317例病毒性肝炎患者6型肝炎病毒混合感染现状

目的 为了了解天津地区病毒性肝炎患中６型肝炎病毒混合感染情况,对３１７例肝炎住院病人,进行了６型肝炎病毒的检测。方法 采用ＥＬＩＳＡ方法。结果 发现单一感染２１９例（６９．１％）,其中以乙型肝炎所占比重最大（７６．２６％）。有９８例（３０．９％）感染了２种或２种以上的肝炎病毒。种肝炎病毒混合感染共８４你,其中以ＨＢＶ／ＨＥＶ和ＨＡＶ／ＨＢＶ所占比重最大,分别为２５例（２５．５％）和２１例（２     

甲乙丙型肝炎病毒重叠感染及其相互关系研究

采用ＥＩＡ法检测５１５例急性慢性肝炎及肝硬化患者ＨＡＶ、ＨＢＶ和ＨＣＶ感染标志。结果表明ＨＢＶ标志阳性率为９３．６％。ＨＡＶ、ＨＢＶ和ＨＣＶ单独感染者占总患者的３．３％、７５．３％和１．９％；ＨＡＶ和ＨＢＶ重叠感染占６．２％；ＨＢＶ和ＨＣＶ重叠感染占６．８％。三型病毒感染关系分析表明ＨＣＶ感染者抗－ＨＢｃ阳性率明显低于非感染者。本文提示目前各种肝病中仍以ＨＢＶ感染为主，三型肝炎病毒感染可同时存在，     

不同人群HCV感染状况及传播途径的研究

应用第二代抗ＨＣＶ ＥＬＩＳＡ试剂对我国中南地区部分人群 ＨＣＶ感染状况进行了血清学调查，同时对ＨＣＶ感染的传播途径进行了研究。结果表明：１．ＨＣＶ感染率在不同人群中检出不一，凡与血液接触频繁的人群感染率较高，如恶性肿瘤患者（９．９％），献血（浆）员（１２．２５％），血液病患者（２４．３％），血液透析者（３７．２％），药瘾者（６０．５％）。无明显血液接触史者则较低，如性错乱者（４．９％），医务人员（０．３３％）及健康孕妇（０．２４％）。２．经血传播是我国ＨＣＶ传播的主要途径。除频繁接触血液者ＨＣＶ感染率高以外，血液制品中丙球制剂抗 ＨＣＶ检出率为 １００％，ＨＣＶ ＲＮＡ阳性率为 ３１． ９％，其余制剂中虽然抗 ＨＣＶ检出率极低，但 ＨＣＶ ＲＮＡ阳性率仍达 ７． ９４％。提示应用被污染的血液制品也存在传播 ＨＣＶ的潜在危险。 ３．性接触和日常生活密切接触有可能传播ＨＣＶ，但机率较低。 ４． ＨＣＶ的家庭内聚集性感染的危险性远低于ＨＢＶ。 ５．职业性暴露感染 ＨＣＶ的危险性亦较低。 上述研究结果为阐明我国 ＨＣＶ感染流行规律及制订ＨＣＶ感染防治措施提供了客观依据。     

河北省固安县某农村HAV,HBV,HCV感染比较流行病学研究

对河北省固安县北斜村ＨＡＶ、ＨＢＶ和ＨＣＶ感染的流行病学特征和传播途径进行了比较研究．该人群ＨＡＶ感染率高达９１％，１０岁以下儿童ＨＡＶ感染率达６８．６％；ＨＢｓＡｇ携带车和ＨＢＶ总感染率分别为３．ｇ％和２５．９％，１０岁以下儿童ＨＢｓＡｇ阳性率和ＨＢＶ感染率分别为２．９％和１７．５％；ＨＣＶ感染率为１２．１％；但２０岁以下和６０岁以上老年人ＨＣＶ感染率仅０．４％。显示ＨＡＶ、ＨＢＶ和ＨＣＶ感染的流行特征明显不同．     

安徽淮北地区人群HCV感染及HCV基因型分布调查

该地区农村自然人群、煤矿工人和职业献血者中抗－ＨＣＶ阳性率分别为１．４％、０．５％和４．８％。在ＨＣＶ感染者中男女之间差别无显著意义。ＨＣＶ感染者中多数具有明确的感染途径和来源。经输血和献血及使用血液制品是其主要的感染途径和来源。人群中ＨＣＶ基因型以Ⅱ型感染为主，占６３．９％。肝炎病人ＨＣＶ感染中混合感染所占比例比一般人群和职业献血者的混合感染比例高。     

