性病患者血清抗-HBV、抗-HCV、抗-HIV的调查

目的探讨性病患者HBV、HCV、HIV的感染率。方法HBV感染指标全部采用时间分辨荧光免疫分析法，抗-HCV、抗-HIV采用酶联免疫间接法。结果206例性病患者乙肝病毒感染标志为81．55％(168／206)，HBsAg阳性率达25．73％(53／206)，抗-HCV阳性率达8．74％(18／206)，HCV合并HBV感染率达66．67％，抗-HIV阳性1例；203名就业查体人员乙肝病毒感染标志为53．20％(108／203)，HBsAg阳性率7．88％(16／203)；抗-HCV阳性率为0．99％(2／203)，抗-HIV全部阴性。结论性传播途径是乙肝传播的重要途径之一，同时也有不可忽视的HCV感染率，应采取干预措施。     

1535例住院患者输血前检查结果分析

目的调查患者输血前传染病感染状况。方法对1535例患者输血前采用酶联免疫吸附试验（ELISA）检测其血清中乙肝病毒表面抗原（HBsAg）、丙肝抗体（抗-HCV）、艾滋病抗体[抗-HIV（1＋2）]和梅毒螺旋体抗体（TP）。结果在1535例患者中，HBsAg阳性187例（12．18％）、抗-HCV阳性12例（O．78％）、抗-HIV阳性（经省CDC确诊）1例（0．07％）、TP阳性16例（1．04％）。检测阳性总数为216例，总阳性率为14．07％。结论对患者进行输血前感染性标志物检测、了解患者输血前感染状况有利于防止医务人员的职业感染及减少或避免因输血而引起的医疗纠纷。     

广西部分地区人类免疫缺陷病毒感染者合并丙型肝炎病毒感染情况分析

目的 了解广西人类免疫缺陷病毒(HIV)感染者中HIV/丙型肝炎病毒(HCV)的混合感染率及其HCV RNA的阳性率,为今后HIV患者丙肝筛查及预防提供参考.方法 采用ELISA法检测HIV感染者血清中的丙肝病毒抗体,按结果分成抗-HCV(+)组和抗-HCV(-)组,再用巢式PCR法检测血清的HCV RNA,分析比较HCV RNA阳性率.结果 在300例HIV感染者中,有146例抗-HCV阳性,154例抗-HCV阴性;在抗-HCV阳性组中,HCV RNA的阳性率为78.08％(114/146);在抗-HCV阴性组中,HCV RNA阳性率为26.62％(41/154);ELISA法和巢式PCR法检测HCV感染的符合率为75.67％[(113+114)/300].结论 在广西的HIV感染者中HCV感染状况较严重.对HIV感染者进行丙肝筛查时,为减少漏诊率,建议采用PCR方法检测抗-HCV阴性血清中的HCV RNA.     

输血前检测患者血清感染性指标的临床意义

目的 对输血前患者做血清感染性指标检测，及早发现阳性患者，避免医疗纠纷。方法 采用酶联免疫法对输血前患者3065例进行乙肝表面抗原（HBsAg）、丙型肝炎病毒抗体（抗-HCV）、人类免疫缺陷病毒抗体（抗-HIV）、梅毒螺旋体抗体（抗-TP）检测。结果 3065例患者中HBsAg阳性患者155例（5．06％）．抗-HCV阳性患者45例（1．47％），抗-HIV无阳性病例，抗-TP阳性患者45例（1．47％）。其中HBsAg与抗-HCV同时阳性2例。HBsAg与抗-TP同时阳性3例．抗-HCV与抗-TP同时阳性4例。男、女的HBsAg与抗-HCV阳性率均不同。而抗-TP阳性率相近。不同年龄组的抗-HCV与抗-TP阳性率相似。而HBsAg不同。结论 输血前患者各项血清感染指标均有一定比例的感染率，应引起高度重视。     

1535例住院患者输血前检查结果分析

目的 调查患者输血前传染病感染状况.方法 对1535例患者输血前采用酶联免疫吸附试验(ELISA)检测其血清中乙肝病毒表面抗原(HBSAg)、丙肝抗体(抗-HCV)、艾滋病抗体[抗-HIV(1 2)]和梅毒螺旋体抗体(TP).结果 在1535例患者中,HBSAg阳性187例(12.18%)、抗-HCV阳性12例(0.78%)、抗-HIV阳性(经省CDC确诊)1例(0.07%)、TP 阳性16例(1.04%).检测阳性总数为216例.总阳性率为14.07%.结论 对患者进行输血前感染性标志物检测、了解患者输血前感染状况有利于防止医务人员的职业感染及减少或避免因输血而引起的医疗纠纷.     

