抗-HCV RIA在临床中的应用

近些年来．人们对乙型肝炎病毒(HBV)的致病作用及感染情况已逐步了解，但对丙型肝炎病毒(HCV)的认识还不够深入，有关HCV的报道也不多。本室用RIA对来自住院的186个肝病患者和120个健康查体者进行了丙型肝炎抗体(抗-HCV)检测，结果显示：健康组中HCV的感染率为3．3％，慢活肝中HCV的感染率为13．3％，     

上海市男性同性恋HIV感染者中乙型肝炎、丙型肝炎病毒的合并感染情况横断面研究

目的 探讨男性同性恋HIV感染者中乙型肝炎病毒（HBV）、丙型肝炎病毒（HCV）的合并感染情况。方法 选择2016年1月~2018年1月在本区域内进行治疗的男性同性恋HIV感染者157例,以横断面调查的方法进行研究,收集所有入组患者的性别、年龄、文化程度、感染途径等资料。对所有患者HBV抗体、HCV抗体进行检测。结果 不同感染途径人群合并感染发生率对比,差异具有统计学意义（P＜0.05）:同性性行为患者单纯HIV感染发生率最高,吸毒患者HIV+HBV感染率最高,输血患者HIV+HCV感染率最高,HIV+HBV+HCV感染率最高者为吸毒患者。不同学历合并感染发生率对比,差异具有统计学意义（P＜0.05）:大专及以上的患者以HIV单纯感染为主,高中及中专患者以HIV和HIV+HBV为主,初中及以下的患者则以合并感染为主。不同职业合并感染发生率对比,差异具有统计学意义（P＜0.05）:单纯HIV感染患者以自由职业及职员为主,职员在HIV+HBV感染发病率高于自由职业者及农民,农民在HIV+HCV及HIV+HBV+HCV的发病率均高于其他职业患者。结论 男性同性恋HIV感染者中乙型肝炎病毒、丙型肝炎病毒合并感染发生率均较高,患者感染途径、文化程度及职业的不同,合并感染情况均有显著差异。     

检测HBV和HCV重叠感染患者血清中IL-6及IFN-γ水平的意义

目的初步探讨血清IL-6及IFN-γ的水平与HBV和HCV重叠感染的关系。方法采用双抗体夹心ELISA法,检测HBV和HCV重叠感染患者血清IL-6及IFN-γ的水平,同时检测血清丙氨酸转氨酶(ALT)和总胆红素(TBil)的水平。结果HBV和HCV重叠感染患者血清IL-6的水平明显高于HBV或HCV单纯感染患者(P<0.01)。与正常对照相比较,HBV和HCV重叠感染急性期患者仅IFN-γ水平升高(P<0.01),慢性期患者仅IL-6水平升高(P<0.01);而重型肝炎和肝硬化患者IL-6及IFN-γ的水平均显著升高(P<0.01)。HBV和HCV重叠感染患者血清IL-6、IFN-γ的水平与ALT、TBil的水平呈正相关(P<0.01)。结论HBV和HCV重叠感染的发病和转归与IL-6及IFN-γ分泌的异常有极其密切的关系。     

病毒性肝炎患者庚型肝炎病毒感染状况的探讨

目的 研究内蒙地区不同民族,不同年龄人群庚型肝炎病毒感染及致病性情况.方法 采用ELISA方法 对298例健康人群111例肝炎患者中进行抗-HGV检测.结果 健康人群HGV感染率为2.5%,汉族为1.69%.在肝炎患者中蒙古族HGV感染率38.7%,汉族为18.75%.健康人群HGV感染率为2.01%,肝炎患者为24.32%,结论 蒙古族HGV感染在健康人群还是肝炎患者中都明显高于汉族人群.肝炎患者HGV感染明显高于健康人群.     

