乙、丙型肝炎病毒重叠感染的慢性肝病患者肝组织和血清中的病毒检测

为了探讨乙型和丙型肝炎病毒（ＨＢＶ和ＨＣＶ）重叠感染者病毒相互干扰现象，对４４例患者血清检测诊断为ＨＢＶ和ＨＣＶ感染的慢性肝病患者，用原位杂交法检测了肝组织中ＨＢＶＤＮＡ和ＨＣＶＲＮＡ。２８例患者肝组织ＨＢＶＤＮＡ和ＨＣＶＲＮＡ同时阳性，两者阳性信号分布类型比较无明显差异（Ｐ＞０．０５），血清ＨＢｅＡｇ阳性和阴性组中肝组织中的ＨＢＶＤＮＡ和ＨＣＶＲＮＡ检出率无明显差异（Ｐ＞０．０５）。８例血清ＨＢｓＡｇ阴性者，肝组织ＨＢＶＤＮＡ阳性５例，ＨＣＶＲＮＡ阳性３例。结果提示，ＨＢＶ和ＨＣＶ重叠感染肝组织损伤加重，可能诱导一种病毒呈现潜伏状态，但不是病毒清除。     

乙,丙型肝炎病毒重叠感染的慢性肝病患者肝组织和血清…

为了探讨乙型和丙型肝炎病毒（ＨＢＶ和ＨＣＶ）重叠感染者病毒相互干扰现象，对４４例患者血清检测诊断为ＨＢＶ和ＨＣＶ感染的慢性肝病患者，用原位杂交法检测了肝组织中ＨＢＶＤＮＡ和ＨＣＶＲＮＡ。２８例患者肝组织ＨＢＶＤＮＡ和ＨＣＶＲＮＡ同时阳性，两者阳性信号分布类型比较无明显差异（Ｐ〉０．０５），血清ＨＢｅＡｇ阳必和阳性组中肝组织中的ＨＢＶＤＮＡＴ ＨＣＶＲＮＡ检出率无明显差异（Ｐ〉０．０５）。８例血清Ｈ     

维持性血透患者丙型肝炎病毒感染的调查及危险因素探讨

目的对本院４８例维持性血透（ＨＤ）患者丙型肝炎病毒感染状况进行调查,并对其危险因素进行分析。方法采用第二代抗体检测试剂检测４８例ＨＤ患者ＨＣＶ抗体,另外采用ＲＴ－ＰＣＲ法检测患者血清中ＨＣＶＲＮＡ。同时测定肝酶ＡＬＴ。结果ＨＣＶ抗体阳性率为３５％,所有ＨＣＶ抗体阳性患者的血清中均检出ＨＣＶＲＮＡ,而ＨＣＶ抗体阴性患者的血清中有７例检出ＨＣＶＲＮＡ。血清ＡＬＴ水平的升高与ＨＣＶＲＮＡ的存在并不总是相关,１７例ＨＣＶ抗体阳性且ＨＣＶＲＮＡ阳性的患者中仅１０例血清ＡＬＴ水平轻度升高。具有输血史的患者在ＨＣＶ抗体阳性组中所占的比例明显大于在ＨＣＶ阴性组中所占的比例。结论输血仍是引起ＨＤ患者ＨＣＶ感染的重要原因,ＨＣＶ抗体阳性率与ＨＤ患者透析时间有关,提示血液透析单位可能存在ＨＣＶ的医院感染     

乙型、丙型、庚型肝炎病毒多重感染研究

目的探讨庚型肝炎感染患者是否存在双重感染和多重感染。方法应用庚型肝炎病毒（ＨＧＶ）ＮＳ３区逆转录聚合酶链反应技术检测了ＨＧＶ系列稀释的质控血清及ＡｂｂｏｔＧＢＶ－Ｃ参比样品中ＨＧＶＲＮＡ，并对９０例丙型肝炎病毒（ＨＣＶ）ＲＮＡ阳性和１２例乙型肝炎、丙型肝炎双重感染献血员进行了ＨＧＶＲＮＡ的检测。结果ＨＧＶ系列稀释质控血清１０－１～１０－５均为阳性；１０－６为阴性。２份ＡｂｂｏｔＧＢＶ－Ｃ样品均为ＨＧＶＲＮＡ阳性。９０例ＨＣＶＲＮＡ阳性样品中，８例ＨＧＶＲＮＡ阳性（１７．８％）；１２例乙、丙双重感染者中４例（４／１２）ＨＧＶＲＮＡ阳性。结论不仅存在ＨＣＶ及ＨＧＶ双重感染，也存在多重感染。     

