HCV不同编码区抗体检测意义的临床研究

目的：研究丙型肝炎病毒（ＨＣＶ）不同编码区抗体检测的临床意义。方法：采用ＨＣＶ核心区合成肽ＣＰ１０、ＣＰ９及非结构区基因重组抗原５－１－１,Ｃ１００检测了１５８例丙型肝炎病人相应抗体抗－ＣＰ１０、抗－ＣＰ９,抗－５－１－１及抗－Ｃ１００。同时检测ＨＣＶ ＲＮＡ、ＡＬＴ。另选３５例健康体检者作对照。结果 四种抗体于输血后４．５￣８周均可检出,于病后４￣８周依次达９２．６％、８８．９％、５９．３％及２     

输血后庚型肝炎的前瞻性研究

为探讨输血后庚型肝炎的发病率,１９９７ 年２ 月开始,我们采用前瞻性研究方法,对１０２名住院输血病人进行了１２ 个月的随访研究。１１３ 名献血员提供的１１３ 份血液中单纯ＡＬＴ 异常率３.５ ％ （４／１１３） ,抗－ ＨＧＶ阳性率８.９ ％ （１０／１１３） ,抗－ ＨＣＶ 阳性率３.５ ％ （４／１１３） ;输血后ＨＧＶ 感染率为３.８ ％ （４／１０２） ;１０ 人输入抗－ ＨＧＶ 阳性血,输血后ＨＧＶ 感染４ 例,其中ＰＴ－ ＨＧ２ 例,ＰＴ－ ＨＧ潜伏期３８ ～６２ 天,平均４５ 天;抗－ ＨＧＶ 最早检出时间为输血后３８ 天,最迟为９６ 天,平均为６３.５ 天;ＰＴ－ ＨＣ发病率为４.９％ （５／１０２） ,５ 例ＰＴ－ ＨＣ 中４ 例输入抗－ ＨＣＶ 阳性血,１ 例输入单纯ＡＬＴ异常血,ＰＴ－ ＨＣＶ 感染率为１００ ％ ,证实ＨＧＶ 可经血传播,ＨＧ 的慢性化程度较高,ＨＧＶ可形成慢性携带;抗－ ＨＣＶ 阳性血具有很强的传染性。     

急慢性丙型肝炎患者抗—HCV—IgM测定临床意义

为了探讨抗－ＨＣＶ－ＩｇＭ抗体在临控ＨＣＶ相关疾病听意义，本文应用ＥＬＩＳＡ间接法检测急、慢性丙型肝炎患者的抗－ＨＣＶ－ＩgM，并同时检测了抗－ＨＣＶ－ＩｇＧ。结果发现在急性、慢性丙肝患者中抗０ＨＣＶ－ＩｇＭ阳性率为９３．３％和８８．９％，抗－ＨＣＶ－ＩｇＧ阳性率为８６．７％和７７．８％。对照组的两各抗体均未检出，结果表明，抗－ＨＣＶ－ＩｇＭ抗体在疾病的早期诊断中的作用优于抗－ＨＣＶ－Ｉdisplay stat     

丙型肝炎病毒RNA非结构区套式聚合酶链反应

目的探讨不同引物对ＨＣＶＲＮＡ检出率的影响，立敏感的ＮＳ５区基因扩增技术。方法选择不同引物，采用非结构５（ＮＳ５）区套式聚合酶链反应（ＰＣＲ）及联合式［ＨＣ非编码区（５′ＮＣＲ）与ＮＳ５联合］ＰＣＲ技术检测１０例抗ＨＣＶ阳性献血员及３７例输血后丙型肝患者的血清ＨＣＶＲＮＡ。结果１０例抗ＨＣＶ阳性献血员应用联合式ＰＣＲ，以ＮＳ５－３＋ＮＳ５－４、ＳＦ２＋ＮＳ５－４、Ｋ１＋ＮＳ５－４、ＮＳ５－１＋ＮＳ５－４引物及套式ＮＳ５－１＋ＮＳ５－４引物扩增时，其ＲＮＡ检出率分别为５／１０、６／１０、７／１０、８／１０和９／１０；而３７例输血后丙型肝炎患者中３５例ＲＮＡ阳性，检出率为９５％，其中１８例１ｂ型和１９例２ａ型样品的检出率分别为１００％和８９％。结论ＨＣＶＮＳ５区的ＲＮＡ检出率与引物的选择有关     

血浆蛋白制品HCV的检测

血浆蛋白制品ＨＣＶ的检测３６２０００福建省泉州市中心血站林毅胜泉州市第一医院张志珊随着ＨＣＶ的发现及其检测试剂的问世，已证明输血后肝炎９０．９％为丙型肝炎［１］。国外有报道从抗－ＨＣＶ阴性的商品静注免疫球蛋白中检测到ＨＣＶ－ＲＮＡ［２］，临床也发现输...     