乙型肝炎病毒宫内感染与IFN-γ和IL-4、IL-6细胞因子的相关性

目的研究乙型肝炎病毒宫内感染与白细胞介素-4(IL-4)、白细胞介素-6(IL-6)和干扰素-γ(IFN-γ)细胞因子的相关性。方法将研究对象分为两组:研究组为80例乙型肝炎病毒表面抗原(HBsAg)阳性孕妇;对照组为20例正常孕妇。采用双抗夹心酶联免疫吸附法(DAS-ELISA)检测孕妇外周静脉血及其新生儿脐静脉血血清中乙型肝炎五项指标及细胞因子IFN-γ、IL-4、IL-6水平。结果研究组孕妇分娩的新生儿80例有11例宫内感染,宫内感染率为13.75%。新生儿HBV宫内感染组孕妇血清中IFN-γ水平显著低于HBV宫内未感染组及对照组孕妇(P<0.01),IL-4、IL-6水平则显著高于HBV宫内未感染组及对照组孕妇均有统计学意义(P<0.01)。HBV宫内未感染组与对照组相比,上述三种细胞因子水平差异均无统计学意义(P>0.05)。上述各组孕妇血清中IL-4与IL-6水平均呈显著正相关(P<0.01,P<0.01,P<0.01);IFN-γ与IL-4呈显著负相关(P<0.01,P<0.01,P<0.01);IFN-γ与IL-6亦呈显著负相关(P<0.01,P<0.01,P<0.01)。各组新生儿脐血清中IFN-γ、IL-4、IL-6水平差异无统计学意义(P>0.05)。结论孕妇细胞免疫功能紊乱导致IFN-γ抗病毒作用减弱,IL-4、IL-6水平升高,不利于孕妇体内HBV清除,易导致胎儿宫内感染。     

HBV、HCV合并感染患者血清抗丙肝抗体分片段与HCVRNA测定的意义

目的 探讨乙型肝炎病毒（HBV）、丙型肝炎病毒（HCV）合并感染患者与单HCV感染者血清抗HCV抗体分片段阳性率以及HCV RNA阳性率是否有显著性差异以及检测意义。方法 对76例同时感染HBV和HCV患者进行抗HCV抗体分片段以及HCV RNA检测,同时从同期仅感染HCV患者中随机抽取163例作为对照组进行以上检测。结果 HBV、HCV合并感染患者与单HCV感染者比较：抗HCV抗体分片段相同片段间比较差异无统计学意义,但其S/CO值比较差异有统计学意义（P〈0.01）;相同片段组合间除抗-C＋抗-NS3组合阳性率HBV、HCV合并感染患者比仅HCV感染患者显著要低（P〈0.05）外,其余各组合间比较差异无统计学意义（P〉0.05）;HBV、HCV合并感染患者HCV RNA阳性率比仅HCV感染患者低（P〈0.01或P〈0.05）。结论 HBV、HCV合并感染时HBV对HCV复制存在抑制作用,从而导致HCV RNA含量显著降低,合并感染与单独感染间抗HCV抗体分片段无显著性差异,但由于HCV复制受到抑制从而导致抗HCV抗体分片段含量降低,这对研究HBV、HCV合并感染时患者体内HBV对HCV间的抑制作用有一定意义。     

苦参素对慢性乙型肝炎患者特异性、非特异性细胞免疫影响的研究

目的 探讨苦参素对慢性乙型肝炎(CHB)患者特异性、非特异性细胞免疫的影响.方法 74例CHB患者随机分为两组,治疗组36例,用苦参素葡萄糖注射液600 mg,静脉滴注,每日1次,1个月后改为苦参素胶囊200 mg,口服,每日 3次,2个月,水飞蓟宾葡甲胺片200 mg,口服,每日 3次,3个月.对照组38例,只用水飞蓟宾葡甲胺片,用法、用量同治疗组.比较两组患者的HBV特异性细胞毒性T细胞(CTL)、非特异性CTL、T细胞亚群、Th1、Th2水平的变化和HBV DNA、HBeAg阴转率.结果 治疗组苦参素治疗3个月后,HBV特异性CTL高于治疗前(P<0.01),也高于对照组治疗后(P<0.05),非特异性CTL高于治疗前(P<0.05),也高于对照组治疗后(P<0.01),CD4+高于治疗前(P<0.05),也高于对照组治疗后(P<0.01),Th1高于治疗前(P<0.05),也高于对照组治疗后(P<0.01),HBV DNA阴转和HBeAg阴转高于对照组(P<0.01).结论 苦参素能提高CHB患者的特异性、非特异性细胞免疫功能,是苦参素清除或抑制CHB患者HBV的机制之一.     

