上海地区血液透析患者与供血者中输血传播病毒DNA检测及部分核苷酸序列分析

目的　了解上海地区暴露于血及血制品的血透患者中输血传播病毒（ＴＴＶ）感染率。方法　采用套式ＰＣＲ技术，检测了 ６例血透患者和 ４９例供血员血清中 ＴＴＶ ＤＮＡ，并对其中各 １例 ＰＣＲ产物（２７２ｂｐ）测］３。结果血透患者ＴＴＶ ＤＮＡ的检出率为 ３２．８％（２０／６１），供血员的检出率为 ２４． ５％（１２／４９）。 ２０例 ＴＴＶＤＮＡ阳性血透患者中，６例为单纯ＴＴＶ感染，６例为ＴＴＶ、ＨＣＶ及ＨＧＶ重叠感染，４例为ＴＴＶ、ＨＣＶ和４例为ＴＴＶ、ＨＧＶ重叠感染。在所有ＴＴＶ感染者中，仅发现１例血清ＡＬＴ升高，该病例为ＴＴＶ、ＨＣＶ及ＨＧＶ重叠感染。对ＰＣＲ阳性扩增产物２７２ｂｐ测序结果显示，上海株（ＳＨＰ、ＳＨＤ）核苷酸的同源性为９９．６％，与深圳株、２株日本株核着酸的同源性分别为９７．４％、９８．７％和９８．７％，表明ＴＴＶ上海株与深圳株及日本株（Ｎ２２、Ｇ１ａ）属同一亚型，首次证实了上海地区的ＴＴＶ感染。结论ＴＴＶ感染可经血传播。其致病性较弱，对ＴＴＶ的研究尚属开始，ＴＴＶ的病原学、流行病学及临床意义等问题还有待进一步探索和阐明。

Genetic and nucleotide sequential analysis of transfusion transmitted virus (TTV ) in hemodialysis patients and blood donors in Shanghai

Objective To study the infectious rate of transfusion transmitted virus (TTV) among hemodialysis patients and blood donors in Shanghai. Methods TTV DNA from sera of patients and blood donors were detected by nested polymerase chain reaction (PCR). One patient and one donor PCR product were sequenced. Results TTV DNA was detected in sera from 20/61 (32. 8%) hemodialysis patients and 12/ 49 (24. 5%) blood donors. In 20 TTV infected hemodialysis patients,there were six patients with simple TTV infection,six with HCV,HGV and TTV co-infection,four with TTV and HCV or TTV and HGV co-infection respectively. Among all these TTV infected patients, we found,only one case of HCV,HGV and TTV coinfection was associated with elevated aminotransferase. PCR product sequence of 272 bp fragment in one patient (SHP) and one blood donor (SHD) were compared with that of Shenzhen (SZE) and Japan (N22 and Gla) reported previously. The nucleotide homology was 99. 6%, 94. 7%, 98. 7% and 98. 7% respectively. It indicated that Shanghai strain and SZE,N22, Gla belong to the same genotype. Conclusion The results of this study confirmed the presence TTV infection in Shanghai for the first time. These results indicated TTV infection can be transmitted by blood but the pathogenicity is mild. Further study should be done to explore its etiology,epidemiology and clinical significance.