Post-Transplant Lymphoproliferative Disorders Occurring After Renal Transplantation in Adults: Report of 230 Cases From the French Registry

Post-transplant lymphoproliferative disorders (PTLD) are a rare but serious complication after organ transplantation. A French Registry of PTLD was set up in a nationwide population of kidney transplant recipients. We prospectively enrolled all adult kidney recipients developing PTLD between January 1, 1998, and December 31, 2003. We analyzed the incidence, risk and prognostic factors of PTLD by Kaplan-Meier and Cox analyses. Totally 230 cases of PTLD were referred to the French Registry. Cumulative incidence was 1.18% after 5 years. Older age (per year, AHR = 2.19, CI = 1.22-3.94) and recipient Epstein-Barr virus seronegativity (AHR = 3.01, CI = 1.57-5.08) were associated with an increased risk of PTLD. Patients with PTLD had a reduced survival rate (61% at 5 years). Graft PTLD had the best prognosis with an 81% survival rate after 5 years. Infection with hepatitis C or B virus (HCV or HBV), late-onset PTLD, multiple sites involvement and high Ann Arbor staging were risk factors for patient death. Use of azathioprine was associated with a poorer survival rate. PTLD incidence and risk factors in French recipients are in line with the international or American PTLD series. We highlighted the role of HBV or HCV in patient mortality and described the relevant prognosis factors for patients with post-transplant lymphoproliferations.     

慢性丙型肝炎患者丙型肝炎病毒核酸与IgM抗体关系的研究

本文检测了１４０例丙型肝炎病毒（ＨＣＶ）抗体（抗－ＨＣＶ）阳性的慢性丙型肝炎（ＣＨＣ）的ＨＣＶ核酸（ＨＣＶＲＮＡ）和ＩｇＭ抗体（抗－ＨＣＶＩｇＭ）两项指标。结果表明，原始诊断为不同临床型的肝炎（ＨＣ）患者，８年随访时，ＨＣＶＲＮＡ和抗－ＨＣＶＩｇＭ阳性率分别为８０．７％和９０．７％（ｕ＝２．３９Ｐ＜０．０５）．在原始诊断不同临床型ＨＣ转慢者中，上述两项指标均未发现统计学上的差别（均为Ｐ＞０．０５）。ＨＣＶＲＮＡ与抗－ＨＣＶＩｇＭ配对比较，符合率为７８．６％。基因分型初步结果表明，河北省固安ＨＣＶ以基因Ⅱ型为主。本研究提示，随访８年的ＣＨＣ患者绝大多数仍有传染性；本文方法检测的抗－ＨＣＶＩｇＭ不能代表早期感染标志，但代表慢性感染活动化或带毒，所以，在不具备检测ＨＣＶＲＮＡ的地方更具有实用价值．     

焦炉工人接触PAH水平与肺癌的关系

焦炉工人接触ＰＡＨ水平与肺癌的关系王溪鸿，马会良，杨玉萍（辽宁本溪钢铁公司劳动卫生研究所，１１７０２１）选择焦炉作业各工种工人两名，配戴个体采样器，测得一个工作班的接触浓度，连续测五个工作班，计算各工种每班平均接触浓度。采用高压液相色谱测定多环芳烃总...     

性传播疾病危险人群乙型肝炎和丙型肝炎病毒感染的血清流行病学调查

通过对４３１名卖淫妇女和１０９名正常妇女ＨＢＶ和ＨＣＶ感染的血清学指标的检测、性传播有关因素的调查，发现卖淫妇女ＨＢＶ和ＨＣＶ感染中的抗－Ｈｋｃ为４３．１５％，抗－ＨＢｓ为３６．８９％，ＨＢｓＡｇ为１０．４４％，抗－ＨＣＶ为９．５１％，明显高于正常妇女；有性传播疾病者ＨＢＶ和ＨＣＶ的各项感染指标也明显高于正常妇女。卖淫妇女的抗－ＨＣＶ感染率有随年龄增长而增高的趋势，与卖淫时限长、卖淫次数多有明显差别，这表明卖淫妇女中有较严重的ＨＢＶ和ＨＣＶ感染。     

