实有较高的庚型肝炎病毒感染率;(2)再次证实该病毒主要通过注射、输血途径传播。     

PREVALENCE AND CLINICAL SIGNIFICANCE OF HEPATITIS G VIRUS INFECTION IN ADULT BETA-THALASSAEMIA MAJOR PATIENTS

The risk of polytransfused patients for hepatitis C virus (HCV) infection is likely to extend to another recently identified member of the Flaviviridae, hepatitis G virus (HGV). We investigated the prevalence of HGV in 40 adult Italian patients with transfusion-dependent thalassaemia and evaluated the clinical significance of HGV infection. HGV-RNA was detected in 9/40 patients (22.5%). HGV infection was significantly associated with HCV viraemia ( P  =0.0012), with all patients positive for HGV being also viraemic for HCV. Overall, the clinical picture of patients with HCV/HGV co-infection was not different from that of patients with isolated HCV. However, patients co-infected with both viruses had lower values of alanine-transferase ( P  =0035) and a lower titre of HCV viraemia ( P  =0042) in the absence of other evident factors which could influence the clinical expression of HCV infection. In conclusion, HGV is highly prevalent among Italian polytransfused patients. No evidence of a clinically significant pathogenic role for HGV in liver disease could be found in these patients. In a subset of cases a possible interference of HGV with HCV infection was observed.     

血液透析患者丙型肝炎病毒感染的研究

为调查血液透析患者丙型肝炎病毒（ＨＣＶ）感染情况，并探讨相对危险因素，对１９９４年１２月～１９９５年６月在北京协和医院血透中心进行血液透析的８０例患者及１９９５年新入学的３０例研究生（健康对照）进行研究。采用第二代ＥＬＩＳＡ检测人类免疫缺陷病毒（ＨＩＶ）和ＨＣＶ抗体，逆转录巢式双聚合酶链反应（ＰＣＲ）法检测ＨＣＶＲＮＡ。追查８０例血液透析患者，２４例ＨＣＶ抗体阳性，５６例ＨＣＶ抗体阴性患者中，２例ＨＣＶＲＮＡ阳性，即８０例血液透析患者ＨＣＶ感染率３２．５％（２６／８０）。Ｍａｎｔｅｌ－Ｈａｅｎｓｚｅｌ法分析显示，血透患者ＨＣＶ感染与输血、透析时间、肾移植及手术史有关。９例ＨＣＶＲＮＡ阳性病人的透析液中，３例检出ＨＣＶＲＮＡ。表明血液透析患者ＨＣＶ感染率明显高于普通人群，主要危险因素是输血和免疫功能低下，透析设备和环境污染是不容忽视的危险因素。     

血液透析与病毒性肝炎的关系

目的：探讨血液透析与病毒性肝炎的关系。方法：采用酶联免疫法检测每例患者的ＨＡＶ，ＨＣＶ，ＨＤＶ，ＨＥＶ及ＨＢｓＡｇ并对血透各组和非透析组进行对比分析，结果：ＨＡＶ，ＨＤＶ，ＨＥＶ和ＨＢｓＡｇ的阳性率在各组单元差异；ＨＣＶ的阳性率在血透组和非血透组之间差异非常显著，且随着血透时间延长而增加，５年以上组达１００％，ＨＣＶ阳性率与是否输过血无关，结论：血透并不导致增加甲，乙，丁，戊型肝炎的感染，但明显增     

Spectrum of viral hepatitis in thalassemic children receiving multiple blood transfusions.

AIM: To investigate the prevalence of infection with hepatitis viruses in children with thalassemia receiving multiple blood transfusions. METHODS: Sera from 50 children with thalassemia aged 5-15 years (30 boys), who had each received over 80 units of blood, were evaluated for the presence of markers for hepatitis A virus (HAV; IgG and IgM anti-HAV), hepatitis B virus (HBV; HBsAg, and IgG and IgM anti-HBc), hepatitis C virus (HCV; IgG and IgM anti-HCV, and HCV RNA) and hepatitis E virus (HEV; IgG and IgM anti-HEV). IgM anti-hepatitis D virus (HDV) was looked for only in HBsAg or IgM anti-HBc positive sera. RESULTS: No child had evidence of recent HAV or HDV infection. IgG anti-HAV was positive in 12 children. One patient had acute HBV infection. Nine patients were HBsAg-positive. HCV infection was present in 15 cases; six of them were HCV RNA positive, and three had superinfection with hepatitis B. Recent HEV infection was present in 5 cases. CONCLUSION: Thalassemic patients receiving multiple blood transfusions often acquire hepatitis B (20%) and C (30%) infections. Recent hepatitis E infection was documented in 10% in this one-point study.     

Co-infection by human immuno deficiency virus, hepatitis B and hepatitis C virus in injecting drug users

Injecting drug users (IDUs) are at risk of parenterally transmitted diseases such as hepatitis B virus (HBV) hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infections. The present study was undertaken to find out the prevalence of HIV infection, HBV infection and HCV infection among IDUs of a deaddiction centre. Serum samples from 250, injecting drug users (IDUs) from a de-addiction centre were screened for HBsAg using immunochromatography, anti HCV antibody by 3rd generation ELISA test and anti HIV antibody by ELISA test and immunochromatographic rapid test during the period August to October 2002. One hundred and forty-nine (59.6%) IDUs were positive for HIV antibody, 226 (90.4%) were positive for anti HCV antibody and 27 (10.8%) were positive for HBsAg. There was co-infection of HIV, HBV and HCV in 15 (6%) of the IDUs. The Co-infection of HBV and HCV were found in 12 cases (4.8%) and Co-infection of HIV and HCV was found in 131 cases (52.4%). The IDUs were in sexually active age group with a risk of infection to their sexual partner. There is high prevalence of HCV and HIV infection and co-infection of both viruses among IDUs. Comprehensive public health interventions targeting this population and their sexual partners must be encouraged. Increase coverage of needle, syringe exchange programme (NSEP) to young and new IDUs is required before they are exposed to blood borne viruses.     

