透析患者的丙型肝炎感染

目的观察血液透析患者的丙型肝炎感染情况。方法用酶联免疫吸附试验检测175例血液透析患者血清中抗丙型肝炎病毒（抗HCV）。结果175例血液透析患者中,抗HCV阳性率透析〈2年为6.20％,透析〉2年为47．83％。结论随着透析年限延长,丙型肝炎感染概率加大。     

维持性血液透析患者肝炎病毒感染情况分析

目的了解维持性血液透析患者肝炎病毒感染状况.方法分别对208例维持性血透患者(实验组)及138例健康献血者(对照组)采用酶联免疫法检测乙型和丙型肝炎标志物.结果维持性血液透析患者HBV感染率为30.77%,HCV感染率5.29%,且HCV感染与透析时间及受血次数呈正相关.结论维持性血液透析患者HCV感染与透析时间及受血次数密切相关.     

Hepatitis C viral infection in a Chinese hemodialysis unit

Background The prevalence of hepatitis C virus （HCV） infection among maintenance hemodialysis （MHD） patients varies among countries and among dialysis units within a single country. The present study aimed to investigate the prevalence and characteristics of HCV infection in MHD patients in a Chinese hemodialysis unit.Methods One hundred and ninety-two patients on MHD for an average of （86.1±30.0） months （range 6-181 months） were enrolled in this cross-sectional study. HCV antibody and HCV-RNA were measured in these MHD patients before hemodialysis by enzyme-linked immunosorbent assay （ELISA） and polymerase chain reaction （PCR） methods.According to the result, all the patients were then divided into two groups： GroupⅠwas positive for HCV antibody and/or HCV-RNA （n=32）, and Group Ⅱ was negative for HCV antibody and HCV-RNA （n=160）. The following information was obtained for all the patients： socio-demographic data, history of blood transfusions and kidney transplantation, and some laboratory values. The MHD patients who were positive for HCV antibody and/or HCV-RNA were followed for more than three years. The disease activities were graded into ＂asymptomatic＂ if alanine aminotransferase （ALT） was less than 40 U/L,＂low activities＂ if ALT was 40-79 U/L, and ＂high activities＂ if ALT was equal to or above 80 U/L.Results The prevalence of HCV infection in MHD patients in our dialysis unit in May 2009 was 16.7, which was significantly higher than in general population （3.2%）. Among the 32 MHD patients with HCV positive, 20 patients were positive for HCV antibody but negative for HCV-RNA, eight patients were positive both for HCV antibody and HCV-RNA,four patients were negative for HCV antibody but positive for HCV-RNA. Eleven patients had a history of kidney transplantation and 12 had a history of blood transfusion, which were significantly more than among the MHD patients without HCV. Thirty of the 32 MHD patients were asymptomatic. There were no significant differences in age, aspartate aminotransferase （AST）, ALT, or between HCV-RNA positive group and HCV-RNA negative group. But the dialysis duration in the HCV-RNA positive group was significantly longer than that in the HCV-RNA negative group. All the 20HCV-RNA negative patients were asymptomatic. Two of the 12 HCV-RNA positive patients had low activity. None of the 32 cases with HCV positive markers had cirrhosis.Conclusions A high prevalence of HCV infection in MHD patients is related to blood transfusion and kidney transplantation. Occult HCV infection is present in MHD patients. Chronic hepatitis C among MHD patients is mild in disease activity, and is not progressive, perhaps due to immunological abnormalities in these patients.     

血透患者丙肝感染情况分析

目的：了解血液透析（ＨＤ）患者丙型肝炎（ＨＣＶ）感染情况，探讨其与透析时间、输血次数的关系。方法：应用第二代酶联免疫法（ＥＬＩＳＡ）检测丙型肝炎病毒，调查慢性肾功能衰竭（ＥＳＲＦ）患者７０例，其中维持性血透患者３９例，未行血透治疗者３１例，并按透析时间、输血次数等分组进行对比分析。结果：ＨＤ组与非ＨＤ组ＨＣＶ感染率分别是４１．３％和３．２３％，输血组与非输血组ＨＣＶ感染率分别是３３．３３％和３．２３％，均有统计学意义。结论：透析年限和输血次数是ＨＣＶ感染的危险因素。     