反转录PCR和免疫学方法检测丙型肝炎病毒感染的比较

本文应用反转录多聚酶链反应(cPCR)和酶联联免疫吸附试验(ELISA)方法检测18例经多次输血并有肝功能改变的急性白血病患者血清中丙型肝炎病毒基因(HCV RNA)和抗丙型肝炎病毒抗体(抗-HCV).HCV RNA 阳性率77.8%;抗-HCV 阳性率66.1%;单项或两项阳性者16例,联合判定 HCV 感染率88.9%。cPCR 检出 HCV RNA 时间早于抗-HCV 阳转时间,而且敏感性高于后者,是一种早期、灵敏及特异的 HCV 感染诊断方法。同时检测 HCV RNA 和抗—HCV,两项互补判定可望提高 IICV 感染的诊断率。     

庚型肝炎的研究进展

随着分子生物学技术的迅速发展及广泛利用 ,一些传统的病毒鉴定方法已被盲克隆 (blind cloning)、表达蛋白质 ,免疫筛选及核酸序列检测等技术所替代 ,使得病毒性肝炎的研究取得了较快的发展。 1989年东京国际会议正式命名 :HAV、 HBV、 HCV、 HEV5型肝炎病毒。并建立了 5型肝炎病毒的测检方法。但仍有一部分肝炎患者的病原学无法查明。在我国的输血后肝炎中除乙型外 ,约 90 %为丙型 ,其中10 %的患者不能进行病原学诊断 ,这都预示着是否有新的肝炎病毒存在。 1995年美国学者发现了一种新型肝炎病毒一庚型肝炎病毒。我国也证实了 HGV感…     

原发性肝癌患者214例乙肝两对半及抗-HCV检测结果探析

目的探讨乙肝病毒(HBV)及丙肝病毒(HCV)感染模式与原发性肝癌(PHC)间的关系。方法选取我院于2012年1月至2015年1月间收治的PHC患者214例,抽取其早晨空腹静脉血5m L,分离获得血清,采用罗氏公司Elecsys2010型全自动化学发光免疫分析仪检测患者的乙肝两对半指标,采用酶联免疫法(ELISA)检测患者血清丙型肝炎病毒抗体(抗-HCV)水平。结果 214例PHC患者中,HBV的感染率高达87.85%,显著高于未感染者,其中HBs Ag阳性感染率为68.22%,显著高于HBs Ag阴性感染率19.63%,并且又以"小三阳"模式所占比例最高,达48.13%,显著高于"大三阳"模式的12.15%及其余10种感染模式所占比例,差异均有统计学意义(P<0.05)。同时HCV的感染率为16.82%,HBV与HCV双重感染率为10.75%;其中感染HCV并HBs Ag阳性感染者所占比例为0.93%,显著低于感染HCV并HBs Ag阴性感染者比例9.82%及仅感染HCV者的比例6.07%,差异有统计学意义(P<0.05)。HBs Ag阳性感染者感染HCV的几率为1.37%,显著低于HBs Ag阴性感染者感染HCV的几率47.62%及未感染HBV者感染HCV的几率53.85%,差异有统计学意义(P<0.05)。结论HBV感染极有可能是致使PHC发生的主要因素,而HBs Ag阳性感染在其中居主导地位,且又以"小三阳"感染模式的PHC患者占多数。同时HCV感染也不容忽视,特别是HBV与HCV的双重感染更应该引起大家的重视。     

Frequencies of GB virus C/hepatitis G virus genomes and of specific antibodies in German risk and non-risk populations

The prevalence of the new flavivirus GB virus C/hepatitis virus G (GBV-C/HGV) in different German populations was investigated by detection of viral genomes and anti-E2 antibodies. While blood donors had an overall prevalence of 10.4% there were increased rates for hemophiliacs (54.7%), hemodialysis patients (30.2%), male homosexuals (30.2%) and intravenous drug users (74.4%). Most GBV-C/HGV positive samples were either viral genome positive or antibody positive, exclusively. Samples with the rare constellation “positive for both GBV-C/HGV genome and specific antibody” originated in almost all cases from patients who were additionally infected with HIV or HCV. Probable transmission of GBV-C/HGV by PCR-positive blood transfusions was observed in 5 of 6 cases approximately six months after transfusion. J. Med. Virol. 53:218–224, 1997. © 1997 Wiley-Liss, Inc.     

