衢州地区献血者戊型肝炎流行病学及其亚临床感染和病毒血症情况调查

目的 调查浙江衢州地区戊型肝炎的感染情况.方法 对2006年4月至2007年4月间衢州市中心血站的献血者进行整群抽样,检测抗HEV IgG以及IgM抗体,并对抗HEV IgM阳性的标本进行RT-PCR检测,经测序后分析其基因型及序列同源性.结果 4860例无偿献血者中,HEV IgG阳性率为40.62%,其中男性感染率显著高于女性感染率(43.09%vs.36.09%)(x2=22.6,P＜0.01).感染率随年龄的增长而升高.在抗HEV IgG抗体阳性者中,抗体滴度与年龄、性别并无显著相关性.IgM阳性率为0.43%,IgM阳性的亚临床感染者较IgM阴性的人群有较高的HEV IgG阳性率及抗体滴度(P＜0.05).21例IgM阳性者中发现2例HEV PCR阳性.献血者中病毒血症总阳性率为0.4‰.2例病毒血症者均为HEV Ⅳ型.结论 衢州地区戊型肝炎感染与年龄和性别显著相关,且感染主要发生在成年之后.在献血者中,HEV病毒血症并不罕见.

The investigation of HEV epidemiology,inferior clinical infection and viral-toxemia in blood donors in Quzhou Area

OBJECTIVE: To investigate the infection of HEV in Quzhou area of Zhejiang Province. METHODS: All sera from blood donors in the central blood bank of Quzhou from April 2006 to April 2007 were used. Anti-HEV IgG and anti-HEV IgM were measured by EIA. RT-PCR was also performed to the samples with positive anti-HEV IgM. Genotype and sequence homology were analyzed after sequencing. RESULTS: The positive ratio of anti-HEV IgG was 40.60%, in which the male infection ratio was higher than the female significantly (43.09% VS 36.09%; chi2=22.6; P < 0.01). The infection ratio was increased with age. The positive ratio of anti-HEV IgM was 0.43%. The positive ratio of anti-HEV IgG and the titers of antibody were higher in the inferior clinical infectors with positive anti-HEV IgM than the negative ones (P < 0.05). Two samples were positive in HEV PCR among 21 samples with positive anti-HEV IgM. The toxemia ratio was 0.4% of all the donors. And the genotype of the two samples with toxemia were both HEV-IV. CONCLUSION: The HEV infection was correlation with age and sex significantly and the infection occurred in the adults mainly in Quzhou area. HEV toxemia was not infrequency in the blood donors.