丙型肝炎病毒感染对肾移植术后影响的临床研究

OBJECTIVE: To study the influence of hepatitis C virus (HCV) infection on the clinical outcome of kidney transplantation. METHODS: The recipient/graft survival, the incidence of acute/chronic rejection and cause of death in 86 HCV-infected recipients of renal transplantation were compared with those in another 86 recipients without HCV infection. RESULTS: HCV-infected recipients had significantly shorter 5-year survival (74.4%) than those without HCV infection (87.2%, P<0.01). The 1-year (94.2%/90.7% vs 96.8%/96.0%) and 3-year recipient/graft survival rates (88.4%/79.1% vs 90.7%/87.2%), the incidence of acute/chronic rejection (31.3% vs 21.2%, and 12.5% vs 6.5%) and the 5-year graft survival (73.3%/81.4%) were comparable between the two groups (P>0.05). Hepatic disease was identified as the primary cause of mortality. CONCLUSIONS: HCV infection may affect the long-term survival of the recipients with kidney transplantation, and therefore should be considered as a relative contraindication of kidney transplantation.     

丙型肝炎病毒感染对维持性血液透析患者微炎症状态的影响

【目的】探讨丙型肝炎病毒(HCV)感染对维持性血液透析(maintenance hemodialysis,MHD)患者微炎症的影响。【方法】比较30例HCV抗体阳性的维持性血液透析患者(阳性组)与30例HCV抗体阴性(阴性组)的维持性血液透析患者微炎症状态标志物:C反应蛋白(C-reactive protein,CRP)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)和白介素-6(interleukin-6I,L-6),同时检测并比较两组营养状况指标:血浆白蛋白(ALB)、前白蛋白(PA)。【结果】阳性组较阴性组血清CRPI、L-6和TNF-α水平均显著增高(P<0.05);阳性组ALB、PA组较阴性组显著降低(P<0.05)。【结论】感染HCV可加重维持性血液透析患者体内的微炎症状态,并进一步加重营养不良。     

丙型肝炎病毒感染与肝细胞癌

目的;了解丙型肝炎病毒（ＨＣＶ）感染与肝细胞癌（ＨＣＣ）的关系。方法：采用ＥＬＩＳＡ和聚合酶链反应（ＰＣＲ）对皖北地区８７例肝细胞癌、８０例肝硬化和１００名健康对照进行乙肝型肝炎病毒（ＨＢＶ）、ＨＣＶ血甭标志和ＨＢＶ－ＤＮＡ、ＨＣＶ－ＲＮＡ检测。结果;皖北地区肝癌和肝硬化的发生,除与ＨＢＶ感染密切相关外,与ＨＣＶ感染亦密切相关。     

维持性血液透析患者丙型肝炎病毒感染血清学诊断方法的比较

目的比较丙型肝炎病毒(HCV)感染的血清学诊断方法,探索诊断维持性血液透析患者HCV感染的可靠方法。方法分别使用国产和进口HCV抗体试剂盒检测抗-HCV,使用TMA法定性检测HCV-RNA,荧光定量PCR法定量检测HCV-RNA,比较各种诊断方法对HCV的检出率,评价ALT变化与HCV-RNA载量的关系,评价抗-HCVS/CO值与HCV-RNA载量的关系。结果国产和进口试剂检测抗-HCV的检出率均为7.3%(P=1.000);TMA法检测HCV-RNA的检出率为9.5%,免疫荧光定量PCR法的检出率为5.6%,两者之间差异无统计学意义(P=0.330);单独检测HCV-RNA比单独检测抗-HCV的检出率高,两者差异有统计学意义(P=0.000);联合检测抗-HCV和HCV-RNA的检出率为10.6%,与单独检测抗-HCV相比较差异有统计学意义(P=0.000)。HCV-RNA的载量和ALT的变化无相关性(r=0.189,P=0.536);抗-HCV初筛的S/CO值与HCV-RNA载量无相关性(r=0.174,P=0.569)。结论检测HCV-RNA能缩短HCV感染后检出的窗口期,以便更早诊断维持性血液透析患者HCV感染,联合检测抗-HCV和HCV-RNA能避免漏诊处于血清转换期或慢性病毒携带的患者。ALT的变化和HCV载量无明显相关性,在血液透析患者中辅助早期诊断HCV感染的作用较小。     

