延边地区医院门诊、住院人群丙型肝炎感染现状调查

[目的]了解延边地区医院门诊、住院人群HCV感染状况. [方法]应用酶联免疫法检测21291例样本血清中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]21291例样本中HCV感染率为4.78%;男性感染率为3.76%,低子女性6.03%(P<0.05).HCV抗体阳性者肝功能及相关生化指标56.67%在异常范围;HCV RNA阳性率为77.33%;HCV感染者中有输血史、手术史者比例较高. [结论]HCV感染率女性高于男性;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异常.     

德宏傣族景颇族自治州跨境婚姻人群的HCV感染的流行病学调查

  目的  了解德宏傣族景颇族自治州(简称德宏州)跨境婚姻人群HCV的感染状况以及相关因素。  方法  横断面研究。2017年5月1日―2018年6月30日通过问卷调查收集研究对象的基本信息,并抽5 ml血72 h内检测HCV抗体。  结果  共调查35 188人,其中31 948人接受了HCV抗体检测,阳性770人,阳性率2.41%,其中中国籍调查对象HCV感染率为3.42%(518/17 150),缅籍调查对象的感染率为1.50%(252/16 798)。男性HCV感染率为3.64%,高于女性的1.33%。景颇族男性的感染率高于其他民族,为7.08%。男性静脉注射吸毒者HCV感染率高达85.23%。有过非婚非商业性行为的女性HCV感染率为29.94%。多因素Logistic回归分析模型结果显示,跨境婚姻人群男性感染HCV的危险因素为:年龄≥30岁、少数民族、吸毒史、非婚性行为史以及HIV感染,女性感染HCV的危险因素为:年龄≥30岁、景颇族、吸毒史、非婚非商业性行为史和HIV感染。  结论  德宏州跨境婚姻人群HCV感染率高于一般人群,需要进一步加强吸毒人群HCV检测与丙型肝炎知识宣传和防治工作。     

福州市美沙酮替代治疗人群丙肝、乙肝、艾滋病和梅毒感染调查

目的了解美沙酮替代治疗者丙肝、乙肝、艾滋病及梅毒感染情况及高危因素,为制定防控措施提供依据。方法对接受美沙酮替代治疗的1 149例进行问卷调查;采集静脉血标本,用ELISA法检测抗-HCV、HBV标志物、抗-HIV和梅毒抗体。结果 1 149例中男性检出抗-HCV 569例(49.5%),HBsAg阳性25例(2.2%),抗HIV阳性31例(2.7%),梅毒抗体阳性5例(0.4%)。抗-HCV阳性者中,女性感染率(63.4%)高于男性(46.8%),感染率最高为30~49岁组。注射吸毒为HCV感染的高危因素。93例HCV感染者中,HCV RNA大于2.7log10拷贝/mL有61例(65.6%)。61例HCV RNA阳性标本中,基因型以1b型为主(65.7%)。结论美沙酮替代治疗的吸毒人群中,抗-HCV阳性率远超自然人群,尤以注射吸毒者感染率为高;其HCV基因型与福建自然人群感染丙肝基因型一致;65.6%HCV感染者存在HCV RNA高复制,需要进行抗病毒治疗。     

男性静脉吸毒人群血清学检测结果分析

目的:了解男性静脉吸毒人群HIV、HBV、HCV、梅毒的感染状况及肝、肾功能的损害情况,为此类人群提出针对性的防控措施提供依据。方法:2009年对东海县一家男性强制戒毒所214名静脉吸毒人群血清中抗-HIV、HBsAg、抗-HCV、梅毒螺旋体抗体(抗-TP)及ALT、AST、ALP、γ-GT、TP、ALB、Urea、Cr、UA九项生化指标进行检测,并同期与287名无吸毒史的健康体检的男性对照组比较。结果:214名男性静脉吸毒人群中抗-HIV、HBsAg、抗-HCV、抗-TP阳性率分别为0%、9.35%、85.05%、7.94%。与对照组比较,抗-HCV、抗-TP阳性率明显高于对照组(P0.005);总合并感染率13.55%明显高于对照组0.35%(P0.005),其中HBV/HCV、HCV/梅毒、HBV/HCV/梅毒的合并感染率分别为7.01%、5.61%、0.93%;男性静脉吸毒人群ALT、AST、ALP、γ-GT、Cr水平明显高于对照组(P0.001),而TP、ALB、Urea水平明显低于对照组(P0.002,P0.001)。在各感染组与对照组和未感染组比较中,以HCV组对肝功指标水平影响大。结论:被调查的男性静脉吸毒人群HCV、梅毒和合并感染的感染率高于正常人群,静脉吸毒导致肝、肾功能损害,静脉吸毒人群感染HCV加重对肝功能的损害。     