河北省供血员农村居民血清谷丙转氨酶异常的流行因素分析

对供血员较多的三个村２５０５位居民血清ＡＬＴ异常与各型肝炎病毒感染标志的关系进行了一半动态观察。首次检测ＡＬＴ异常率为３．２７％（８２／２５０５），抗－ＨＣＶ阳性和饮酒是ＡＬＴ异常的主要危险因素且二者有联合作用。一年后ＡＬＴ异常率为３．２２％（６７／２０７９）；原ＡＬＴ异常者２４．６４％（１７／６９）仍异常，与ＡＬＴ持续异常有关的主要因素是抗－ＨＣＶ，阳性者持续率为４４．４４％（４／９），阴性者持续率为１１．６３％（５／４３）；原ＡＬＴ正常者中有５０人（２．４９％）发生异常，抗－ＨＣＶ阳性和饮酒是发生ＡＬＴ异常的危险因素。甲型和乙型肝炎病毒感染对ＡＬＴ异常率及正常者一年后异常发生率的影响就总体人群而言均无统计学意义，但对儿童可能起主要作用。     

输血后丙型肝炎调查分析

输血后丙型肝炎调查分析郑连方１黄智１王志学１李辉１关崇斌１刁海源２常虹３潘永华３赵淑媛４郭莉５孙光６朱绍军７刘险峰８赵连福９樊虹９陈德新１０丙型肝炎病毒主要经血传播，然而揭示献血员开展抗－ＨＣＶ检测与否输血后丙型肝炎（下称丙肝）发病情况，对评价预防效...     

708名献血员丙型肝炎病毒感染的血清学测定

７０８名献血员丙型肝炎病毒感染的血清学测定东光县医院检验科（０６１６００）王国英资料表明８０％以上的丙型肝炎由输血而引起。我们现报告７０８名献血员的抗－ＨＣＶ及ＡＬＴ血清学检测。一、方法按天津正华生物科技有限公司酶试剂盒操作。检查献血员７０８名，体检...     

人工单采血浆过程HCV污染途径调查

人工单采血浆过程ＨＣＶ污染途径调查２０００５１上海市输血研究所吴昌烈郑岚陆素萍冯恭文１９８５年，河北省固安县单采血浆献浆者中发生丙型肝炎流行，ＨＣＶ抗体阳性率达９８．８％〔１〕，之后各地许多报道单采血浆者抗－ＨＣＶ阳性率显著比全血献血者高，认为可能...     

反向间接血凝法检测HCV抗原的初步报告

用多克隆抗ＨＣＶ抗体致敏醛化绵羊红细胞（ＳＲＢＣ）建立了检测ＨＣＶ抗原的反向间接血凝（ＲＰＨＡ）技术，发现乙肝，肝细胞癌、肝硬化患者血清中ＨＣＶ抗原的阳性率分别为１１．５％，４５．４％，２１．４％；献血员阳性率为５．４％。     

Impact of screening blood donors for hepatitis C antibody on posttransfusion hepatitis: a prospective study with a second-generation anti-hepatitis C virus assay

BACKGROUND: Hepatitis C is the major cause of posttransfusion hepatitis. Blood components that are positive for antibody to hepatitis C virus (anti-HCV) can transmit posttransfusion hepatitis. STUDY DESIGN AND METHODS: To investigate the effect on posttransfusion hepatitis of screening blood donors with a second-generation test for anti-HCV, 249 transfusion recipients who underwent cardiovascular surgery were prospectively followed. Six recipients who were positive for anti-HCV before transfusion and 51 subjects with incomplete follow-up were excluded from this study. RESULTS: Eleven (13.8%) of 80 subjects who received unscreened blood had two successive serum alanine aminotransferase levels > 90 U per L. Seven (8.8% of total) developed anti-HCV and HCV RNA and two (2.5% of total) developed IgM antibody to cytomegalovirus (IgM anti-CMV). By contrast, 3 (2.7%) of the 112 subjects who received anti-HCV-screened blood had two successive serum alanine aminotransferase levels > 90 U per L. None of these three developed anti-HCV and HCV RNA, but two (1.8% of total) showed the development of IgM anti-CMV. The study shows that screening for anti- HCV in blood donors with a second-generation test almost abrogated posttransfusion viral hepatitis C. CONCLUSION: After anti-HCV screening, other body fluid-transmitted viruses such as CMV may become important in posttransfusion hepatitis.     