血液透析病人庚型肝炎病毒感染状况调查

自 1995年发现庚型肝炎病毒 (ＨｅｐａｔｉｔｉｓＧｖｉｒｕｓ ,ＨＧＶ)以来 ,国内关于庚型肝炎病毒的流行情况仅有少数研究报道[1] 。本研究采用血清学和分子生物学的方法 ,检测血液透析病人抗 ＨＧＶ抗体和ＨＧＶ ＲＮＡ ,以了解血液透析病人庚型肝炎病毒感染状况 ,并对其传播途径进行探讨。1　对象和方法1.1　对象　　本院肾病中心 76例血液透析病人 ,其中男性 43例 ,女性33例 ,平均年龄 3 5岁。抽取全血后分离血清 ,分装后置 -70℃冰箱保存。1.2　试剂和方法1.2 .1　试剂　　①ＨＧＶ抗体检测试剂盒 :北京解放军传染病研究所免疫病毒研…     

Hepatitis C virus infection in patients with sickle cell anaemia at the Lagos University Hospital

The objective of this studies is to determine the frequency of antibodies to Hepatitis C virus (anti-HCV), (2) assess the role of blood transfusion in transmission of infection, and (3) evaluate the clinical implication of anti-HCV sero-positivity in patients with Sickle cell anaemia (SCA). Two hundred and seventy-eight (278) patients with SCA were evaluated by questionnaire interviews for risk factors, clinical examination and serum testing for anti-HCV using a third generation ELISA kit. The overall anti-HCV prevalence was 5.0% (14/278). Anti-HCV was positive in 7% (5/76) of never transfused compared with 5% (9/202) of previously transfused sicklers. (p = 0.5). Clinically, splenomegaly alone or in combination with hepatomegaly was associated with a positive anti-HCV (p = 0.04 and 0.01 respectively). Anti-HCV was detected in 5% of adult patients with Sickle cell anaemia, especially in patients with persistent splenomegaly alone or in combination with hepatomegaly. Blood transfusion did not appear to be the major route of HCV transmission.     

维持性血液透析病人感染丙型肝炎的前瞻性研究

评价血液透析病人ＨＣＶ阳转率和危险因素。方法随访１９９５年６月－１９９６年１２月在本院透析的１９９例血透病人,均未隔离抗－ＨＣＶ阳性病人。采用敏感的ＥＬＩＳＡ２每隔３个月在同一实验室检测。结果１９９５年６月的抗－ＨＣＶ阳性率为５８．７％,每隔半年的阳性率分别为５３．７％,５４．８％和５０．０％。     

维持性血液透析患者丙型肝炎病毒感染对胰岛素抵抗、动脉粥样硬化的影响

目的 探讨丙型肝炎病毒(HCV)感染对维持性血液透析(MHD)患者胰岛素抵抗、微炎症及动脉粥样硬化的影响.方法 HCV(+)组和HCV(-)组患者各24例,比较两组患者血压、体重指数、胰岛素抵抗指数(HOMA-IR)、超敏C反应蛋白(hsCRP)、颈动脉内膜中层厚度(IMT)、心脏彩超及生化指标.结果 两组患者在年龄、...     

Detection of hepatitis G virus RNA in hepatitis C patients and hepatitis C virus infected hemodialysis patients

AlthoughsensitiveandspecificimmunoassayandmolecularbiologicaltechniquesforthedetectionofthehepatitisA--Evirusesareavailable,theetiologyofasubstantialfractionofpost--transfusionandcommunity--acquiredhepatitiscasesremainsundefined[1],suggestingtheexistenceofadditionalcausativeagents.Anewhumanhepatitisviruswasisolatedbytwoindependentgroups.ThenewvirusisprovisionallydesignatedashepatitisGvirus(HGV)[ZJorGBvirusC(GBV~C)[3'4),whichwasthoughttobetheagentofpartofthenon--A--Ehepatitispatients.Fro…     

Hepatitis C virus infection: Its role in chronic liver diseases

Summary In order to find out the infectious rate of hepatitis C viris (HCV) among chronic liver diseases, we investigated antibodies against hepatitis C virus and HCVRNA by method of ELISA, R1BA and RT-PCR in 410 patients with chronic liver disease. The prevalence of HCV infection was found to be 4%. Whereas the positive rate of HBsAg and HBV-DNA of these cases was 69% and 58%, respectively. There is no statistical significance between HCV infectious rate of patients with positive and negative HBsAg. The relative low infectious rate of HCV infection among chronic hepatic diseases indicates that HBV infection plays a more important role in causing chronic hepatitis than that of HCV. Thus, special emphasis should be paid to the preventive and therapeutic measures against hepatitis B in China.     