两种人群中抗-HIV、抗-HCV及梅毒抗体检测比较分析

目的了解包头市两类人群中HIV、HCV及梅毒的感染情况。方法采用标准的HIV、HCV及梅毒抗体血清学检测方法,对2010年1～2011年12月间1 220例眼科手术病人（普通人群）和1 982例男性同性恋、暗娼及戒毒所戒毒者（高危人群）进行了抗-HIV、抗-HCV及梅毒抗体的检测。结果普通人群中,抗-HIV抗体、抗HCV抗体、梅毒抗体检出率分别为0、0.33%和0.66%;高危人群中,三者的检出率分别为1.21%、2.12%和13.42%。结论在普通人群中未检出HIV抗体阳性者,HCV抗体和梅毒抗体的阳性检出率较高危人群低,说明三种疾病在特殊人群中的感染率高于一般人群。因此,必须采取有效措施,做好我市高危人群中性病、艾滋病的干预工作,防范这类疾病从高危人群向普通人群的扩散。     

1995年菏泽地区人群病毒性肝炎感染情况调查报告

菏泽地区自然人群、医务人员和献血员HAV、HBV、HCV感染调查结果显示,人群HAV总感染率为53.02%,HBV总感染率为47.99%,HCV总感染率为4.97%.分析比较了不同年龄组和不同职业人群HAV、HBV和HCV感染率差异.三型肝炎病毒单独感染以HAV为主,混合感染以HAV HBV为主.我区属HAV感染中流行区,有半数人群属HBV易感者,人群HCV感染率高,对今后工作的重点进行了探讨.     

广西部分吸毒人群丙型肝炎病毒及艾滋病病毒感染情况调查分析

目的 了解我区吸毒人群中丙型肝炎病毒(HCV)及艾滋病病毒(HIV)感染和两者合并感染的情况,为制定艾滋病及丙型肝炎的防治措施提供理论依据.方法 对我区部分在押的吸毒者共计3000名作为调查对象,制定统一的调查问卷进行调查,并采集静脉血,分离血清,用酶联免疫吸附试验(ELISA)夹心法检测HCV抗体和HIV抗体,当HIV抗体阳性时则用蛋白免疫印迹试验(Westem Blotting,WB)进行HIV抗体确证实验.结果 在3000名吸毒患者中,男性占88.4%,女性占11.6%;总的HCV抗体阳性率是85.6%,HIV抗体阳性率是18.2%,其中静脉注射吸毒者(IDUs)HCV抗体阳性2553名,感染率为86.1%,口吸吸毒者HCV抗体阳性21名,感染率60.O%;口吸吸毒人群中HIV抗体阳性3名,感染率为8.56%,静脉吸毒人群中HIV抗体阳性543名,感染率18.31%;HCV抗体阳性合并HIV抗体阳性有537名,感染率为20.86%.结论 广西吸毒人群的HCV感染率较高,尤其是静脉注射吸毒人群,应当加强对吸毒人群的综合干预措施,控制HCV及HIV的传播,降低新发感染.     

河南省吸毒人群HIV/HCV感染状况分析

目的 了解河南省吸毒人群人类免疫缺陷病毒(HIV)、丙型肝炎病毒(HCV)感染状况及其相关危险因素,为针对其制订艾滋病防治措施提供科学依据.方法 于2009年1月-2010年6月对河南省美沙酮维持治疗门诊收治的836名吸毒者进行行为学和血清学调查,分析其HIV、HCV感染的危险因素.结果 836名吸毒者HIV抗体阳性者12例,阳性率为1.44％,HCV抗体阳性者32例,阳性率为3.83％;HIV/HCV合并感染率为0.8％ (7/836);近半年吸毒方式为单纯注射的人群合并感染率为12.1％ (7/58);曾共用针具人群的合并感染率为9.5％(2/21);20.5％(171/836)的吸毒者曾注射过毒品;66.7％(565/836)的吸毒者曾戒毒,但均未成功;在进入美沙酮门诊时59.7％(499/836)的研究对象尿检阳性,提示近期曾使用毒品.结论 吸毒人群是HIV、HCV感染的易感人群,同时其存在多种导致HIV传播的危险因素;应加强美沙酮维持治疗,降低吸毒人群高危行为,遏制艾滋病在该人群中的传播.     