Declining value of alanine aminotransferase in screening of blood donors to prevent posttransfusion hepatitis B and C virus infection. The Retrovirus Epidemiology Donor Study

BACKGROUND: Since the mid-1980s, blood banks in the United States have screened donors for elevated alanine aminotransferase (ALT) in an effort to prevent posttransfusion hepatitis. The present study was designed to quantitate the residual value of ALT screening following the implementation of hepatitis C virus (HCV) assays. STUDY DESIGN AND METHODS: Two approaches were used. First, a database of 2.3 million donations made by 586,507 volunteer blood donors between 1991 and 1993 was used to compare the incidence of seroconversion to hepatitis B virus (HBV) and HCV marker positivity in donors with elevated ALT values and with normal ALT values. Second, the duration of ALT elevation prior to HBV and HCV seroconversion was determined from 34 well-documented cases of posttransfusion HBV and HCV; elevated-ALT window periods were multiplied by rates of HBV and HCV incidence in donors to project the yield of ALT screening. Predictive value and cost- effectiveness analyses were also performed to compare the value of ALT screening before and after HCV screening was implemented. RESULTS: Both approaches indicate that ALT testing does not detect HBV in the window phase but does currently identify approximately 3 HCV window-phase donations per 1 million donations; this contrasts with ALT detection of approximately 1800 HCV-infectious units per 1 million donations prior to anti-HCV screening. Currently, only 8 in 10,000 donated units with elevated ALT (negative anti-HCV) are infected with HCV. The cost of continued ALT screening was estimated at $7,931,000 per quality- adjusted year of life saved. CONCLUSION: The yield, predictive value, and cost-effectiveness of ALT screening of blood donors have declined dramatically with the implementation of progressively improved anti-HCV assays. ALT screening of volunteer blood donors should be discontinued.     

血液病患者输血与庚型肝炎病毒感染的研究

目的：了解血液病患者输血后的庚型肝炎病毒（ＨＧＶ）感染情况。方法：对６３例血液病患者采用ＲＴＰＣＲ方法检测ＨＧＶＲＮＡ、丙型肝炎病毒（ＨＣＶ）ＲＮＡ，应用ＥＬＩＳＡ方法检测抗ＨＧＶ、ＨＢｓＡｇ。结果：ＨＧＶＲＮＡ阳性率为７．９％，抗ＨＧＶ阳性率６．３％；ＨＣＶＲＮＡ阳性率为４６．０％。ＨＧＶ感染通常伴有ＨＣＶ感染及丙氨酸转氨酶升高。ＨＧＶ感染与输血量有关，与血液病种类无关。结论：血液病输血可引起ＨＣＶ、ＨＧＶ的传播     

固安县献血(浆)者HCV和HBV感染的血清学追踪观察

1985年固安县献浆者中发生丙型肝炎流行。1986年初,调查了该县当年(1985年)献浆村、献浆5年村和基本无献血村的献浆者和献全血者HCV和HBV的感染状况,1990年又追踪观察。结果是1986年和1990年献浆者抗-HCV阳性率分别为64.7％和43.9％。在献浆者中ALT异常的抗-HCV阳性率分别为77.5％和81.1％;ALT正常的分别为51.3％和34.3％。献浆者抗-HCV阳性率均高于献全血者和非献血成人。提出在固安县供血单位增加抗-HCV筛选献血者势在必行。另外对91例抗-HCV阳性献浆者第5年又进行了追踪观察,阴转率为30.8％,约有70％的病例转为慢性。     

2008～2011年重庆市江津区无偿献血者血液检测结果分析

目的调查重庆市江津区无偿献血者血液传染性疾病的感染状况,为无偿献血招募方式和招募策略提供依据,达到减少血液报废,净化血液资源,提高血液质量的目的。方法收集江津区2008～2011年13 499人次无偿献血者血液检测资料,对其丙氨酸氨基转移酶（ALT）、乙型肝炎表面抗原（HBsAg）、丙型肝炎抗体（抗-HCV）、人类免疫缺陷病毒抗体（抗-HIV）、梅毒抗体（抗-TP）检测不合格率进行统计学分析。结果 13 499人次无偿献血者血液检测总不合格率为4.54%,各年间总的不合格率差异有统计学意义,其ALT、HBsAg、抗-HCV、抗-HIV、抗-TP检测不合格率依次是1.65%、1.17%、0.34%、0.2%、1.3%,除ALT（P〈0.01）外,HBsAg、抗-HCV、抗-HIV、抗-TP各年间的不合格率比较差异均无统计学意义（P〉0.05）。结论江津区无偿献血者血液检测不合格率排名依次是ALT、抗-TP、HBsAg、抗-HCV、抗-HIV,其中ALT、HBsAg不合格率呈先降后升趋势,抗-HIV不合格率呈逐年上升趋势,抗-HCV和抗-TP呈逐年下降趋势。     

Trends in hepatitis B and hepatitis C virus seropositivity among blood donors over 15 years screened in the blood bank of a university hospital

Blood transfusion carries well defined risks including hepatitis B and hepatitis C virus transmission. In this study, records of blood donation candidates between the years 1996-2010 were retrospectively reviewed. A total of 220 841 apparently healthy adult donors were screened for hepatitis B surface antigen, anti-HCV with enzyme linked immunosorbent assay (ELISA) method. The overall prevalence of HbsAg and HCV were 1.07% and 0.39%, respectively. HBV seroprevelance decreased through years 1996-2010 but HCV seroprevelance showed a fluctuant course decreasing from 1996 to 2002. In order to decrease transfusion transmitted infections there should be centralized blood collection systems having qualified staff, equipment and non-remunerated voluntary blood donations must be strongly encouraged.     