加热与洗涤法对HBV,HCV血清标志的影响

采用ＥＬＩＳＡ和聚合酶链反应（ＰＣＲ），对经６０℃１０ｈ加热的ＨＢｓＡｇ、ＨＢｅＡｇ、抗－ＨＢＣ及抗－ＨＣＶ阳性血清和洗涤４次的ＲＢＣ洗涤及放散液的血清标志及ＨＢＶＤＮＡ、ＨＣＶＲＮＡ进行了检测。结果，６０℃加热１０ｈ用ＥＬＩＳＡ检测血清标志均由强阳性转为阳性，ＰＣＲ检测ＨＢＶＤＮＡ及ＨＣＶＲＮＡ均为阴性；洗涤液用ＥＬＩＳＡ和ＰＣＲ检测血清标志及ＨＢＶＤＮＡ、ＨＣＶＲＮＡ均呈阴性反应，放散液用ＥＬＩＳＡ检测阴性，用ＰＣＲ检测ＨＣＶＲＮＡ１０份标本９份阴性，１份阳性。提示６０℃加热１０ｈ和洗涤ＲＢＣ可灭活或去除血清中大部分ＨＢＶ、ＨＣＶ及其血清标志。     

抗—HCV阳性单采浆供血员HGV感染随访研究

为了解单采浆供血员庚型肝炎病毒（ＨＧＶ）感染及其转归，对１０２名抗－ＨＣＶ阳性单采浆供血员冻存血清进行抗－ＨＧＶ和ＨＧＶＲＮＡ检测，对抗－ＨＧＶ和（或）ＨＧＶＲＮＡ阳性者作３年随访研究。采用ＥＩＡ法检测抗－ＨＧＶ，包被抗原来自ＨＧＶ不同功能区的合成肽。应用ＲＴ－ＰＣＲ法检测ＨＧＶＲＮＡ，引物选自ＨＧＶＮＳ３区。结果表明，抗－ＨＣＶ阳性单采浆供血员ＨＧＶＲＮＡ阳性率为１９．６１％（２０／１０２），抗－ＨＧＶ阳性率为１７．６５％（１８／１０２），ＨＧＶ感染率（抗ＨＧＶ和／或ＨＧＶＲＮＡ阳性）为２４．５１％（２５／１０２），而对照组仅为０．９４％（１／１０６）。提示单采血浆是ＨＧＶ感染的重要危险因素。ＨＧＶＲＮＡ和抗－ＨＧＶ的３年阴转率分别为３５．００％（７／２０）和１１．１１％（２／１８），说明ＨＧＶ感染有慢性携带趋势     

丙型肝炎病毒在外周血单个核细胞中复制状态的研究

采用套式逆转录ＰＣＲ方法检测２６例丙型肝炎及丙型肝炎病毒携带者的血清，外周血单个核细胞及其末次洗液中的ＨＣＶＲＮＡ。结果２６例血清中正链ＨＣＶＲＮＡ全部阳性；外周血单个核细胞中正链ＨＣＶＲＮＡ２２例阳性、负键ＨＣＶＲＮＡ１５例阳性；末次洗液中正链ＨＣＶＲＮＡ全部阴性。说明ＨＣＶ不仅感染ＰＢＭＣ，而且在其中复制．与丙型肝炎的复发、慢性化及干扰素治疗的疗效不佳有关。     

丙型肝炎病毒抗体光密度值与丙型肝炎病毒核酸的关系

［目的］了解抗ＨＣＶ的ＯＤ值与ＨＣＶ－ＲＮＡ的关系。为丙型肝炎的诊断提供科学依据。［方法］从太原市中心血站、太原市卫生防疫站、山西省妇女劳动教养所、本站性病门诊、山西医科大学第一医院采集抗ＨＣＶ阳性血清２９６份，筛选出抗ＨＣＶ阳性的血清２２８份，用逆转录巢式多聚酶链反应（ＲＴ－nestPCR)进行ＨＣＶ－ＲＮＡ的检测。［结果］２２８份抗ＨＣＶ阳性标本中，检出ＨＣＶ－ＲＮＡ阳性者１６１例，阳性率为７０.6%，在抗ＨＣＶ的效价增高到一定值（ＯＤ／ＣＯ≥8.0)时，ＨＣＶ－ＲＮＡ检出率增高较明显，结果还显示不同人群抗ＨＣＶ阳性者的ＨＣＶ－ＲＮＡ检出率有差别，献血员、丙型肝炎患者的ＨＣＶ－ＲＮＡ检出率较高（８５.25%和８１82%）。［结论 ］当抗ＨＣＶ阳性的血清ＯＤ／ＣＯ≥8.0时，ＨＣＶ－ＲＮＡ很可能也为阳性。     