肿瘤患者肝炎病毒感染分析

目的以2070例肿瘤患者为研究对象,分析其乙型肝炎(HBV)及丙型肝炎(HCV)感染率,研究HBV及HCV感染与恶性肿瘤的关系。方法采用回顾性分析方法,按肿瘤类别、年龄和性别进行分组,对检测结果进行统计分析。结果肝癌的HBV、HCV及混合感染的感染率最高,分别为82.87%、6.71%和4.86%;45～55岁年龄段HBV及HCV单项感染率最高,为22.26%、3.71%;而55～65岁年龄段HBV及HCV混合感染率最高,为2.91%;肝癌及胃癌HBV和HCV单项感染率男性高于女性,而肺癌及结肠癌HBV及HCV单项感染率男性低于女性,肝癌及结肠癌的HBV及HCV混合感染率男性高于女性,肺癌及胃癌则男性低于女性。结论肝癌的HBV、HCV及混合感染的感染率最高;在HBV及HCV单项感染情况下,45～55岁年龄段感染率最高并且男性高于女性。     

绵阳市海洛因成瘾者HCV和HIV抗体监测分析

[目的]了解绵阳市海洛因成瘾者HCV、HIV感染现状,深入开展社区药物维持治疗工作. [方法]对首次参加社区药物维持治疗海洛因成瘾者进行问卷调查,采血样检测HCV和HIV血清抗体. [结果]监测574名海洛因成瘾者,HCV抗体阳性率为74.91%,HIV抗体阳性率为2.96%.不同年龄组人群HCV抗体阳性率均高,HIV抗体阳性者集中在25～40岁人群.不同吸毒方式中,单纯口吸者HCV抗体阳性率为26.79%,未检出HIV抗体阳性;单纯注射吸毒者HCV抗体阳性率为80.12%,HIV抗体阳性率为3.28%.HCV和HIV合并感染率为2.79%. [结论]海洛因成瘾者HCV和HIV感染率高,应加大健康教育和综合干预力度,积极开展社区药物维持治疗工作,以减少共用针具高危行为.     

广西某美沙酮维持治疗门诊HCV抗体阳性就诊者病毒载量及相关因素分析

目的 检测广西某美沙酮维持治疗(methadone maintenance treatment,MMT)门诊丙型肝炎病毒(hepatitis C,HCV)抗体阳性者的HCV病毒载量探讨其相关影响因素.方法 对广西南宁市MMT门诊HCV抗体阳性就诊者进行调查,收集一般人口学信息、吸毒及HIV感染情况等,并进行HCV病毒载...     

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。     

HCV transmission in family members of subjects with HCV related chronic liver disease

To investigate the risk of sexual and intrafamilial transmission of HCV, 220 family members of 76 patients (index cases) with chronic type C viral liver disease were tested for serological markers of HCV Of the family members, 129 were offspring, 64 sexual partners, 15 parents and 12 siblings of the index cases. Anti-HCV was tested in all the household contacts; HCV-RNA was tested in antibody positive samples. The serologic markers of HCV were tested in a control group of 168 family members of 81 patients with chronic hepatitis unrelated to HCV. The overall prevalence of anti-HCV was 8.2% compared to 0.6% in the control group (p < 0.001). Sexual partners were anti-HCV positive more frequently than the other contacts (20% vs 2.2%; p < 0.001), without any difference in males or females. No correlation was observed between the occurrence of HCV infection in contacts and age, severity of liver disease or risk factor for the acquisition of HCV in the index cases. Seven of the 18 (39%) anti-HCV positive family contacts had biochemical evidence of chronic liver disease, histologically confirmed in the 6 patients who underwent a liver biopsy. Liver chemistry was normal in all the HCV-negative contacts. Ten of the 18 anti-HCV positive contacts (55%) were HCV-RNA positive. Genotypes were the same (lb) in 4 of the 7 viremic couples of subjects: in 3 of the 6 couples of sexual partners and in the only mother/son couple. These data suggest the occurrence of intraspousal transmission of HCV, while intrafamiliar acquisition of HCV in non-sexual contacts seems to be rare.     