广州市人群乙型肝炎病毒感染模式与丙型肝炎病毒感染情况调查

为了解广州市人群乙型肝炎病毒（ＨＢＶ）与丙型肝炎病毒（ＨＣＶ）双重感染情况，对１９９３年４月体检中检出的１９３例ＨＢＶ标志物阳性血清归类分析，发现有１４种ＨＢＶ感染模式，其中以ＨＢｓＡｇ·ＨＢｅＡｂ·ＨＢｃＡｂ和ＨＢｓＡｇ·ＨＢｅＡｇ·ＨＢｃＡｂ为多见，阳性模式构成分别为４３．０１％和３０．５７％。在ＨＢＶ感染者中ＨＣＶ感染的检出率为１１．３９％（２２／１９３）．不同ＨＢＶ感染模式组别的抗－ＨＣＶ阳性率差异有统计学显著意义（ｐ＜０．００１）．     

合肥地区献血员感染HBV和HCV危险因素的多因素分析

用ＥＬＩＳＡ法检测了合肥地区１４４０名献血员抗ＨＣＶ和乙肝五项指标，抗ＨＣＶ阳性率为５５％；ＨＢｓＡｇ携带率为１５％，ＨＢＶ总感染率４３７％。分别以抗ＨＣＶ阳性与感染过ＨＢＶ的献血员为病例，以抗ＨＣＶ阴性与未感染ＨＢＶ的献血员为对照进行了ＨＣＶ和ＨＢＶ感染危险因素的单因素和多因素分析。结果显示，ＡＬＴ、献血次数、献血量、文化程度、献血员心理和输血史与ＨＣＶ感染有关；血型、家庭人口数和家庭子女数与ＨＢＶ感染有关。     

247例丙型肝炎病毒(HCV)RNA FQ-PCR定量结果分析

目的为了了解丙型肝炎病毒载量在两性间的流行状况.方法荧光定量PCR用于HCV RNA定量检测.结果男性患者阳性率为20.27%(30/148),病毒拷贝对数值为4.18±1.04;而女性分别为29.29%(29/99),4.28±1.07.结论男女HCV阳性病人的阳性率(P=0.103,χ2=2.656)和病毒量(P=0.487 ,t=0.699)在男女两性间无统计学差异.     

Immunoglobulin mimicry by Hepatitis C Virus envelope protein E2

Hepatitis C virus (HCV) establishes persistent infection in the majority of infected individuals. The currently accepted hypothesis of immune evasion by antigenic variation in hypervariable region 1 (HVR1) of glycoprotein E2 does not however, explain the lack of subsequent immune recognition. Here, we show that the N-terminal region of E2 is antigenically and structurally similar to human immunoglobulin (Ig) variable domains. E2 is recognized by anti-human IgG antibodies and also possesses common amino acid (aa) sequence features of the conserved v-gene framework regions of human Ig light chains in particular but also heavy chains and T cell receptors. Using a position specific scoring system, the degree of similarity of HVR1 to Ig types correlated with immune escape and persistence in humans and experimentally infected chimpanzees. We propose a unique role for threshold levels of Ig molecular mimicry in HCV biology that not only advances our concept of viral immune escape and persistent infection but also provides insight into host-dependent disease patterns.     

Analysis of aberrant somatic hypermutation (SHM) in non-Hodgkin's lymphomas of patients with chronic HCV infection

Hepatitis C virus (HCV) and aberrant somatic hypermutation (SHM) have each been suggested to contribute to the development of B-cell non-Hodgkin's lymphoma (NHL). The incidence of PIM-1, PAX-5, RhoH/TTF, and c-MYC mutations in tumour biopsy specimens from 32 HCV-infected B-cell NHL patients was analysed to determine whether the extent of aberrant SHM among these patients differed from that previously reported for HCV-negative B-cell NHL patients. Mutation of PIM-1, PAX-5, RhoH/TTF, and c-MYC was detected in 4 (13%), 5 (16%), 4 (13%), and 4 (13%) of 32 samples, respectively. In HCV-positive B-cell NHL patients, the frequency of aberrant SHM was lower than that already found in HCV-negative B-cell NHL patients. This indicates that, unlike B-cell lymphomas from HCV-negative patients, aberrant SHM may not contribute significantly to malignant transformation in HCV-associated B-cell lymphomas.