血液透析及肾移植患者乙型和丙型肝炎病毒感染状况分析

测定２０９例肾透析患者血液中ＨＢＶ－ＤＮＡ和ＨＣＶ－ＲＮＡ，阳性率ＨＢＶ－ＤＮＡ为２．４％、ＨＣＶ－ＲＮＡ为１６．３％；７６例肾移植后患者阳性率ＨＢＶ－ＤＮＡ为２．６％、ＨＣＶ－ＲＮＡ为２３．７％；对照组阳性率ＨＢＶ－ＤＮＡ为１．８％、ＨＣＶ－ＲＮＡ为２．０％。ＨＢＶ－ＤＮＡ阳性率在各组间无显著差异，Ｐ＞０．０５；血液透析组和肾移植组ＨＣＶ－ＲＮＡ阳性率高于对照组，且有显著性差异Ｐ＜０．０１；肾移植组高于肾透析组，但无显著性差异，Ｐ＞０．０５。ＨＢＶ－ＤＮＡ阳性合并ＨＣＶ－ＲＮＡ阳性为４２．９％（３／７）。５２例ＨＣＶ－ＲＮＡ阳性患者基因分型为Ⅱ型７６．９％、ⅡⅢ型１１．５％、Ⅲ型１１．５％。介于目前的状况，对献血检测，对阳性患者进行ＨＢＶ－ＤＮＡ、ＨＣＶ－ＲＮＡ检测，对阳性患者实行分机透析，是降低血透及肾移植患者乙、丙型肝炎病毒医院感染的关键。     

非乙非丙型慢性肝炎中的庚型肝炎病毒感染研究

为研究临床诊断为非乙非丙型慢性肝炎患者中的庚型肝炎病毒感染，应用逆转录套式多聚酶链反应法检测其血清中的ＨＧＶ／ＧＢＶＣＲＮＡ和ＨＣＶＲＮＡ，并用多聚酶链反应检测ＨＢＶＤＮＡ。采用合成肽抗原作为固相，以ＥＩＡ法检测抗ＧＢＶＣ抗体；应用ＨＣＶ不同功能区抗原，分片段检测抗ＨＣＶ抗体。结果表明，临床诊断为非乙非丙慢性肝炎患者血清中，１．０４％（１／９６）为ＨＢＶＤＮＡ阳性；１０．４２％（１０／９６）为ＨＣＶＲＮＡ或抗ＨＣＶ阳性；２７．０８％（２６／９６）为抗ＨＧＶ／ＧＢＶＣ阳性或ＨＧＶ／ＧＢＶＣＲＮＡ阳性。研究提示庚型肝炎病毒是临床非乙非丙型慢性肝炎的重要致病因子；还可能存在非乙非丙非庚型慢性肝炎的致病因子；ＨＣＶ感染的检测水平有必要进一步提高。     

HCV单克隆抗体的制备及其应用的初步研究

目的:丙型肝炎病毒(Hepatitis C Virus,HCV)感染已成为全球公认的健康难题,目前并没有很好的疫苗和特效药,尽早检出HCV感染者是实现丙型肝炎早期诊断、阻断传播的重要途径。方法:研究通过免疫Core-NS4B融合重组蛋白,制备抗HCV单克隆抗体,并获得5H5和4E7-HRP最优的抗体配对组合,检测120例血清,同时与HCV-RNA检测做比较。结果:阴性血清均未测出阳性,HCV阳性标测出23例阳性,检出率77%,HCV-RNA测出26例,检出率87%;HCV可疑标本测出15例阳性,HCV-RNA测出17例;单项ALT增高的标本测出2例阳性,HCV-RNA测出1例。结论:研究所获得的抗体能够用于HCV抗原检测,具有巨大的潜力,为建立HCV抗原检测试剂盒奠定了基础,为临床检测提供了实验依据。     

