湖北省十堰地区献血人员戊型肝炎病毒感染率调查

戊型肝炎是由戊型肝炎病毒（Hepatitis E Virus，HEV）引起的急性肝炎，传播方式及临床表现与甲型肝炎相似。HEV主要经粪一口途径和／或母婴垂直传播，以亚临床感染为主，感染后出现阶段性病毒血症，故其也存在着经输血传播的可能性。我国是戊型肝炎的高流行区，开展无偿献血者HEV携带情况调查，对评估输血后戊型肝炎感染的潜在危险，有重要的医学意义和社会意义。     

山西某县HIV/HCV感染调查的实验室质量控制

目的 分析山西某县开展HIV/HCV调查的实验室质量控制方法,探讨质控对调查准确性的影响.方法 在整个调查中对现场的HIV、HCV检测实施插入质控品及样本抽检的质控方案.根据预调查质控结果,通过增加人员培训、加强考核频次、提高抽检比例等手段调整质控方案用于主调查.结果 HIV感染预调查,现场的插入质控品检测和抽检结果与...     

135例HIV/AIDS患者合并HBV或/和HCV感染的分析

由于HIV、HBV、HCV传插途径类似,所以HIV感染者合并HBV和/或HCV感染并不少见.由于HBV,HCV引发的肝脏疾病是HIV感染者病死的原因之一.本文旨在调查135例HIV/AIDS患者HBV、HCV合并感染情况及分析慢性HCV感染对HIV疾病的影响.     

HCV与HIV混合感染研究进展

艾滋病病毒(HIV)与丙型肝炎病毒(HCV)感染是世界性的重要公共卫生问题,因二者存在相同的传播途径,其混合感染的发生率极高.HIV感染可导致免疫抑制,加速HCV发展为慢性肝病、肝硬化及原发性肝癌,同时HCV感染可加速HIV感染的疾病发展进程.从流行病学方面对HIV/HCV混合感染的作用特点、治疗方面进行综述,深入探讨HIV与HCV混合感染相互影响特点,为将来进行关于HIV和HCV混合感染研究提供方向.     

HCV与HIV混合感染研究进展

艾滋病病毒(HIV)与丙型肝炎病毒(HCV)感染是世界性的重要公共卫生问题,因二者存在相同的传播途径,其混合感染的发生率极高.HIV感染可导致免疫抑制,加速HCV发展为慢性肝病、肝硬化及原发性肝癌,同时HCV感染可加速HIV感染的疾病发展进程.从流行病学方面对HIV/HCV混合感染的作用特点、治疗方面进行综述,深入探讨HIV与HCV混合感染相互影响特点,为将来进行关于HIV和HCV混合感染研究提供方向.     

HIV/HCV共感染患者病毒特异性CTL细胞定量研究

目的探讨病毒特异性CTL对HIVHCV共感染患者病情进展的影响机制。方法观察对象为HIVHCV共感染患者、单纯HIV感染者、单纯HCV感染者。采用四聚体技术,运用流式细胞仪检测病毒特异性CTL。前瞻性比较HIV、HCV特异性CTL在三组中的异同,并对HIVHCV共感染患者的HIV、HCV特异性CTL进行相关性分析。结果HIVHCV共感染组与单纯HIV感染组比较HIV特异性CTL,差异无显著性(P=0.586)。HIVHCV共感染组中HCV特异性CTL的百分数及绝对计数(0.37±0.29,3.52±3.79)均高于单纯HCV感染组(0.15±0.05,0.86±0.33),差异有统计学意义(P=0.001,P=0.002)。HIVHCV共感染组中的HIV特异性CTL与HCV特异性CTL存在正性线性相关(P<0.001),方程成立。并且各系数均有统计学意义,方程似然比(r2)0.761。结论HCV特异性CTL可能是HIVHCV共感染组中肝脏功能损伤加重的原因之一;HIV与HCV在同一患者存在相互影响。     

