血液透析患者丙型肝炎病毒高变区核苷酸序列分析

目的探讨维持性血液透析（血透）患者感染丙型肝炎病毒（ＨＣＶ）的传播途径。方法应用核苷酸序列分析技术检测１５例血透患者感染的ＨＣＶ高变区（ＨＶＲ）核苷酸序列,并进行同源性比较。结果比较１５例血透患者ＨＣＶＨＶＲ核苷酸序列发现,分离株８、１２和１４间核苷酸序列同源性高达９７．００％,株４、５和１０间同源性高达９５．００％,株１、３～８、１０～１４相互间同源性均在８０．００％以上,这些患者均在同一房间透析或有共用透析机史;株２与其他各株间同源性为６１．２５％～６６．２５％,株９与其他各株间同源性５７．５０％～６７．５０％,两者均有大量输血史。结论血透患者感染ＨＣＶ的主要原因为输血,同时在血透环境中亦可能存在ＨＣＶ感染的医源性传播途径。

Nucleotide sequence analysis for high variance region of hepatitis C virus in patients with hemodialysis

Objective To investigate the route of transmission for hepatitis C virus (HCV) infection in patients on hemodialysis(HD). Methods Nucleotide sequence of high variance region (HVR)of HCV was analyzed with nucleotide sequencing technique in 15 HD patients, and its homology was compared. Results Comparison of the nucleotide sequences of HCV HVR in 15 HD patients showed that their homologies in isolates 8, 12 and 14 reached 97.50%, 95.00% in isolates 4, 5 and 10, and more than 80.00% in isolates 1, 3 8 and 10 14. Clinical data showed that all these patients were hemodialyzed in the same room with the same HD machine. Isolates 2 and all others were 61.25% 66.25% in homology, and 57.50% 67.50% in isolates 9 and all others, and both the patients had histories of large quantity blood transfusion. Conclusion Blood transfusion was the primary risk factor for HCV infection in HD patients, but iatrogenic transmission of HCV through HD environment could also exist.