庚型肝炎病毒感染对慢性丙型肝炎的影响

研究慢性丙型肝炎患者中庚型肝炎病毒(UGV)的感染及其对丙型肝炎临床表现、肝功能和对干扰素应答的影响。以HGV的5′非编码区引物建立了检测HGV RNA的RT-PCR法,检测51例慢性丙型肝炎病人中的HGV感染。结果51例病人中,11例为HGV RNA阳性。慢性丙型肝炎病人的临床表现与是否感染HGV不相关,肝功能试验结果也无统计学差异。29例接受干扰素治疗的病人中,有6例病人(20.7％)合并HGV感染。HGV阳性组6人中1例完全应答,HGV阴性组23人中,有3例完全应答,在这有限的病例中,两组应答率没有统计学差异。提示在我国丙型肝炎病人中,混合HGV较为常见,HGV感染对丙型肝炎的临床表现无明显影响,也不影响其对干扰素的应答。     

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。     

丙型肝炎病毒感染与膜性肾病及膜增殖性肾炎的研究

目的：了解我国膜性肾病（ＭＮ），膜增殖性肾炎（ＭＰＧＮ）的丙型肝炎病毒（ＨＣＶ）感染率，ＨＣＶ感染与冷球蛋白血症及肾脏病关系，以期阐明ＨＣＶ在ＭＮ及ＭＰＧＮ中的作用。方法：前瞻性观察４６例健康工作人员以及１９９６年５月至１９９７年１１月期间６７例ＭＮ１２例ＨＰＧＮ患者血清ＨＣＶ抗体ＨＣＶ－ＲＮＡ的阳性率，血清冷球蛋白浓度及冷沉淀物的中的ＨＣＶ抗体及ＨＣＶ－ＲＮＡ阳性率，并结合肾组织ＨＣＶ抗原沉积特     

POLYARTHRITIS ASSOCIATED WITH HEPATITIS C VIRUS INFECTION

Two cases of polyarthritis associated with hepatitis C infectionare reported. In Patient 1, stiffness and polyarthritis occurredduring the acute stage of hepatitis. The arthritic symptomslasted for 4 months. A transient polyarthritis recurred 4 yrlater. The persistent presence of anti-hepatitis C viral antibodieswas noted. Hepatitis C viral RNA (HCV RNA) was identified inthe serum using the polymerase chain reaction proving that thepatient was a carrier. In Patient 2, polyarthritis occurredassociated with chronic hepatitis C liver disease. Synovialiopsy showed infiltration of mononuclear cells HCV RNA was demonstratedin both serum and SF. These cases suggest an aetiologic associationbetween arthritis and hepatitis C antigenaemia. KEY WORDS: Polyarthritis, Hepatitis C virus carrier, Chronic antigenaemia     

筛查献血员丙型肝炎病毒（HCV）抗体控制HCV感染

为研究筛查抗－ＨＣＶ控制ＨＣＶ感染的作用，在献血员（简称血员）筛查抗－ＨＣＶ前（１９９０年１１月～１９９２年２月）调查５个城市血站和４个县单采血浆站，血员抗－ＨＣＶ阳性率：献浆血员为５５．５％，全血血员为１０．２％。其中合格和不合格献浆血员分别为４６．２％和９１．６％，合格和不合格全血血员分别为５．８％和４２．３％，说明血员ＨＣＶ感染率高，血员不合格主要与ＨＣＶ污染有关。筛查血员抗－ＨＣＶ１年后，调查３个城市中心血站和４个县医院供血基地，合格血员抗－ＨＣＶ阳性率：献浆血员降至４．０％、全血血员降至０．２％，分别比筛查前降低９１．３％和９６．６％，Ｐ＜０．００１。义务血员抗－ＨＣＶ阳性率０．５％。筛查抗－ＨＣＶ前后首次献血员８６人，抗－ＨＣＶ皆阴性。说明筛查血员抗－ＨＣＶ既可控制ＨＣＶ感染，又可提高供血质量。     

HCV感染的慢性肝病患者肝组织HCV RNA和HCV C33c检测

为探讨丙型肝炎病毒在肝组织分布和致病机理，用地高辛标记的 ＨＣＶ５＇－ＮＣ区ｃＤＮＡ探针和抗ＨＣＶ Ｃ３３ｃ单克隆抗体对２４例ＨＣＶ感染的慢性肝病患者肝组织进行了原位核酸杂交和免疫组化研究，发现ＨＣＶ ＲＮＡ和Ｃ３３ ｃ阳性信号主要定位于肝细胞浆，ＨＣＶ感染的阳性肝细胞呈散在、局灶和弥漫三种形式分布，与丙氨酸转氨酶水平、肝组织学类型没有明显联系：ＨＣＶ感染的细胞周围有较多的淋巴细胞和单核细胞浸润。     

乙型肝炎病毒前C区变异株和野生株感染者血清HBV DNA水平

为探索HBV前C区变异株和野生株感染者血清HBA水平,我们用3’末端限定引物扩增HBV变异株和野生株DNA,并采用信号引物能量转移法对50例患者进行DNA定量分析。结果显示,15例变异株患者DNA含量为1.26×10~5—8.52×10~9拷贝/ml,而野生株含量明显低于变异株(P<0.01),为3.37×10~3—9.46×10~7拷贝/ml。提示变异的病毒可以逃避宿主的免疫压力而大量复制,使感染持续。     