用芯片研究丙型肝炎病毒不同功能区抗体

目的 用蛋白质芯片研究HCV不同功能区抗体及临床意义。方法 将抗原性强的C、NS3、NS4、NS5片段用芯片点样仪定量点加在醛基化玻片上来制作蛋白芯片。用进口HCV（ELISA）筛选出65例抗－HCV阳性标本,阳性标本用芯片检测不同功能区抗体,并测定HCV－RNA;同时用芯片检测24例抗－HCV阴性的正常献血员血清。结果 24例抗－HCV阴性标本用芯片检测均阴性;65例抗－HCV阳性标本经芯片均有1－4中抗体阳性,其中抗－C＋抗－NS3＋抗－NS54＋抗－NS5阳性率最高,占33．8％;抗－C、抗－NS3、抗NS5、抗NS4总的检出率分别为98．5％、89．2％、52．3％和50．8％;未发现单独含抗－NS3、抗－NS4的血清;抗－C＋抗NS3＋抗－NS4＋抗－NS5阳性血清中HCV－RNA检出率最高,占77．3％;HCV－RNA阳性血清中抗－NS5阳性率最高,占61．8％,说明抗－NS5与HCV－RNA最有相关性（P＜0．05）。结论 蛋白质芯片显示较高的敏感性与特异性;抗－C、抗－NS4在诊断抗－HCV都很重要,抗－NS4及抗－NS5有诊断的互补作用,而抗－NVS5在一定程度上能反映HCV的复制情况。     

The occurrence of hepatitis B and C viruses in Pakistani patients with chronic liver disease and hepatocellular carcinoma.

To study the occurrence of hepatitis B virus (HBV) and hepatitis C virus (HCV) in patients with chronic liver disease (CLD) and hepatocellular carcinoma (HCC) in Pakistan, blood samples from 105 sequential patients with biopsy-proven CLD (n = 82) and HCC (n = 23) were tested for HBV and HCV markers. Of the 105, 87 (83%) had evidence of hepatitis B exposure, 58 (55%) were positive for hepatitis B surface antigen (HBsAg), 23 (22%) had hepatitis C antibodies and 25 (24%) had detectable HCV RNA. Significantly more patients with HCC had evidence of HBV exposure in the absence of HCV markers (49/82 vs. 20/23, odds ratio 4.49, 95% CI 1.17-25.16). The proportion of patients positive for HBsAg with no HCV markers was also significantly higher in the HCC group (34/82 vs. 18/23, odds ratio 5.08, 95% CI 1.59-18.96). There were more patients with only HCV markers in the CLD group than the HCC group but the difference was not statistically significant (19/82 vs. 1/23, odds ratio 6.63, 95% CI 0.93-288.01). A modified non-isotopic restriction fragment length polymorphism study on PCR products was used to investigate the epidemiology of HCV genotypes in Pakistan. Due to depletion of the initial samples, a second series of specimens collected one year afterwards was used. Fifteen out of 40 samples had amplifiable product and all were identified as type 3. A commercial serological typing method on the same samples also confirmed that type 3 was the predominant HCV genotype in Pakistan.     

近期ALT升高史单采浆供者乙型肝炎和丙型肝炎病毒感染现状的调查

对一组一年内一次以上ALT升高史的单采浆供者血清中多项乙肝与丙肝病毒感染标志进行了检查,并与本地区无ALT升高史供浆者进行比较。两组检测结果分别为抗HCV:14.03%和6.45%;抗HCV-IgM:3/8和2/13;HBsAg:2.82%和0.46%;抗HBs:32.39%和25.35%;抗HBc:45.07%和33.18%;其检出率前者均高于或显著高于后者,并与ALT升高次数有显著的伴随关系。     