Low prevalence of hepatitis c virus infection in porphyria cutanea tarda in Germany

Previous studies from Spain, Italy, and France have demonstrated a high prevalence (71% to 91%) of antibodies against hepatitis C virus in patients with porphyria cutanea tarda (PCT). To determine the role of hepatitis C virus (HCV) in PCT in Germany, we have assessed the prevalence of antibodies against HCV and hepatitis B virus (HBV) in 106 patients (mean age, 60 ± 14 years) with the disease. Eight of 106 patients (8%) were positive for HCV antibodies and HCV RNA using second-generation enzyme-linked immunosorbent assay (ELISA), recombinant immunoblot assay, and polymerase chain reaction. Antibodies against HBV core antigen were found in 14 patients (13%). Of the patients with antibodies against HCV alanine transaminase (ALT) (aspartate transaminase [Ast]) levels above normal occurred in 71% (86%). Because elevated ALT (AST) levels were also found in 51% (64%) of 88 patients without markers of HCV or HBV, we suggest that liver damage in PCT may exist in absence of these viruses. This is supported by the finding that in patients without HCV or HBV markers, higher serum ALT and AST activities were found in patients with overt disease or relapse (ALT, 59 ± 44 U/L; AST, 37 ± 21 U/L), whereas patients in remission displayed significantly lower serum enzyme activities (ALT, 16 ± 8 U/L; AST, 16 ± 7 U/L), (P < .001). These results indicate that HCV infection does not play a major role in the pathogenesis of PCT in Germany.     

Longitudinal evaluation reveals a complex spectrum of virological profiles in hepatitis B virus/hepatitis C virus-coinfected patients

Hepatitis B virus (HBV) and hepatitis C virus (HCV) coinfection is often associated with severe forms of liver disease. However, comprehensive studies are lacking, and scant information is available regarding the virological behavior over time in coinfected patients. This study enrolled 133 untreated HBV/HCV-positive patients (male/female = 102/31; median age 51 years [range: 22-83 years]) who were longitudinally followed up for 1 year with bimonthly evaluation of HBV/HCV viremia levels and liver biochemistry. Thirty of these patients had triple infection with hepatitis Delta virus (HDV), while 103 patients were HDV-negative. In the HDV-negative group, active infection with both HBV and HCV was revealed in 24 cases, inactive infection by both viruses was seen in 15 cases, active HBV/inactive HCV was seen in 15 cases, and inactive HBV/active HCV was seen in 49 cases. However, 32 subjects (31%) presented dynamic virological profiles characterized by fluctuation of HBV and/or HCV viremia levels that at different time points were over or under the cutoff limits. Consequently, a correct diagnosis could be performed in these subjects only by serially repeating the virological tests 1 year apart. Similarly, 15 of the 30 HDV-positive subjects showed active HBV and/or HCV infection, with fluctuating virological patterns in 8 cases. In conclusion, this study showed that the virological patterns in HBV/HCV coinfection are widely divergent and have dynamic profiles. A careful longitudinal evaluation of the viremia levels of both viruses is essential for making a correct diagnosis and tailoring the appropriate therapeutic schedule in coinfected patients.     

Hepatitis delta virus propagation enabled by hepatitis C virus—Scientifically intriguing,but is it relevant to clinical practice?

In vitro cell culture experiments and animal models have demonstrated that hepatitis delta virus (HDV) can theoretically propagate being enveloped by human pathogenic viruses other than hepatitis B virus (HBV), namely hepatitis C virus (HCV) and dengue virus. However, the clinical relevance of these findings and whether HDV replication occurs in real‐world hepatitis B surface antigen (HBsAg)–negative HCV patient cohorts remain unknown. To this aim, we analysed 323 HCV‐RNA–positive and HBsAg‐negative sera for the presence of HDV‐RNA and anti‐HDV antibodies (anti‐HDV). All 323 (100%) samples were negative for HDV‐RNA. Interestingly, 8/316 samples tested positive for anti‐HDV. The HBV serology of these eight patients showed a positive result for HBV core antibodies (anti‐HBc) indicating a seroconversion of an acute HBV infection in the past. None of the anti‐HBc–negative patients were positive for anti‐HDV. Our results indicate a distinctly low probability of replicative HDV infection in HCV mono‐infected patients in Germany. Current German clinical guidelines rightly recommend performing HDV screening only in HBsAg‐positive patients. However, larger studies on this subject should be performed in regions that are endemic for chronic HBV/HDV as well as HCV infections.     

34例庚型肝炎病毒感染的临床特点

庚型肝炎病毒(HGV)是最近证实的一种新型肝炎病毒。我们以血清中检测到HGV RNA作为诊断HGV感染的指标,以了解HGV感染的临床特征。本文对34例HGV感染者进行临床分析,结果显示:在各类肝病人群中HGV总感染率为8.6％。在34例感染者中,有32例与其它类型肝炎病毒重叠感染。而且在各类急慢性肝病人群中均可有不同程度的HGV感染。HGV感染(含重叠感染)的临床表现各异,大多数症状较轻、恢复较快,但部分可导致肝病慢性化。HGV感染与肝硬变关系值得进一步探讨。