Low prevalence of anti-hepatitis C virus antibodies in female hemodialysis patients without blood transfusion: A multicenter analysis

To investigate whether nosocomial infection with hepatitis C virus (HCV) in chronic hemodialysis patients is related primarily to hemodialysis procedures, a multicenter analysis was carried out on 2,132 chronic hemodialysis patients (male: 1,274, female: 858) from 23 dialysis units using a second-generation anti-HCV antibody assay. The prevalence of anti-HCV antibodies in patients with blood transfusion (29.9%) was significantly higher (P < .0001) than in those without blood transfusion (7.6%). Although the prevalence of anti-HCV antibodies increased with the length of hemodialysis in males without blood transfusion, it did not increase even after long-term hemodialysis (more than 5 years) in females without blood transfusion, who exhibited a rate (1.9%) similar to that of healthy blood donors in Japan. There was a significant correlation between the presence of anti-HCV antibodies and anti-HBs antibody in males without blood transfusion. In anti-HBs antibody-negative male patients without blood transfusion, the prevalence of anti-HCV antibodies was significantly lower compared with anti-HBs antibody-positive male patients without blood transfusion. There was marked difference in the prevalence rate in patients without blood transfusion among dialysis units, and there was no correlation between the prevalence and the mean period of dialysis of each dialysis unit. Although nosocomial infection with HCV appears to be related to the hemodialysis environment, the low prevalence of anti-HCV antibodies in females suggests that dialysis procedures per se may not present the risk of hepatitis C virus infection. © 1996 Wiley-Liss, Inc.     

GB virus C/hepatitis G virus infection in hemodialysis patients: determination of seroprevalence by a four-antigen recombinant immunoblot assay

GB Virus C/Hepatitis G Virus (GBV-C/HGV) was identified recently and only two assays, consisting of a single recombinant protein, have been described for determination of the seroprevalence of this virus. An immunoblot assay was devised, which contains four recombinant GBV-C/HGV proteins. In this study, serum samples from 154 patients on maintenance hemodialysis were examined to assess the rate of seroreactivity against GBV-C/HGV. All sera were tested for the presence of antibodies by an in-house recombinant immunoblot assay, for GBV-C/HGV viremia by RT-PCR, and for HCV infection by PCR and by serological assays. Antibody reactivity against GBV-C/HGV was detected in 20.8% (n = 32) and viremia was found in 6.5% (n = 10) of the patients. In no case were viremia and GBV-C/HGV antibodies detected in parallel. HCV infection was observed in 15.6% (n = 24) by RT-PCR. In 20 of these patients, HCV antibodies were detected by enzyme immuno assay (EIA) and immunoblot assay. However, four of the HCV PCR-positive patients were negative by both serological tests. Only two patients were viremic for GBV-C/HGV and HCV in parallel. It is concluded that antibody reactivity against GBV-C/HGV is common among patients on maintenance hemodialysis. In contrast to HCV, parallel occurrence of GBV-C/HGV viremia and GBV-C/HGV seroreactivity was not observed. This suggests that GBV-C/HGV infection might be self-limiting.     

Presence and significance of transfusion-transmitted virus infection in Iranian patients on maintenance hemodialysis.

BACKGROUND AND PURPOSE: Transfusion-transmitted virus (TTV), a recently discovered DNA virus, was first identified in patients with non-A to -G hepatitis following blood transfusion. Transmission is generally via the parenteral route but recent data suggest that TTV can also be transmitted by the fecal-oral route. METHODS: This cross-sectional study was conducted in March 2005 and included 324 patients on maintenance hemodialysis (HD) at 3 different centers in Tabriz, Iran. Demographic and clinical data were recorded. Blood samples for virological and biochemical tests were drawn simultaneously. TTV DNA was detected using semi-nested polymerase chain reaction. Serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase were also measured. RESULTS: Overall seroprevalence of TTV was 9.3% (95% confidence interval, 6.1-12.5%). Prevalence rates of hepatitis B surface antigen, hepatitis C virus antibody, and hepatitis E virus antibody were 4.6% (15/324), 20.4% (66/324), and 7.4% (24/324), respectively. Patients were negative for human immunodeficiency virus antibody. There was no association between TTV infection and elevated ALT levels. TTV-positive patients were significantly younger than TTV-negative patients (p=0.018). There was no significant association between TTV positivity and age, gender, duration of HD, positivity for hepatitis B, C, or E virus infection markers, and history of transfusion and transplantation. CONCLUSION: We observed low TTV prevalence and no association between TTV and blood-borne infections in our HD patients. TTV infection was not related to elevated levels of liver enzymes; however, the clinical impact of this virus need further investigations.     