福州地区海洛因依赖者艾滋病毒、肝炎病毒及梅毒感染调查

「目的」对福州地区海洛因依赖者的艾滋病毒（ＨＩＶ）、肝炎病毒（ＨＶ）和梅毒感染情况及其危险因素进行流行病学调查。「方法」对福州地区１２０名吸毒者检测ＨＩＶ、乙肝病毒（ＨＢＶ）及梅素感染标志物,并对结果进行统计和分析。「结果」１２０名吸毒者中ＨＩＶ感染为０,ＨＢＶ、ＨＣＶ、ＨＤＶ和ＨＧＶ单独感染率分别为２５．８％、９．２％、０和４．２％。ＨＶ混合感染率为１４．１％,ＨＶ总感染率为５３．３％,梅毒的感染率为５％。「结论」在福州地区的海洛因依赖者中存在梅毒和ＨＶ的感染,并以ＨＢＶ和ＨＣＶ感染占绝对优势。未发现ＨＩＶ感染。     

北京市密云区２００５－２０１４年鼠间汉坦病毒 自然感染状况调查研究

摘要：目的　了解北京市密云区的鼠种构成及汉坦病毒（ｈａｎｔａｖｉｒｕｓ，ＨＶ） 自然感染状况，探索肾综合征 出血热疫源地分布特征。方法　采用夹夜法开展啮齿类动物监测，采集鼠肺样本及鼠血样本；采用间接免 疫荧光法（ＩＦＡ）检测汉坦病毒抗原及抗体。结果　共捕获啮齿类动物９ 种４００ 只， 总捕获率为６．４７％ （４００／６１８０），其中社鼠（３９．５０％）和黑线姬鼠（２４．００％）为优势鼠种；不同年度、地区捕获率差异有统 计学意义（χ ２＝８８．６９，犘＝０．００；χ ２＝９４．８５，犘＝０．００）。ＨＶ 抗原总阳性率为１．２５％，ＨＶ 抗原阳性样 本分别为社鼠和黑线姬鼠，带毒率分别为２．５３％、１．０４％；ＨＶ 抗体总阳性率为７．７５％，ＨＶ 抗体阳性样 本分别为社鼠、黑线姬鼠和小家鼠，阳性率分别为１２．６６％、９．３８％、５．８８％。结论　北京市密云区存在 野鼠型ＨＶ 自然疫源地，应进一步开展人群ＨＶ 感染风险的相关研究。 关键词：汉坦病毒；自然疫源地；啮齿动物；监测；捕获率；自然感染 中图分类号：Ｒ３７３．３＋２；Ｓ４４３　　文献标识码：Ａ　　文章编号：１００９ ６６３９ （２０１７）０７ ０５３８ ０３     

丙型肝炎病毒母婴传播的研究

采用随访观察的研究方法，观察了１３名感染ＨＣＶ的母亲和她们生的１５例婴儿的母婴传播ＨＣＶ可能性、传播机率和后果。１５例婴儿中，ＨＣＶ感染率为８６．７％，其中临床型１例（７．７％），亚临床型ＨＣ３例（２３．１％），隐性感染９例（６９．２％）。抗－ＨＣＶ阳性率为：３月龄前为１００．０％，６月龄开始有阴转，１８月龄降至３３．３％，到３６个月龄时仍有１例阳性（１６．７％）。ＨＣＶＲＮＡ检出率：９月龄前与抗－ＨＣＶ相同，之后较高，１８月龄后为６６．７％，３６月龄时为３３．３％。婴儿感染ＨＣＶ的临床类型与母亲怀孕时的病态有关，母亲孕期为临床型ＨＣ者，其婴儿易发展为临床型或亚临床型感染；ＨＣＶＲＮＡ和抗－ＨＣＶ持续时间也相对长。ＨＣＶ感染婴儿可能均为宫内感染，而非出生后所致。母亲及其婴儿血清标本ＨＣＶＲＮＡ基因型均为Ⅱ型。     