肝病与输血患者丙型肝炎病毒抗体及免疫指标观察分析

本文对慢性肝炎、肝硬化、肝癌及输血史患者血清进行抗丙型肝炎病毒抗体测定及慢性肝病免疫指标观察分析,146例慢性肝病及输血史患者抗-HCV阳性率为52.7％(77/146),HBsAg和抗-HCV双阳性率为18.5％(27/146)。3种肝病患者抗-HCV及HBsAg阳性结果分析表明,HBsAg阳性率无明显差异,而抗-HCV阳性率肝硬化和肝癌明显高于慢性肝炎。HCV引起的慢性肝病IgG、IgA明显增高。预防输血后肝炎,减少HCV对血液的污染是重要一环。     

应用聚合物链反应检测丙肝病毒RNA与ELISA结果比较

本文应用聚合酶链反应(PCR)技术及酶联免疫吸附实验(ELISA)检测120例门诊和住院病人血清中HCV-RNA及抗-HCV抗体。结果HCV-RNA和抗-HCV均阴性84.17％(101/120);HCV-RNA和抗-HCV均阳性7.5％(9/120);HCV-RNA(+)和抗-HCV(-)7.5％(9/120);HCV-RNA(-)和抗-HCV(+)0.83％(1/120)。经统计学处理(P<0.05)两者有显著差异。说明PCR阳性率明显比ELISA法高。在诊断HCV感染时有较高价值,为了避免漏诊,建议有条件的实验室必要时应使用PCR技术检查HCV-RNA。     

116例血清中HCV RNA定量检测与抗-HCV结果对比分析

目的探讨丙型肝炎病毒抗体(抗-HCV)和HCVRNA定量检测阳性结果对丙型肝炎诊断治疗的临床意义。方法采用第三代ELISA夹心法检测抗-HCV，荧光定量PCR法检测HCVRNA检测116例血清抗-HCV或HCVRNA阳性标本。结果在116例标本中，抗-HCV( )／HCVRNA( )双阳性者83例，抗-HCV( )／HCVRNA(-)者12例，抗-HCV(-)／HCVRNA( )者21例)。两者阳性符合率为71．6％(83／116)。在HCVRNA定量阳性结果中，则有104例为HCV感染，其中抗-HCV的阳性检出率为80．0％(83／104)。随着血清HCVRNA滴度的增高，抗-HCV的阳性率也增加，两者变化趋势一致。结论抗-HCV检测，HCVRNA荧光定量PCR法检测均有一定的局限性，同时应用抗-HCV和HCVRNA检测对临床上完善HCV诊断、评价抗病毒疗效更为准确。     

输血前和围术期患者抗-HGV的检测及其意义

目的 探讨输血前和固术期患者进行血清抗-HGV检测的临床意义.方法 用ELISA法检测3131例患者血清抗-HGV,同时检测乙型肝炎标志物(HBV)、丙肝病毒抗体(抗-HCV)、艾滋病病毒抗体(抗-HIV)、梅毒螺旋体抗体(抗-TP).结果 抗-HGV阳性率0.06%(2/3131),HBV阳性率5.39%(169/3131)、HCV阳性率0.19%(6/3131)、HIV阳性率0.06%(2/3131),抗-TP阳性率0.57%(18/3131).该次调查未见HGV与HBV、HCV、HIV、梅毒的重叠感染.结论 输血前和围术期患者抗-HGV检测对于庚肝的诊治、预防医院感染以及防止医疗纠纷都具有重要意义.     