Prevalence of hepatitis B, hepatitis C, GB virus C/hepatitis G and TT viruses in predialysis and hemodialysis patients

Patients with chronic renal failure on hemodialysis have a high risk of infections with viruses such as hepatitis B (HBV), hepatitis C (HCV), GB virus C/hepatitis G (GBV-C/HGV) and TT (TTV) viruses. The prevalence of HBV, HCV, GBV-C/HGV and TTV in patients with chronic renal failure who are on conservative management before entering into a hemodialysis program (predialysis) in comparison with hemodialyzed patients was studied to elucidate whether the high prevalence of these viruses is influenced by that observed in the predialysis stage. The presence of hepatitis B virus surface antigen (HBsAg), HCV RNA, GBV-C/HGV RNA and TTV DNA was analyzed in sera from 80 patients with chronic renal failure (35 on predialysis and 45 on hemodialysis). HBsAg, HCV RNA, GBV-C/HGV RNA and TTV DNA were detected in one (2.8%), six (17.1%), eight (22.5%) and 16 (45.7%) of the 35 patients on predialysis. Two (5.7%) of these patients were coinfected with HCV and GBV-C/HGV, whereas six (17.1%) had GBV-C/HGV and TTV coinfection. In the 45 hemodialyzed patients, HBsAg, HCV RNA, GBV-C/HGV RNA and TTV DNA were detected in one (2.2%), two (4.4%), seven (15.5%) and 26 (57.7%). One (2.2%) patient had HBV and TTV coinfection, two (4.4%) HCV and TTV coinfection whereas four (8.8%) were coinfected with GBV-C/HGV and TTV. No differences regarding age, gender, previous surgery and number of transfusions were found between infected and uninfected patients within and between both groups. In conclusion, the prevalence of the viruses studied in predialysis may influence their prevalence in dialysis units.     

Hepatitis C virus infection in 2,744 hemodialysis patients followed regularly at nine centers in Hiroshima during November 1999 through February 2003

Patients on maintenance hemodialysis (HD) are at increased risk of infection with hepatitis C virus (HCV). A prospective follow-up study on HCV infection from November 1999 to February 2003 was conducted in nine hemodialysis (HD) units in Hiroshima. A total of 2,744 HD patients were surveyed regularly for HCV RNA in serum. The prevalence of HCV RNA decreased from 15.7% (262/1,664) on the first survey to 12.9% (242/1,882) in the last one (P<0.05). This decrease may be attributed to the inclusion of patients with a lower prevalence of HCV RNA compared to patients leaving dialysis centers (111/1,080 [10.3%] vs. 132/862 [15.3%], P<0.01). During the 40 months of this study, 16 de novo HCV infections were documented in the nine HD units corresponding to an incidence of 0.33% per year. These cases included eight new HCV infections, three re-infections, and five infections that presumably occured in the window period when tested during the first survey. Our study shows that the annual incidence of de novo HCV infection during HD was 0.33%, and emphasizes the need for frequent serum HCV RNA testing and for stringent disinfection procedures in order to prevent the transmission of HCV in these settings.     

High prevalence of GB virus C/hepatitis G virus genotype 3 among autochthonous Venezuelan populations

GB virus C or hepatitis G virus (GBV-C/HGV) is highly prevalent among population groups at risk of parenterally transmitted viral agents, but it has also a worldwide distribution in other non-risk population groups. GBV-C/HGV RNA and antibodies against its envelope protein (anti-E2 Abs) were found in 3/86 (3%) and 7/89 (8%) of biomedical science personnel (BSP), in 31/453 (7%) and 37/200 (19%) of blood donors (BD), and in 6/64 (9%) and 26/59 (44%) of hemodialysis patients (HD) from Caracas, Venezuela. A significant gradient of GBV-C/HGV exposure (anti-E2 Abs and/or GBV-C/HGV RNA) was found between BSP (lowest prevalence), BD, and HD (P < 0.001). GBV-C/HGV RNA and anti-E2 Abs were also found in 2/69 (2.9%) and 2/44 (4.5%) of individuals from a rural community, in 9/162 (5.5%) and 2/40 (5%) of West Amerindians, and in 14/56 (25%) and 4/53 (7.5%) of South Amerindians. Socioeconomic and cultural factors may have contributed to the relatively high risk of exposure to GBV-C/HGV in BD and Amerindians. Whereas GBV-C/HGV genotypes 1 (n = 1), 2 (n = 6), and 3 (n = 22) were present in Venezuela, only the Asiatic genotype 3 was found infecting Amerindians and rural populations (n = 16). Genotype assignment based on the 5' noncoding region of the GBV- C/HGV genome was corroborated in some isolates by genetic analysis of the E2 region. This report confirms the circulation of the Asiatic genotype of GBV-C/HGV among Amerindians, suggesting an old origin of GBV-C/HGV. This might be associated with the apparently low pathogenesis of this virus.