患者输血前感染性指标的检测及意义

目的：评估受血者在输血前接受输血相关传染病检查的意义。方法：对2305例受血者在输血前进行谷丙转氨酶（ALT）、乙型肝炎病毒表面抗原（HBsAg）、丙型肝炎病毒抗体（抗HCV）、艾滋病毒抗体（抗HIV）和梅毒试验（TPPA）检测。结果：HBsAg阳性、抗HCV阳性和两者均阳性的百分率分别为11．58％、1．69％和0．50％，其中92例HBsAg阳性者没有输血史，在输血前检查中首次捡出阳性；61例抗HCV阳性者均有输血史，在肾透析患者中，抗HCV阳性率达10．00％。ALT〉40U／L者567例，除并发HBsAg和（或）抗HCV阳性外，单独ALT升高者207例。抗HIV阳性者1例，TPPA阳性者1例。结论：对患者在输血前进行输血相关5项传染指标检测有重要的临床意义     

Prevalence of antibody to hepatitis C virus in a blood donor population

Blood samples from 2000 accepted blood donors and 343 deferred donors with antibody to hepatitis B core antigen (anti-HBc) and/or an alanine aminotransferase (ALT) elevation were evaluated for antibody to hepatitis C virus (anti-HCV). Sixteen (0.8%) of the 2000 sera initially reacted on enzyme-linked immunosorbent assay (ELISA); 12 (0.6%) were repeatably reactive. One repeatably reactive sample had an elevated ALT; two reacted on anti-HBc testing and had ALT elevations. When the repeatably reactive ELISA samples were tested by an immunoblot assay, four reacted, three were indeterminate, and five did not react. Among the 343 deferred donors, HCV antibodies were detected in 8 (3.8%) of 210 anti-HBc-reactive samples, 12 (11.8%) of 104 elevated-ALT samples, and 15 (52%) of 29 combined elevated-ALT and anti-HBc-reactive samples; 25 of 28 reacted on immunoblot. The anti-HBc-reactive sera were subdivided into groups according to strength of anti-HBc reactivity (weak or strong) and antibody to hepatitis B surface antigen status and then were compared for anti-HCV reactivity rates. The group of samples showing the greatest frequency of anti-HCV had strong anti-HBc reactivity. For blood donors, the anti-HCV test correlates with the surrogate tests for non-A, non-B hepatitis (anti-HBc and ALT); however, most anti-HCV-reactive units remain undetected by surrogate tests, so that implementation of anti-HCV screening should further reduce the transmission of HCV via transfusion.     

1 036例受血者输血前感染性指标检测结果分析

目的了解患者输血前血液感染性指标的阳性率,探讨其检测的意义。方法对需要输血的患者1036例采用酶联免疫吸附(ELISA)法检测血清中乙型性肝炎病毒标志物(HBsAg)、丙型肝炎病毒抗体(抗HCV-IgG)、梅毒螺旋体抗体、人类免疫缺陷病毒抗体(HIV1+2抗体)。结果HBsAg的阳性率为4.83%,抗HCV-IgG的阳性率为0.87%,梅毒的感染率为0.39%,HIV抗体的阳性率为0%。结论对患者进行输血前感染性指标检测是必要的,它可以避免和预防医护人员的职业感染,也可以避免因输血而引起的医疗纠纷。     

血友病A患者血制品治疗后HBV和HCV感染指标分析

目的对血友病A患者替代治疗后血液传播乙型、丙型肝炎病毒(HBV、HCV)的感染指标进行检测。方法对经本院确诊的35例血友病A患者采用酶联免疫吸附法(ELISA)检测抗-HCV、HBV六项指标。结果 35例血友病A患者的抗-HCV阳性率为88.6%,输血次数和输注血液制品为主的种类与患者抗-HCV阳性率有相关性(P<0.01)。HBV六项指标检查,其中5例患者抗-HBe阳性(占14.3%),明显低于抗-HCV阳性率。结论血友病A患者替代治疗输血次数越多,感染风险越大,而较少输注以冷沉淀为主的血液制品的患者,其感染风险相对较小,且目前HCV感染率明显高于HBV感染率。