122例艾滋病患者合并乙肝病毒 丙肝病毒感染的临床流行病学研究

目的 研究在抗逆转录病毒药物治疗(HAART)状态下HIV/AIDS患者合并乙肝病毒(HBV)、丙肝病毒(HCV)的流行状况以及相关血清生化和病毒学特征.方法 对122例正在接受HAART治疗的HIV/AIDS患者采集血标本,使用酶免法(ME-IA)检测乙肝五项指标(HBs Ag、抗-HBs、HBe Ag、抗-HBe、抗-HBc)、肝功能,应用酶联免疫吸附法(ELISA)检测丙型肝炎病毒抗体,运用RT-PCR法对丙肝病毒抗体阳性标本以及表面抗原和/或核心抗体阳性标本分别进行HCV-RNA以及HBV-DNA测定.以43名单纯HCV感染者作为对照组进行研究.结果 122名 HIV/AIDS患者,乙肝五项指标全阴性97例(78.86％),表面抗原阳性3例(2.46％),表面抗体阳性者总计19例(15.57％),单纯核心抗体阳性者3例(2.46％).HCV 抗体阳性84例(68.85％),84例HCV抗体阳性标本中HCV-RNA 阳性58例(69.05％),HIV/HCV/HBV合并感染者为0.HIV/HCV合并感染组 HCV-RNA 水平与感染者性别,CD4 +细胞数水平无明显差异(P＞0.05);HIV/HCV合并感染组与单纯HCV感染组 HCV-RNA水平、肝功能异常率无明显差异(P＞0.05).结论 HIV感染者HBsAg阳性率低于普通人群,HIV/HCV合并感染的比例显著高于普通人群.HIV/HCV合并感染与单纯HCV感染者血清生化及病毒学改变相似.     

对血站合格献血员复检HBV HCV阳性率分析

目的：了解我区献血员的管理及筛查情况。方法：随机采集了我区4个盟市血站503份合格献血员血样,并进行了相关调查,采用ELISA法复检。结果：HBsAg阳性率为1.99%（10/503）;抗-HBc阳性率15.90%(80/503);抗-HBs阳性率21.87%(110/503);抗-HCV阳性率2.19%(11/503),其中HBV、HCV双重感染的8例,HBsAg、抗-HBc双阳性3例。对抗-HBc、抗-HBs双阳性以及单纯阳性者经PCR法检测HBVDNA均为阴性。结论：说明我区血站管理及对献血员筛查工作还存在着一定的漏洞,献血员筛查抗-HBc对预防输血后乙肝无多大价值,应把重点放在选用灵敏度高的试剂进行筛查。     

三种肝炎病毒在肝细胞癌组织及慢性肝炎肝组织中的表达

目的:探讨乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)及庚型肝炎病毒(HGV)在肝细胞癌(HCC)及慢性肝炎肝组织中的存在状态。方法:分别采用抗HBVS,抗-HBVC,抗HCVNS5及抗-HGVNS5单克隆抗体,以免疫组织化学SPAB法检测27例HCC及37例慢性肝病患者石蜡包埋的肝组织中HBVS抗原(HBsAg)、HBVC抗原(HBcAg)、HCVNS5抗原(HCAg)和HGVNS5抗原(HGAg)。结果:HCC中检出HBsAg18例(66.7%),HCAg13例(48.2%)及HGAg9例(33.3%)。其中HBV/HCV/HGV重叠感染7例,HBV/HCV重叠感染4例,HBV单独感染7例,HCV单独感染2例,HGV单独感染2例;在慢性肝炎中检出HBsAg26例(70.3%),HCAg19例(51.4%)及HGAg12例(32.4%)。其中HBV/HCV/HGV重叠感染10例,HBV/HCV重叠感染5例,HBV单独感染11例,HCV单独感染5例,HGV单独感染2例。HBsAg、HCAg、HGAg均表达于肝细胞或肝癌细胞浆内,呈细颗粒状分布。HBcAg表达于肝细胞或肝癌细胞胞核或胞浆内。结论:慢性肝炎及HCC患者有较高的HBV、HCV及HGV感染率,HBV感染在HCC的发生过程中起重要作用,HCV和HGV的感染可能是HCC发生的相关因素。     

The Role of anti-HBc IgM in Screening of Blood Donors

Background

Transfusion transmitted hepatitis B has always been a dreaded disease, with incidence of increased transmission through donated blood. The screening test for hepatitis B infection is detection of HBsAg that does not rule out the risk of transmission of hepatitis B as the donor may be in the ‘window period’. During this period, detection of the antibody to the hepatitis B core antigen (anti-HBc) IgM type serves as a useful serological marker. The aim of this study was to screen blood donors for anti-HBc type IgM and anti - HBc Ag total for detection and to find their incidence amongst blood donors.