某农村人群甲、乙、丙、戊和庚型肝炎病毒感染的现况研究

目的　了解某农村人群甲、乙、丙、戊和庚型肝炎病毒的感染状况及其流行特点。方法　应用酶联免疫试验 (EIA)检测血清抗 -HAV、HBsAg、抗 -HBs、抗 -HBc、抗 -HCV、抗 -HEV和抗 -HGV ,并对抗 -HGV阳性者应用套式逆转录聚合酶链反应法 (RT -nPCR)检测HGVRNA。结果　该人群抗 -HAV、抗 -HCV、抗 -HEV和抗 -HGV流行率分别为 86.9%、11.5 %、2 .9%和 1.8% ,HBsAg阳性率为8.0 % ,HBV总感染率为 5 4.8%。HAV以 5岁以下儿童感染率最低 ( 35 .0 % ) ,到 10岁时 85 .0 %的儿童已感染HAV。HBsAg阳性率呈现两个高峰 ,分别在 5～ 9岁和 40～ 49岁年龄组 ;HBV总感染率到 10岁时为 5 5 .0 % ,然后随年龄增长而上升。HCV感染主要集中在 2 0～ 49岁年龄组 (占 77.8% )。各型肝炎病毒男女感染率无明显差异。献浆次数、年限与HCV、HEV、HGV感染呈正相关。HBsAg、抗 -HBc、抗 -HCV呈现家庭聚集性 ,但仅HBsAg呈现母亲与子女相关。抗 -HCV阳性者中ALT异常率 ( 15 .9% )显著高于抗 -HCV阴性者 ( 1.2 % ,P <0 .0 1)。结论　该人群甲、乙、丙、戊和庚型肝炎病毒感染具有不同的流行病学特点 ;献血浆是该人群HCV、HEV和HGV感染的主要危险因素 ;抗 -HCV阳性者多伴有肝损害     

Occupational risk of blood-borne viruses in healthcare workers: a 5-year surveillance program.

OBJECTIVE: This study presents the results of a 5-year surveillance program involving the prospective follow-up of healthcare workers (HCWs) in the Veneto region of Italy exposed to blood-borne viruses. DESIGN: All HCWs who reported an occupational exposure to blood-borne infection joined the surveillance program. Both HCWs and patients were tested for viral markers (hepatitis B surface antigen [HBsAg], antibody to hepatitis B surface antigen [anti-HBs], antibody to hepatitis B core antigen [anti-HBc], antibody to hepatitis C virus [anti-HCV], HCV RNA, and antibody to human immunodeficiency virus [HIV]) and had these markers plus transaminases assayed at 3, 6, and 12 months and then yearly thereafter. Moreover, a program of hepatitis B virus (HBV) prophylaxis was offered to those whose anti-HBs levels were less than 10 IU/mL. PARTICIPANTS: Two hundred forty-five HCWs (156 women and 89 men) with a mean age of 37 (+/- 10) years who reported occupational exposure during the 5-year period. RESULTS: At the time of exposure, 1 HCW was positive for HBsAg (0.4%) and 2 were positive for HCV RNA (0.8%). Among the patients involved, 28 (11.4%) were positive for HBsAg, 68 (27.8%) were positive for HCV RNA, 6 (2.4%) were positive for HIV, and 147 (60.0%) were negative for all viral markers (4 patients were positive for both HCV and HIV). During the follow-up period after exposure (mean, 2.7 [+/- 1.6] years), there was no increase in transaminases or seroconversions to any of the viral markers. CONCLUSION: Our accurate postexposure follow-up revealed a lack of transmission of HBV, HCV, and HIV.     

维持性血液透析患者庚型肝炎病毒感染的研究

目的 了解血液透析患者庚型肝炎病毒(HGV)感染情况，探讨其危险因素。方法 采用酶联免疫法(ELISA)和逆转录—套式PCR法分别检测44例血透患者的抗—HGV抗体和HGVRNA。结果 血透患者HGV感染率为13．6％，HGV阳性组与阴性组相比输血次数较多、透析时间较长，但差异无显著性；而单独HGV阳性组与全阴性组相比透析时间明显延长，HGV感染与年龄、HBV感染、HCV感染及肝功能损害无显著相关。结论 血透患者HGV感染率明显高于普通人群，严格消毒措施、预防交叉感染、减少输血、血源中HGV筛查，对减少透析中庚型肝炎病毒感染至关重要。     

Human chronic fascioliasis: hepatitis B and C among infected cases

Sera from one hundred and fifty three chronic Fasciola cases were screened for the presence of HB markers (HBsAg, anti HBc and anti HBs) and anti HCV using ELISA technique. Quantitative stool examination and estimation of liver enzymes (AST-ALT-bilirubin) levels of the study population were performed. HBsAg was present in 5 (3.3%), anti HBs in 13 (8.5%), HBexposed (HBex) in 44 (28.8%) and anti HCV in 13 (8.5%) of examined sera. HBV and HCV markers were significantly higher among older age groups. Concerning familial aggregation of hepatitis markers, 7 (15.9%) of the 44 HBex cases had two individuals per family who had evidence of exposure to HBV. No significant change in Fasciola GMEC and liver function tests have been noticed.