杭州市349例吸毒人员HIV、HCV、梅毒感染血清学监测及行为特征

本文对2005年6月～2008年6月入住美沙酮治疗诊所的349名吸毒人员进行HIV、HCV及梅毒的血清学监测，并调查其吸毒方式，现将结果报告如下。     

柳州地区HIV感染者合并HBV、HCV及TP感染现状分析

目的分析人类免疫缺陷病毒（HIV）感染者中合并乙型肝炎病毒（HBV）、丙型肝炎病毒（HCV）以及梅毒螺旋体（TP）感染的流行现状及其特点。方法对确诊的184例HIV感染者进行流行病学调查，并采集血标本进行HBV、HCV和梅毒血清学检测。结果HIV感染者感染途径分别为：静脉注射毒品44．0％，性传播20．1％，母婴传播4.3％，输血或血制品3．8％，其他（原因不详）27．7％。184例HIV感染者中，抗-HCV阳性者36人（19．6％），HBsAg阳性者29人（15．8％），梅毒感染者21人（11．4％）。HIV、HBV和HCV三重感染者9人，约占4．9％。结论柳州市HIV感染以静脉注射毒品为主，性传播有所上升，HIV感染正由特殊人群向普通人群蔓延。HIV合并HBV、HCV、TP感染较为常见。建议在性病门诊中常规开展HIV的筛查，对HIV感染者常规进行HBV、HCV的相关检查并积极采取相关的预防治疗措施。     

血液透析患者感染HIV、TP、HBV和HCV的情况调查

目的：了解血液透析患者人类免疫缺陷病毒（HIV）、梅毒螺旋体（TP）、乙肝病毒（HBV）、丙肝病毒（HCV）感染现状,为控制传染科疾病的医源性感染提供依据。方法：对进行血液透析治疗的320例患者进行HIV、TP、乙肝五项、抗-HCV检测。结果：本文患者HIV感染0例,梅毒感染7例（占2.19%）,乙肝感染153例（占47.81%）,与国内相关报道大致相符,丙肝感染37例（占11.56%）,低于国内相关统计数据;其中梅毒＋丙肝混合感染1例,梅毒＋乙肝混合感染4例,丙肝＋乙肝混合感染20例,总感染率达到53.75%。严格感控措施后,感染率由44.44%降到了21.21%。结论：血液透析患者是经血传播疾病的高发人群,与正常健康查体人群的梅毒、乙肝、丙肝的感染率有较大差异,混合感染多见,严格感控措施后感染率下降明显,提示加强血液透析患者传染性疾病的监控,有助于阻止医源性传染性疾病的传播。     

有偿献血艾滋病感染者歧视的质性研究

目的:探讨中国农村地区有偿献血艾滋病感染者(Paid Blood Donors with HIV/AIDS,PBDWH)面临的歧视表现特点、造成的影响和形成原因,以及如何减少歧视。方法:采用半结构式访谈对5名PBDWH、8名包括干部、教师、医生和社区工作者等人员进行了访谈。对访谈内容进行了录音,然后转录成文字并对转录内容进行了分析。结果:①有PBDWH遭受到了来自周围人的歧视,歧视主要表现在被周围人拒绝和被社会隔离上;②歧视严重影响了PBD-WH对感染艾滋病事实的告知、日常生活、甚至导致一些PBDWH选择自杀;③歧视形成的原因上,除了艾滋病具有传染性外,PBDWH的贫穷、艾滋病症状也是重要原因。结论:PBDWH受到了很大的歧视,增加对艾滋病的宣传可减少歧视。     

Prevalence of HCV and HIV antibodies and related risk factors among entrants to the main southeastern French prison

Objectives: To estimate the prevalence of HCV and HIV serologic markers and related factors among entrants to the main southeastern French prison.
Methods: During the mandatory consultation at the STD clinic of the Marseilles Prison (HIV counseling, and syphilis/HIV screening), physicians also offered HCV serologic testing to each entrant. Inmates were interviewed face to face by a physician with a standardized questionnaire.
Results: In total, 391 of 411 new inmates (89%) participated in the survey; 79% were male, 75% were aged 18–35 years, and 23% were injecting drug users (IDUs). Twenty per cent of the IDUs admitted that they had shared their injection equipment during the last 12 months. Of the 391 new inmates, 104 (27%) were HCV positive (91% among IDUs) but only 45 of 104 (43%) knew their seropositivity status; 23 of 389 (6%) were HIV positive (21% among IDUs).
Conclusions: This survey underlines the high HCV and HIV seroprevalence among entrants to French prisons, especially injecting drug users, and the high proportion of inmates at risk for these infections as well. There is an urgent need for education and screening programs in prison and also in the at-risk free-living populations.     