Methods

2552 voluntary blood donors were screened by the ELISA method for HBsAg and anti - HBc IgM and other mandatory screening markers. 704 of the test blood samples were also screened for anti-HBc total.

Result

Of the 2552 donor, 47 (1.84 %) cases were HBsAg positive. A total of 11 (0.43 %) blood units were reactive for HBcAg IgM and of these, 10 (0.39 %) were HBsAg negative and reactive for anti-HBcAg IgM. Of the 704 samples tested for anti - HBcAg total, 112 (15.9%) samples were reactive.

Conclusion

Screening of blood for anti-HBc total is practical in the western world as the incidence of HBsAg and anti-HBc is low in these countries and these positive blood units for anti - HBcAg total can be discarded. This may not be practical in India as the incidence of anti- HBcAg total is high in our population. It is recommended that all blood units should be tested for anti - HBc IgM for infectivity status of the blood donors in the window period and to discard blood if positive.Key Words: Window period, Hepatitis B surface antigen, Anti hepatitis B core antigen     

Increased severity and morbidity of acute hepatitis in drug abusers with simultaneously acquired hepatitis B and hepatitis D virus infections

Hepatitis D virus (delta agent) markers were present in 111 (36%) of 308 intravenous drug abusers who were positive for hepatitis B surface antigen (HBsAg), 52 of these having hepatitis D virus antigenaemia. IgM antibody to hepatitis B core antigen (anti-HBc IgM) was present in 92 out of 95 subjects tested, indicating that hepatitis D virus and hepatitis B virus infections had been acquired simultaneously. Hepatitis D virus markers were present in three out of four patients with fulminant hepatitis, and in 80 of 223 (36%) with mild or moderate hepatitis compared with four of 29 (14%) of those who were asymptomatic. These proportional differences were significant (p less than 0.001). Hepatitis D virus markers were present in twice as many patients positive for anti-HBc IgM requiring admission to hospital with acute hepatitis compared with outpatients attending a drug treatment centre. Tests on one patient showed complete disappearance of HBsAg, but hepatitis D antigen (HDAg or delta antigen) and hepatitis B e antigen (HBeAg) were still present in serum samples. All five patients with chronic active hepatitis had hepatitis D antibody (anti-HD) compared with seven of 24 (29%) with chronic persistent hepatitis (p = 0.008). Blocking anti-HD persisted for long periods after simultaneous infections with hepatitis B virus and hepatitis D virus but at lower titres than in patients with chronic liver disease.     

Infectivity and Risk Factors of Hepatitis C Virus Transmission Through Sexual Contact

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Hepatitis B virus transmission between heterosexuals

To determine if heterosexual activity was a risk factor for acquiring hepatitis B virus (HBV) infection, we studied attendees at a sexually transmitted disease (STD) clinic and students at a large university. Responses to self-administered questionnaires were used to exclude persons with factors known to be related to the acquisition of HBV and to determine the number of recent (past four months) and lifetime sexual partners. Serum samples were tested for hepatitis B surface antigen, antibody to hepatitis B surface antigen, and antibody to hepatitis B core antigen. For white heterosexuals in the STD group, the prevalence of HBV infection was 6% for those with fewer than five recent partners vs 21% for those with five or more partners, and 5% for those with fewer than 50 lifetime partners vs 20% for those with 50 or more partners. For black heterosexuals in the STD group, no association was found between prevalence of HBV infection and number of recent or lifetime sexual partners. For the heterosexual student group (all white), the prevalence of HBV infection was 1.5% for fewer than three recent partners vs 14% for three or more partners, and 2% for fewer than ten lifetime partners vs 7% for ten or more partners. For white heterosexuals, the risk of acquiring HBV infection increases with increasing amounts of sexual activity and may reach a level similar to that of other groups previously recognized to be at high risk of acquiring hepatitis B.     