丙型肝炎病毒家庭内感染状况的血清学调查

对６０例抗－ＨＣＶ阳性患者的家庭成员１２４人进行血清学检测，并收集４０例乙肝患者的家庭成员８３人为对照．结果丙肝组检出抗－ＨＣＶ阳性的家庭成员９人，检出率７．３％．除去有供血史的抗－ＨＣＶ阳性家庭成员，检出率为１．８５％（２／１０８）．乙肝组未检出抗－ＨＣＶ阳性者．在单一丙肝家庭组中，家庭成员的ＨＢＶ感染率为２５．３３％，而在ＨＢＶ／ＨＣＶ重叠感染和ＨＢＶ感染组的家庭成员中，ＨＢＶ的感染率为４０．９１％，故提示，ＨＣＶ的家庭内聚集性感染的危险性远低于ＨＢＶ，且母于垂直传插的危险性更低于夫妻间水平传播．     

２０１６年北京市儿童腺病毒感染疫情的 流行病学和病原学研究

摘要：目的　对２０１６年北京市儿童腺病毒感染暴发疫情及同期散发病例进行流行病调查和病原学分析,以 了解腺病毒在北京市儿童的感染状况以及基因遗传特征。方法　选取２０１６年１０月下旬至１２月初暴发疫情 及同年９月２１日至１２月３１日散发病例咽拭子样本,提取核酸进行ｈｅｘｏｎ基因扩增,扩增产物经测序和比 对后,采用ＭＥＧＡ５．０软件进行基因进化树构建和分析。结果　２０１６年北京市报告的腺病毒暴发疫情均发 生在小学。疫情１发生于１０月底,累及１１名病例,病例年龄均为９岁,罹患率为３５．４８％。疫情２发生于 １２月初,累及１７名病例,病例年龄均为７岁,罹患率为３７．７８％。两起暴发疫情均由Ｂ 组ＨＡｄＶ ３ （ｈｕ ｍａｎａｄｅｎｏｖｉｒｕｓ ３）型腺病毒导致。散发病例样本分型结果以Ｂ 组ＨＡｄＶ ３型为主（１１／１６,６８．７５％）,其 余为Ｃ 组ＨＡｄＶ １ （１／１６,６．２５％）、５ 型（１／１６,６．２５％）、６ 型（２／１６,１２．５０％） 以及Ｅ 组ＨＡｄＶ ４ （１／１６,６．２５％）。序列比对和进化分析结果显示分离的暴发和同期散发病例分离ＨＡｄＶ ３型毒株ｈｅｘｏｎ序 列核苷酸和氨基酸的同源性均为１００％,与国内分离株亲缘关系较近。结论　目前北京市儿童腺病毒感染 主要为Ｂ组ＨＡｄＶ ３导致,其ｈｅｘｏｎ基因未见明显的变异。 关键词：儿童;人腺病毒;感染;暴发;散发;遗传进化分析 中图分类号：Ｒ５１１．８　　文献标识码：Ａ　　文章编号：１００９ ６６３９ （２０１９）０１ ００２１ ０６     

Outbreak of hepatitis A in an extended family after importation by non-immune travellers

The incidence of hepatitis A in England has declined in recent years, but travel-related cases and imported infections remain a challenge. We report an outbreak of hepatitis A in an extended family where two primary cases were infected while in Pakistan and two secondary cases were infected in England. All four were infected by the same genotype IIIA virus. Testing of the children in the extended family by dried blood spots (DBS) determined that three had evidence of recent past infections (anti-HAV IgM positive), one had a current asymptomatic infection (anti-HAV IgM and HAV RNA positive) and one was incubating the virus (anti-HAV IgM negative, HAV RNA positive). HAV RNA from the DBS was identical to the adult cases. This outbreak demonstrates secondary spread of hepatitis A by asymptomatic children after importation from abroad and highlights the importance of preventing travel-associated hepatitis A infection.     

125例慢性乙肝病毒感染住院患者临床特征分析

目的通过调查分析某院慢性HBV感染住院患者的临床特征,为制定传染病防制对策提供参考依据。方法采用回顾性描述研究的方法,调查患者的一般情况、临床表现、病程、外周血血小板检测结果等。结果慢性乙肝的发病年龄以20~35岁居多,肝硬化和肝癌均在35岁以上;临床表现:慢性乙肝以乏力、纳差为主,肝硬化除乏力纳差外,腹胀明显,肝癌除乏力外,肝区痛较为突出;三者均有不同程度的外周血血小板减少,特别是肝硬化患者血小板减少最为明显。结论慢性HBV感染危害大,应积极推广成年人乙肝疫苗的预防接种;定期作好健康体检,及早诊断,及时治疗,以阻断HBV的持续感染。     