各型病毒性肝炎、肝癌抗—HCV检测及HCV感染与输血的关系

本文对各型病毒性肝炎、肝癌２００例进行血清抗－ＨＶＣ检测，阳性率为２０．５％，以重型肝炎和肝硬化检出率为高，分别为４２．８６５、４６．１５％，二者与其他型肝炎相比，有显著性差异（Ｐ＜０．０５）。输血后肝炎抗－ＨＣＶ阳性率为６７．５％，健康献血员抗－ＨＣＶ阳性率为２０．４７％，而输血后乙型肝炎仅占２．５％。说明输血是造成丙型肝炎传播的重要途径，因此，对献血员应进行严格筛选。观察表明，ＨＢＶ与ＨＣＶ双     

各型病毒性肝炎、肝癌抗－HCV检测及HCV感染与输血的关系

本文对各型病毒性肝炎、肝癌２００例进行血清抗－ＨＣＶ检测，阳性率为２０．５％，以重型肝炎和肝硬化检出率为高，分别为４２．８６％、４６．１５％，二者与其他型肝炎相比，有显著性差异（Ｐ＜０．０５）。输血后肝炎抗－ＨＣＶ阳性率为６７．５％，健康献血员抗－ＨＣＶ阳性率为２０．４７％，而输血后己型肝炎仅占２．５％。说明输血是造成丙型肝炎传播的重要途径，因此，对献血员应进行严格筛选。观察表明，ＨＢＶ与ＨＣＶ双重感染，可能是形成慢性肝炎，肝硬化以及促使肝炎向重型发展的重要原因之一。抗－ＨＣＶ阳性的慢性肝炎，血清ＡＬＴ５０％在正常范围内，余者仅轻度升高，说明ＨＣＶ感染所致的肝损伤可能是一个较慢的过程     

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)     

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。     

出国移民中丙型肝炎病毒感染检测结果分析

〔目的〕探索简便而准确的丙型肝炎血清学诊断方法,并了解一般人群中丙型肝炎病毒感染的状况。〔方法〕以酶联免疫吸附试验(ELISA)作为主要检测方法,用金标法复核,并与HCV-RNA的检测进行对比;同时对2004年7月￣2006年6月的26366份血样抗-HCV检测的结果进行分析。〔结果〕用ELISA法为主,结合金标法来判断抗-HCV的检测结果,与HCV核酸检测的方法符合率为96.0%;在出国移民中丙型肝炎病毒感染率为0.44%,且男性高于女性,其中有64.10%的人丙氯酸转氨酶(ALT)超过正常值范围。〔结论〕用ELISA与金标结合的方法判断抗-HCV检测结果,可避免单纯使用ELISA方法假阳性较高的现象;有2/3的HCV感染者中ALT超过正常值范围。     

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.     

Prevalence of antibodies to hepatitis C virus among family members of patients with chronic hepatitis C

In this study, 108 family members of 40 chronically HCV-infected patients (19 post-transfusion and 21 sporadic), and 45 families of 16 anti-HCV-negative index cases (control group) were tested for anti-HCV antibodies. Anti-HCV antibodies were found in 16 (14.8%) families of anti-HCV positive index cases (15% males and 14.6% females; p = NS), with no difference between families of index cases with post-transfusion and those with sporadic HCV infection. Out of the 16 anti-HCV positive family members, 12 (75%) had clinical and/or serological evidence of chronic liver damage. None of the control group subjects were anti-HCV-positive (p < 0.01). The rate of anti-HCV positivity was 34.4% among spouses, 14.3% among siblings, 16.7% among cohabitants and 2.3% among children; anti-HCV antibodies were not detected among parents. We found a positive correlation between the prevalence of anti-HCV antibodies among families and the severity of the HCV-related chronic liver damage of the index cases (p < 0.00005). In addition, to confirm that HCV infection and HCV-related chronic hepatitis may be transmitted intrafamiliarly, our findings also indicate that horizontal, especially sexual contact, is a more important route of HCV infection than vertical/perinatal transmission. Finally, the risk of acquiring HCV infection among families appears to be the highest when index cases are suffering from severe HCV-related chronic hepatitis.Corresponding author.