HCV in peripheral blood mononuclear cells are predominantly carried on the surface of cells in HIV/HCV co-infected individuals

HCV replication in extra-hepatic reservoirs has been suggested to occur in many tissues including PBMCs. A recent study showed evidence for compartmentalization and evolution of HCV in PBMCs. However, the cells that support HCV replication in PBMCs have not been identified. In this study we have fractionated the PBMC from HIV/HCV co-infected patients into T, monocytes, B and NK cells, and most of the HCV was located in CD3-cell fractions. Protease treatment of PBMCs to remove cell surface receptors resulted in the loss of HCV RNA suggesting that most of the HCV is present on the cell surface. PBMCs were treated by freeze-thaw nuclease method that would protect the HCV RNA in the virus but not the intracellular viral RNA. Data from this analysis support the conclusion that most of HCV is present on the cell surface. Even though the presence of minus strand RNA in PBMCs suggests that a low level HCV replication takes place within the PBMCs of HIV/HCV co-infected individuals, HCV in PBMC is present mainly on the surface of non-T cells, mostly on NK, monocytes and B cells. These results suggest a unique pathogenic role of NK, monocyte and B cells as carriers of HCV.     

291例HIV感染者合并HCV及HSV-2感染状况及相应免疫特征分析

目的了解HIV感染者中HCV及HSV-2合并感染的情况及CD4＋T细胞免疫特征。方法用ELISA方法检测291例HIV感染者的抗HCV及HSV-2抗体,对HIV感染者进行CD4＋T淋巴细胞绝对计数和其占T淋巴细胞的百分比分析。结果 HIV合并HCV感染43例,合并HSV-2感染99例,合并HCV和HSV-2感染31例。CD4＋T淋巴细胞百分比以合并感染HCV组最高（78.4%）,合并感染HSV-2组和无合并感染次之,合并感染HCV和HSV-2组最低,组间差异无统计学意义。CD4＋T淋巴细胞绝对数以合并感染HCV和HSV-2组最低,合并感染HCV组、合并感染HSV-2组居中,无合并感染组最高,组间差异无统计学意义。结论 HIV感染者合并HCV、HSV-2感染率较高,HIV合并HCV和HSV-2感染时,CD4＋T细胞绝对数和CD4＋T淋巴细胞百分比下降,加重损害机体的免疫系统。     

Effect of HCV Infection on Glucose Metabolism in Pregnant Women with HIV Receiving HAART

Abstract

Objective: A prospective study was designed to evaluate the prevalence and determinants of glucose metabolism abnormalities (GMAs) among HIV-1–infected pregnant women receiving highly active antiretroviral therapy (HAART). Methods: Blood samples were collected in fasting conditions and following a 100 g oral glucose tolerance test among HIV-infected pregnant women consecutively followed at asingle HIV reference centre in 2001–2008. GMAs were defined by glucose intolerance(IGT) or gestational diabetes (GDM), according to the National Diabetes Data Group criteria. Predictors of GMAs were assessed in univariate and multivariate analyses. Results: Overall, 78 women with no history of diabetes or GMAs were eligible for analysis. All were on stable HAART with either nevirapine or protease inhibitors (PIs) from at least 4 weeks at the time of sampling. GMAs during pregnancy were observed in 20 women (25.6%; GDM: 6, 7.7%; IGT: 14, 17.9%). In a multivariate analysis, after adjusting for age and ongoing antiretroviral treatment (PI or nevirapine), GMAs in pregnancy were significantly associated with HCV coinfection(adjusted odds ratio 4.16; 95% CI, 1.22–14.1;p = .022). No maternal or neonatalcomplications were observed. Conclusion: GMAs represent a relevant issue in the management of HIV-1–infected pregnant women. Our data suggest that these abnormalities are relatively common in this particular group. Women with HCV coinfection have an increased risk of developing GMAs during pregnancy and should be monitored for potential complications.     

Differences in HCV-specific T cell responses between chronic HCV infection and HIV/HCV co-infection

Hepatitis C virus (HCV)-specific CD4+ and CD8+ T cell responses were investigated using a panel of 728 overlapping peptides spanning the whole HCV genome in 47 HCV mono-infected and 26 HIV/HCV co-infected individuals using the IFN-gamma ELISPOT assay and flow cytometry. The frequency of HCV-specific T cell responses was similar (approximately 40%) in both groups, but the breadth of the T cell responses tended to be reduced in HIV/HCV co-infected individuals. Of interest, 23 new HCV-derived epitopes were identified, and CD4+ HCV-specific T cell responses were detected overall in a proportion similar to CD8+ T cell responses. A tendency towards a dominant CD8+ T cell response was associated with HIV/HCV co-infection. HCV-specific CD8+ T cells secreted both IL-2 and IFN-gamma, although a reduction in the percentage of IL-2/IFN-gamma-secreting cells was observed in HIV/HCV co-infected individuals. The increase in CD4+ T cell counts after antiretroviral therapy in HIV/HCV co-infected individuals was not associated with restoration of HCV-specific T cell responses. Altogether, these results provide new insights into the characterization of HCV-specific T cell responses in HCV mono-infected and HIV/HCV co-infected individuals.