丙型肝炎病毒感染对肾移植术后影响的临床研究

目的 探讨丙型肝炎病毒(Hepatitis C virus,HCV)感染对肾移植术后的影响。方法 比较86名HCV感染和86名非HCV感染病人肾移植术后1,3,5年人/肾存活率和急、慢性排斥反应的发生率,并对死亡病例的原因进行分析。结果 两组病人在肾移植术后不同时间人/肾的存活率分别为:术后1年(94.2%/90.7%和96.8%/96.0%);术后3年(88.4%/79.1%和90.7%/87.2%);术后5年(74.4%/73.3%和87.2%/81.4%)。两组急性排斥反应发生率为31.3%和21.2%,慢性排斥反应发生率为12.5%和6.5%。其中HCV感染组5年人存活率低于非HCV感染组(P<0.05),而其他各项结果无统计学差异(P>0.05)。肝病为感染组的首位死亡原因(36.4%)。结论 HCV感染对肾移植受者术后长期存活存在负面影响,HCV感染应作为肾移植手术的相对禁忌证。     

Hepatitis C virus infection in different groups of children in Wuhan area

Summary To investigate the incidence of child’s HCV infection in our area, 637 children with different background, including 65 posttransfusion cases, 419 hepatitis patients (250 cases of acute hepatitis A, 156 cases of chronic hepatitis B and 13 cases of non-A, non-B hepatitis), 50 infantile hepatitis syndrome (1HS) infants and 103 healthy day-cared children were tested for serum anti-HCV antibody (EIA) and HCV RNA (nested PCR). It was found that posttransfusion children had significantly higher anti-HCV positive rate (30. 8%) and HCV infection incidence (43.1%) than hepatitis patients (4.3% and 5.3%), IHS infants (6.0% and 8.0%) and daycared children (2.9% and 2.9%). 25 of 33 cases with posttransfusion hepatitis (PTH) developed hepatitis C, which was the leading cause of PTH (75.8%) and NANB PTH (25/30, 83.3%). The incidence of HCV infection in NANBH patients was 23.1% (3/13) which was apparently higher than that in day-cared children (P <0. 02) and lower than that in PTH patients (P<0. 001), but not statistically different from that in AHA and CHB patients (P>0. 05). Mother-infant paired study in IHS group showed that 4 pairs of mother-infant had HCV infection, one boy aged 8 months and his mother were anti-HCV positive, and another 3 pairs possessed HCV RNA in sera. 3 of 103 healthy day-cared children were found to have inapparent HCV infection, who were anti-HCV and HCV RNA positive.     

Hepatitis B virus infection in monocytes and their functional changes in patients with chronic hepatitis B]

We detected the HBV DNA in peripheral blood monocytes of 70 patients with chronic hepatitis B and 20 healthy controls by polymerase chain reaction (PCR) and Southern transfer hybridization technique, the HLA-DR expression on monocytic membrane and tumor necrosis factor-alpha (TNF alpha) content and interleukin 1 (IL 1) activity in their monocytic culture supernatant were also measured respectively by indirect immunofluorescence technique, ELISA, and thymocytic multiplication assay. HBV DNA sequences were detected in monocytes of 42(60%) of the 70 patients. The percentage of monocyte-expressing HLADR and the TNF alpha content in monocyte culture supernatant were significantly elevated in patients with HBV DNA-positive monocytes compared with those patients with HBV-DNA-negative monocytes. The percentage of monocyte-expressing HLA-DA and the level of TNF alpha produced by monocytes correlated markedly with the intensity of HBV DNA-positive signal in monocytes. These data suggested that HBV infection in monocytes might cause a series of functional changes in these cells.