Inapparent infection of hepatitis A virus

To detect inapparent infection with hepatitis A virus, serial sera were collected from patients with hepatitis A and their contacts in two waterborne epidemics in China. Epidemic 1 occurred in a rural village near Hangzhou during August 1978-January 1979, and epidemic 2 took place in a rural primary school in Pinghu County in Zhejiang in April-May 1985. These sera were tested for antibodies against hepatitis A virus (anti-HAV), serum glutamic pyruvic transaminase (SGPT) activity, and icteric index. Feces also were collected in epidemic 1 to test for hepatitis A virus antigen. Both anti-HAV immunoglobulin M (IgM) and total anti-HAV were assayed in sera from "healthy persons" (symptomless persons without icterus and with normal SGPT level) who were in close contact with hepatitis A patients. In epidemic 1, among 18 "healthy persons", 12 were anti-HAV IgM positive, two were immune, and four susceptibles escaped infection. In epidemic 2, among 32 "healthy children", three were anti-HAV IgM positive, five had been infected by hepatitis A virus in the past, and 24 were not infected. These results demonstrate that inapparent infections occur along with overt and subclinical infections during epidemics of hepatitis A. The proportions of inapparent, subclinical, and overt infections were, respectively, 34.3%, 45.7%, and 20% in epidemic 1, and 25%, 50%, and 25% in epidemic 2. In addition, hepatitis A virus particles were demonstrated in the feces of all infected subjects who were examined and who included all levels of clinical response. These particles were identified with immuno-electron microscopy and enzyme-linked immunoassay.     

Incidence and prevalence of hepatitis B. A community-based survey in the Philippines

In a rural village in the Philippines, sera were collected from 744 residents and tested for evidence of hepatitis B virus infection. In the subsequent year, every household was visited every other week for a period of three months in an attempt to identify clinically apparent cases. At the end of the year, sera were obtained from 78% of persons initially negative for hepatitis B virus and 97% of those initially positive for hepatitis B surface antigen (HBsAg). Overall, HBsAg was found in 8.8% of the population tested, of whom 86% were still HBsAg-positive at the end of the year. Susceptibility to hepatitis B virus infection declined significantly with age, to only 16% in the age group 50 years and older. No difference in the prevalence of markers by sex was observed. The risk of infection in children appeared to increase if one or both parents were infected, compared with both parents susceptible (odds ratio = 3.3 and 7.6, respectively); the risk increased if older siblings were infected, compared with all older siblings susceptible. The overall incidence rate of hepatitis B virus infection was 3.3% per year. For those aged five years or younger, the incidence rate was 9.2%. None of the seroconverters manifested acute symptoms of infection. Despite the evident clustering in families of persons with hepatitis B virus markers, which is suggested by the prevalence survey, only two of nine incident infections observed were in children with HBsAg-positive close relatives. The findings support the impression that in countries endemic for hepatitis B virus, most new cases occur in the young and are clinically inapparent. Furthermore, screening families of young children for chronic carriers in an effort to identify children at high risk for hepatitis B virus infection would have a low sensitivity in the Philippine setting.     

Epidemiology of hepatitis A and B in the Shanghai area: prevalence of serum markers

Different population groups from the Shanghai area were surveyed by radioimmunoassay for serologic markers of previous infections with hepatitis A virus and hepatitis B virus. There were no significant differences in the prevalence of antibodies to hepatitis A virus (anti-HAV) in males and females, or in persons living in rural or urban areas. The prevalence of anti-HAV showed a biphasic increase with age, approaching 100% above age 50 years whereas the geometric mean titers declined. The rate of infection (attack rate) with hepatitis A among susceptibles in Shanghai declined appreciably between 1950 and 1960. The prevalence of hepatitis B markers also did not differ in the sexes, or in rural and urban populations. The patterns of prevalence of hepatitis B markers at different ages were compared to various theoretical mathematical models, and the data fitted best a model constructed from the assumption that two subpopulations of approximately equal size, one at low and the other at high risk, existed in the population groups studied. It was estimated that in Shanghai up to 12% of all individuals infected with hepatitis B became chronic hepatitis B surface antigen (HBsAg) carriers, although the overall prevalence of HBsAg carriers was only 6.9%. All HBsAg-positive individuals subtyped had been infected with hepatitis B virus of the subtype ad; 41.7% of HBsAg carriers also had hepatitis B e antigen (HBeAg), whereas in 32% of HBsAg carriers antibodies to HBe were present. Antibodies to HBsAg appeared to be lower in titer than in Western populations and to decline with age, and age-specific prevalence data indicated a relatively longer persistence of antibodies to hepatitis B core antigen.     

