Prevalence of hepatitis C virus genotypes in southern Italy

HCV is ubiquitous. In 50% of all cases it causes chronic hepatitis that often evolves into liver cirrhosis and hepatocellular carcinoma. Recently HCV has been classified in 5 genotypes by Okamoto. The purpose of this study is to evaluate the prevalence of 5 genotypes in Campania, a region of Southern Italy, where the prevalence of anti-HCV antibodies ranges from 0.87 to 4%, and to evaluate the correlation between the HCV genotypes and the severity of histological damage. One hundred and thirty-five anti-HCV positive patients were enrolled and tested by PCR to identify HCV-RNA. One hundred and twenty-four patients resulted HCV-RNA positive. Genotyping was performed as described by Okamoto et al. with minor modifications of the specific primer to type III proposed by Silini et al. Eight patients were negative for all genotypes. Eight patients were positive for type I(1a), 61 for type II(1b), 39 for type III(2a), 11 for type IV(2b) and 1 for type V(3a). In 4 cases two different genotypes were present in the same sample [II(1b)-IV(2b), III(2a)-II(1b) twice, III(2a)-IV(2b)]. Histological evaluation of liver damage showed: CPH (22 cases), minimal CAH (56), severe CAH (31) and liver cirrhosis (15). There was no statistically significant correlation between the 5 genotypes and the severity of histological damage. Data on the prevalence of genotype II(1b) in Italy are similar to those reported for other European countries. The prevalence of genotypes in Southern Italy is similar to that reported in the population of Northern Italy.     

我国消除丙型肝炎的普通人群HCV检测策略的成本效果分析

目的 分析我国消除丙型肝炎（丙肝）的普通人群HCV检测策略的成本效果,明确最佳成本效果的HCV检测年龄。方法 运用TreeAge pro 2019软件构建决策树马尔科夫模型,以1年为周期,模拟10万名20~59岁各年龄组人群HCV检测和治疗结果,以全社会角度分析策略间比较的成本效果和效益。效果指标为增量成本效果比（ICER）,效益指标为净货币效益（NMB）,以我国2022年人均国内生产总值（85 698元）为意愿支付阈值。通过单因素敏感性分析和概率敏感性分析评估结果可靠性。结果 在20~59岁人群HCV检测有成本效果,在40~49岁年龄组进行HCV检测成本效果最佳。20~59岁年龄组人群HCV检测策略与未HCV检测策略比较,增量成本为161.24元/人,增量效用为0.003 6质量调整寿命年（QALYs）/人,ICER为45 197.26元/QALY,ICER小于意愿支付阈值,具有成本效果。各年龄组人群HCV检测策略与未HCV检测策略比较,ICER为42 055.06~53 249.43元/QALY,NMB为96.52~169.86元/人,其中40~49岁年龄组的ICER最低,NMB最高。单因素敏感性分析结果显示,贴现率、丙肝抗体（抗-HCV）检测成本、人群抗-HCV阳性率和直接抗病毒药物治疗成本对经济学评价影响较大,但改变参数取值,结论不变。概率敏感性分析结果表明模型分析结果稳定。结论 医疗机构探索动员20~59岁普通人群进行HCV检测具有较好的成本效果,以40~49岁年龄组人群的HCV检测成本效果最佳。在我国普通人群中实施HCV检测的“愿检尽检”策略,能降低人群丙肝疾病负担。     

抗—HEV IgG与乙型肝炎标志物关系的研究

近年已有学者提出戊型肝炎的肠道外传播途径,深圳市散发性戊型肝炎的高发区,本研究以乙型肝炎作为肠道包传播途径的标记探讨该病在我市的传播途径。研究发现抗－ＨＥＶ ＩｇＧ阳性率与乙型肝炎标记物及输血史,手术史等无相关性,提示我市散发性戊型肝炎以肠道途径传播而非肠道外传播为主。     

输血传播病毒（TTV）感染的研究

目的: 了解输血传播病毒 (TTV) 在广西人群中感染情况, 探讨TTV 在肝炎发病中的作用与地位。方法: 用套式聚合酶链反应检测血清中TTVDNA,用ELISA或RT—PCR法排除非甲—庚型肝炎病毒。结果:正常献血员TTVDNA阳性率为16.4% (12/73), HBV感染者TTV DNA阳性率为4.3% (2/46), 显著低于正常献血员(χ2 = 3.97, P< 0.05), 非甲—庚肝炎患者TTV DNA阳性率为35.4% (6/17), 与正常献血员无显著性差异(χ2 = 3.0, P> 0.05), TTV感染在男女性别中无显著性差异, 但在30～50岁人群中感染率(17/78) 显著高于其他年龄段(4/58) (χ2 = 4.92, P< 0.05)。结论: 广西存在TTV 感染,且中年人群高于其他年龄段人群,TTV与HBV可有存在互相抑制或干扰作用, 但TTV可能不致病或具轻微致病性     