血液病患者中HCV和HBV感染及其复制分析

对１２６例血液病患者ＨＣＶ和ＨＢＶ感染及其病毒复制进行了研究，结果：（１）１２６例患者中ＨＣＶ抗体阳性８例（６．４％）大约比献血员感染率高１０倍（Ｐ〈０．０１），在抗体阳性者中有７例ＨＣＶ－ＲＮＡ阳性（８７．５％）（２）所测患才中ＨＢＶ五项标志物单项或多项阳性２６例（２０．６％）其中ＨＢＶ－ＤＮＡ阳性１２例（４６．２％）在８例ＨＣＶ感染者中有３例与ＨＢＶ重叠感染（３７．５％）５例有既往输血史（６２     

HBV感染的HBcAb动力学观察

HBcAb在HBV感染个体中的出现和持续状态已被清楚地证明,并把它视为HBV感染的一个血清学重要指标。为了进一步探讨它在临床学和流行病学上的意义,本文研究了159例正常人的HBcAb。经两年的追踪观察,发现HBcAb检出率高于乙型肝炎的其它血清学指标,并发现HBcAb滴度与HBsAg滴度间存在着正相关,同时有按滴度变动的依存关系,即呈对数曲线形式(R~2=0.96033)。此结果为今后检测HBcAb与HBsAg指标的数量分析提出了参考依据。     

Detection and significance of anti-pre S2 in patients with hepatitis B and HBsAg carriers

We studied anti-Pre S2 by ELISA incorporating a synthetic peptide corresponding to the pre S2 (120-150) sequence and a monoclonal anti-human IgG, conjugated with peroxidase in 139 patients with hepatitis B and HBsAg carriers. The positive rate was 90% inpatients with acute-hepatitis 6.7% in chronic active hepatitis and 2.5% in persistent hepatitis. No positive case was seen in the HBsAg carriers. These findings indicate that anti-pre S2 may contribute to virus clearance and early diagnosis. The coexistence of anti-pre S2 with pre-S2 antigen was found only in patients with acute hepatitis, and anti-pre S2 may be coexistent with HBeAg in acute hepatitis, whereas all HBeAg positive patients with chronic hepatitis and HBsAg carriers lacked anti-pre S2. Comparing with anti-HBc IgM, anti-HBs and anti-HBe, anti-pre S2 is an earlier antibody in humoral immune response to HBV infection during the acute phase of hepatitis.     

Seroprevalence of hepatitis B and hepatitis C in patients with thalassemia and sickle cell anemia in a long-term follow-up

BACKGROUND: Transfusion-dependent patients are more prone to acquiring various transfusion-transmitted infections such as hepatitis B (HBV), hepatitis C (HCV) and human immunodeficiency virus (HIV). The aim of the study was to investigate the prevalence of these infections in patients with thalassemia and with sickle cell anemia (SCA) receiving multiple blood transfusions. METHODS: The subjects of the present study were 399 multi-transfused patients with beta-thalassemia major or intermedia and SCA who have been registered at the two regional hemoglobinopathy centers in Turkey since 1996. Hepatitis B surface antigen (HBsAg), hepatitis C virus antibodies (anti-HCV) and human immunodeficiency virus antibodies (anti-HIV) tests were assayed by a second-generation enzyme-linked immunosorbent assay method. RESULTS: Of the 399 patients, 3 were HBsAg positive (0.75%), 18 were anti-HCV positive (4.5%), and none was anti-HIV positive. All patients with HBsAg and 14 (77.7 %) patients with HCV received initial blood transfusions before second-generation tests were performed. Patients who were anti-HCV positive had a significantly higher mean number of blood transfusions and peak serum alanine transaminase level than anti-HCV-negative patients. CONCLUSIONS: These results showed that after introduction of more sensitive screening tests and stringent donor selection procedures, incidence of HCV infection was significantly reduced, but there was still a serious risk for HCV infection, and there was a minor risk for HBV infection in patients with thalassemia and SCA.