An epidemic of hepatitis A in an institution for young children

A common-source epidemic of hepatitis A occurred in an Athenian institution boarding 38 children (mean age 4.8 years). All children were examined, and blood was drawn from each at the onset of the study and repeatedly during the next three months. Only one child (2.6%) was initially immune to hepatitis A virus as a result of prior infection. The attack rate (62.2%) and the ratio of icteric to anicteric cases (1:1.3) were high despite the administration of immunoglobulin (IG). Assays for anti-HAV IgM and a rising titer of anti-HAV IgG identified 19 (82.6%) and 22 (95.7%) of the 23 hepatitis A infections, respectively. One case (4.3%) was detected only by the presence of hepatitis A virus antigen and hepatitis A virus RNA in a fecal specimen, but these assays were otherwise marginally useful in this study. Nevertheless, the use of all available tests for the detection of hepatitis A virus is mandatory for the most accurate estimation of an epidemic of hepatitis A. Prompt administration of immunoglobulin had no effect on the number of clinical cases that were in the late incubation period, but it may have diminished the clinical expression of the infection and thus made diagnosis of infection more difficult.     

乙型肝炎患者检测HAV、HCV、HDV、HEV、HGV重叠感染在医院感染控制中意义的探讨

目的对乙型肝炎与其他型肝炎重叠感染状况分析;进一步探讨相关肝炎病毒的检测在医院感染控制中的临床意义。方法对786例乙型肝炎患者血清进行甲、丙、丁、戊、庚型肝炎血清标志物的检测。结果乙型肝炎患者双重感染占16.67%,多重感染占1.78%,尤其是与丙型肝炎的双重或多重感染占重叠感染的45.52%。结论乙型肝炎患者重叠或合并感染其他类型肝炎病毒的情况较为常见;对乙型肝炎患者做其他型肝炎标志物的检测可为医院感染诊断提供依据。     

2003年大连市部分血液透析者肝炎及相关病毒感染现况调查

[目的]了解血液透析患者肝炎及相关病毒感染状况，为采取防治对策提供依据。[方法]2003年，对在大连市部分医疗单位血液透析中心治疗的223例血液透析者进行HBsAg、抗-HBs、抗-HBc、HBeAg、抗-HBe、抗-HCV、抗-HGV、抗-TTV检测。[结果]检测223人，HBsAg、抗-HBs、抗-HBc、HBeAg、抗-HBe阳性率分别为10．8％、40，8％、71，3％、6．3％、24．2％，HBV感染率为78．0％；抗-HCV、抗-HGV、抗-TTV阳性率分别为35．0％、4．9％、33．6％。223人中，感染1种病毒的113人，占50．67％；感染2种或2种以上病毒的84人，占37．67％。[结论]血液透析是HBV、HCV、HGV、TTV感染的重要途径。     

Incidence and risk factors for hepatitis C infection in a cohort of women in rural Egypt

A prospective cohort study of the incidence and risk factors for hepatitis C virus (HCV) infection was performed in 2171 pregnant women in three rural Egyptian villages who were HCV antibody (anti-HCV) and RNA (HCV-RNA) negative at baseline. During an average of 2.2 years follow up, 25 incident cases were observed, giving an estimated HCV incidence of 5.2/1000 person-years (PY). The infection rate correlated with community anti-HCV prevalence in pregnant women, while the perinatal incidence rate of 11.2/1000 PY was almost five times that of the non-perinatal rate (2.3/1000 PY). The data suggested iatrogenic perinatal risk factors were associated with infection in one village, while health education reduced infections in another. Among the 25 incident cases, eight were HCV-RNA negative when they were first found to be anti-HCV positive and one-third of the 15 viraemic cases with follow-up data available cleared their HCV-RNA after an average of 1.3 years. None of the 25 incident cases were jaundiced or had symptoms of hepatitis but elevated serum alanine aminotransferase levels confirmed hepatitis in nine. Our data suggest that asymptomatic HCV infections frequently occurred during the perinatal period but often cleared and that educating medical personnel on safe practices possibly reduced HCV transmission.