影响维持性血液透析患者感染HCV的因素分析

目的: 分析影响维持性血液透析患者 (血透) 感染HCV 的因素。方法: 收集120 例血透患者的临床资料并进行统计学分析。结果: 血透患者HCV感染与血透时间、每周透析时间、输血、血制品史和量、肾移植史、院内感染史、ALT增高史显著相关。结论: 输血为血透患者感染HCV的主要途径, 但也存在医源性传播的可能     

北京铁路部分人群散发性急性非甲非乙非丙型肝炎病原学分析

对北京铁路地区部分人群５８例散发性急性非甲非乙非丙型肝炎进行了ＨＥＶ和ＨＧＶ血清学调查。结果如下,抗－ＨＥＶ阳性２２例（３７．９３％）,抗－ＨＧＶ和ＨＧＶＲＮＡ阳性共１２例（２０．６８％）,其中３例为戊型和庚型肝炎病毒混合感染。戊肝、庚肝病毒感染均以３１～４０岁发病最多,且男多于女;戊肝主要发生在冬春季,多有肠道暴露史;庚型肝炎病毒感染无明显季节性,有肠道外暴露史。ＨＧＶ可单独感染,提示它可能有一定的致病性。     

血源乙型肝炎疫苗免疫持久性观察

为了解血源乙型肝炎（乙肝）疫苗的免疫持久性,对澄江县1991～1995年按照0、1、6个月免疫程序完成血源乙肝疫苗接种的人群,按接种后间隔1～5年分组,每组随机抽取100名儿童,采末梢血,共得517份免疫者的血清样品．用酶联免疫吸附试验（ELISA）检测抗-HBs、HBsAg。结果表明,接种乙肝疫苗2年内抗-HBs阳性率在90％以上,以后随间隔年眼的延长而明显下降,间隔5年降至60％,人群平均保护率达78.57％．     

Hepatitis and HIV Risk among Drug-Using Men Who Have Sex with Men: Demonstration of Hart's Law of Inverse Access and Application to HIV

Objectives: The first 215 drug-using men who have sex with men (DU-MSM) evaluated for possible participation in a controlled behavioral intervention study were tested for Hart's law of inverse access, which predicts that access to prevention resources varies inversely to need. Methods: Hepatitis B vaccination, mental health, and substance abuse treatment were used to measure health resource use; hepatitis B (HBV) and HIV infections and unsafe sex measured preventive care needs. Socioeconomic status indicators included education, ethnicity, and income. Results: HBV-vaccinated men were more likely to be white and college educated. HBV-infected men were more likely to be black, older, HIV-positive, and have higher rates of substance use with sex. When stratified according to socioeconomic status indicators, levels of HBV vaccination were inverse to the rates of HBV and HIV infection. This relationship was not found for psychosocial treatment utilization. Conclusions: Demonstration of Hart's law among high-risk DU-MSM has important implications for future HIV prevention efforts among high-risk individuals. Combining HIV, hepatitis, and substance abuse prevention in primary care and substance abuse treatment settings is discussed.     

抗核抗体在甲型病毒性肝炎中的检测

目的:探讨抗核抗体在甲型病毒性肝炎中的检测及意义。方法:用间接免疫荧光法对58例正常献血员和39例甲型病毒性肝炎患者进行抗核抗体(ANA)的检测。结果:甲型肝炎中抗核抗体阳性率为77%(339),3例阳性均为甲肝急性期患者。结论:ANA存在甲型肝炎中,虽阳性率低,仍提示甲型病毒性肝炎中可能存在自身免疫现象     

垂直传播中乙型肝炎病毒S区变异株检出及其流行病学意义

目的　研究垂直传播中乙型肝炎病毒Ｓ基因变异的流行病学意义。方法　以配偶无乙型肝炎病毒（ＨＢＶ） 标志的４ 名女性携带者与６ 名男性携带者及其子宫内感染ＨＢＶ 的胎儿为对象,以双脱氧链末端终止法检测母子、父子所携ＨＢＶＳ区４５１ ～６６０ 位核苷酸序列。结果　母子、父子间同源性９８ ％ ～１００ ％ ,检出４９１ 、４９４、５３０ 、５４６、５８１ 位点变异致使１１３ 、１１４、１２６ 、１３１、１４３ 位氨基酸替代,其中２ 对父母与胎儿检出１２６ 位变异。４ 例胎儿检出１３１ 位变异,其中２ 例胎儿合并检出１４３ 位变异。结论　ＨＢＶ垂直传播中存在Ｓ基因变异株,可能以１２６、１３１、１４３ 位氨基酸变异株为主,这些变异株可能使ＨＢ疫苗免疫失败。