输血后HCV感染的前瞻性研究

在无国产抗－ＨＣＶ试剂供应的１９９０和１９９１年，甲地观察输血者９０名（不筛查ＡＬＴ），乙地筛查ＡＬＴ观察输血者６４名。输血后ＨＣＶ感染率甲地４５．６％，乙地１８．８％，ｐ＜０．０１；其中输血后丙型肝炎发生率甲地４１．１％，乙地１４．１％Ｐ＜０．０１，甲地观察二年未发现抗－ＨＣＶ阴转；输血距抗－ＨＣＶ阳转甲地３８．４±１１．８天，乙地４２．９±１５．９天；输血后ＡＬＴ异常率甲地４４．４％，乙地２１．９％，输血距ＡＬＴ异常甲地４８．２±１６．８天（观察二年ＡＬＴ异常率２７．８％），乙地５１．９±２０．９天。输抗－ＨＣＶ阳性、阴性血受血者，其ＨＣＶ感染率８８．２％（４５／５１）和７．８％（８／１０３）。既往ＨＣＶ隐性感染的受血者，输后丙型肝炎发病率５２．９％（１１／２２），同时发现３例输血后抗－ＨＣＶＳ／ＣＯ值渐低，２例阴转，似有ＨＣＶ中和性抗体存在。     

HEPATITIS C VIRUS AND ESSENTIAL MIXED CRYOGLOBULINAEMIA

Clinical and laboratory evidence of liver involvement are frequentlyfound in essential mixed cryoglobulinaemia (EMC). We lookedfor evidence of hepatitis C virus (HCV) infection in 37 patientswith EMC. Anti-HCV antibodies (Ab) were found in 16/37 (43%)patients with EMC using the ELISA 2 test and the RIBA 2 test.The 16 anti-HCV-Ab positive patients (group 1) were comparedto the 21 anti-HCV-Ab negative patients (group 2). Group 1 patientshad more frequent cutaneous involvement (P = 0.02), clinical,biological and histologic hepatic involvement (P<0.01), higherserum cryoglobulin and lower CH50 levels (P<0.001). Serumhepatitis B virus markers were infrequent in both groups andno patient from either group had detectable serum HBV DNA. Thesepreliminary results suggest that HCV may be another cause ofmixed cryoglobulinaemia. KEY WORDS: Hepatitis C virus, Cryoglobulinaemia     

EUROPEAN STUDY ON EPIDEMIOLOGY AND MANAGEMENT OF HEPATITIS C VIRUS (HCV) INFECTION IN THE HAEMODIALYSIS POPULATION PART 3: PREVALENCE AND INCIDENCE

An analysis of the literature showed a high prevalence of HCV in the European dialysis population in the nineties. The prevalence was similar in most countries in northern Europe, but infection was more common in France, Italy, Spain, Portugal and Greece (1) and in Eastern European countries (2). The reported prevalence of anti‐HCV‐positive patients in the EDTA registry was 21% in 1992 and 18% in 1993 (3) ranging from 1% in Finland to 42% in Egypt (4). The incidence of HCV, in new patients starting renal replacement therapy, ranged from 3% to 7% (5,6) and reported seroconversion rates during dialysis treatment varied between 1% (7) and 16% (8) per year.     

丙型肝炎病毒感染者肝组织中病毒抗原表达的免疫组化研究

为探讨丙型肝炎病毒（ＨＣＶ）在肝组织中的表达状况，应用免疫组化方法以多克隆人抗－ＨＣＶ和单克隆鼠抗－ＨＣＶ－ＮＳ＿３检测一组ＨＣＶ感染者石蜡包埋肝组织中ＨＣＶ抗原（Ａｇ）和ＨＣＶ－ＮＳ＿３，并对抗原检出与血清ＨＣＶ标志的关系进行分析。结果：ＨＣＶＡｇ和ＨＣＶ－ＮＳ＿３检出率分别为３８．３％（２３／６０）和３０．０％（１８／６０）；所有ＨＣＶ－ＮＳ＿２，阳性者均同时表现ＨＣＶＡｇ阳性；阳性颗粒定位于肝细胞胞浆；阳性细胞分布呈散在、弥漫状和簇状，周围多天坏死及炎性细胞浸润；不同血清ＨＣＶ标志模式间抗原检出率存在明显差别。研究结果对认识ＨＣＶ致病机理有一定意义。     

中国藏族和维吾尔族人群丙型肝炎病毒基因型分析

目的与方法根据不同基因型丙型肝炎病毒（ＨＣＶ）核心区基因序列，合成一条通用引物和四条型特异性引物用于ＲＴ／ＰＣＲ扩增反应，所得不同长度的扩增产物分别对应于ＨＣＶⅠ、Ⅱ、Ⅲ、Ⅳ的基因型，用此方法对采自西藏的６９例藏族和新疆的８１例维吾尔族的丙型肝炎病毒阳性血清进行了分析。结果藏族的６９例中３例为Ⅰ型（３／６９，４．３％），３３例为Ⅱ型（３３／６９，４７．８％），４例为Ⅲ型（４／６９，５．８％），２９例为混合型（２９／６９，４２．１％）；维吾尔族的８１例中８例为Ⅰ型（８／８１，９．９％），１４例为Ⅱ型（１４／８１．１７．３％），３例为Ⅲ型（３／８１，３．７％），５６例为混合型（５６／８１，６９．１％），这同我国内地汉族人群中丙型肝炎病毒基因型分布明显不同。结论　ＨＣＶ基因型的分布有一定的地区特异性。     

HEPATITIS B INFECTION AMONG STD CLINIC PATIENTS IN SYDNEY

Evidence of current or past infection with hepatitis B has been studied in 809 patients attending clinics for sexually transmitted diseases in Sydney by assaying serological markers. Prevalence rates were 13.9% among male heterosexuals; 13.5% among female heterosexuals; 30.7% among female prostitutes; 64.3% among male homosexuals and 47.1% among male bisexuals. The prevalence was 80% for male homosexuals aged 36 years or more. Vaccination should be considered for persons at high risk of sexual transmission of hepatitis B, and it is the immunization of this group that is likely to have a major impact on this disease.