邢台市健康献血员TT病毒感染状况初探

目的：探讨当地健康人群TT病毒(TTV)感染状况及其在人体内长期存在的意义。方法：选择邢台市志愿献血员(120名)进行TTV感染情况检测,利用N22 PCR和UTR PCR两种方法。结果：N22 PCR方法血清中TTV阳性率为30．00％,UTR PCR方法血清中TTV阳性率为100％。结论：说明邢台市区健康人群中存在有TTV感染,并与贵州(6．45％)、深圳(7．80％)等地区报告的TTV DNA阳性率不同。     

内蒙古呼和浩特地区丙型肝炎病毒基因型分布

为了解内蒙古呼和浩特地区丙型肝炎病毒(HCV)基因型的分布特征,为本地区丙型肝炎的治疗、预防提供基础数据资料。收集呼和浩特地区2014年1月至2015年1月就诊的门诊和住院丙型肝炎患者血清采样标本149份,均为HCV抗体检测阳性且HCVRNA定量检测阳性。QIAGEN柱式病毒RNA提取法提取HCV RNA,反转录成cDNA,巢式PCR法扩增HCVNS5B区,对扩增片段进行测序,在NCBI BLAST上进行序列比对得到相似度最大的参考序列并确定基因型,用Megalign,Clustal W进行序列分析并建立同源关系树,分析呼和浩特地区HCV感染基因型的分布特征,以及基因型与宿主性别、年龄的关系。在测序成功的94份样本中,共检出6个基因型,1b型占73.40%(69/94),2a型占19.14%(18/94),3a、3b、6a型各占2.12%(2/94),6u型占1.06%(1/94)。性别资料明确的93例样本,男女基因型分布无显著差异(P0.05)。年龄资料明确的90例HCV样本,1+2型的患病年龄高于3+6型的患病年龄有统计学意义(P0.05)。得出内蒙古呼和浩特地区HCV感染的基因型1b为主,其次为2a型,但也有3型、6型等基因型的传入。HCV的基因型4型和5型未检测到。     

巢式荧光定量RT-PCR检测中枢神经系统HCV方法的构建

目的 建立丙型肝炎病毒5′NCR基因的巢式荧光定量RT-PCR检测方法 ,用于中枢神经系统感染超低浓度HCV的准确和快速定量检测.方法 选择高度保守区5′NCR基因片段,设计并合成相应的特异性引物和探针,建立巢式荧光定量RT-PCR检测中枢神经系统感染样本中的超低浓度HCV正负链RNA的方法 .并对32例血清HCV抗体检查阴性的病毒性脑炎患者脑脊液有核细胞和外周血单个核细胞(PBMC)进行检测.结果 可特异性地检出脑脊液有核细胞及PBMC中HCV正负链RNA,最低检出浓度均可达7.85 copies/μl,与其他单股正链RNA病毒如登革热病毒(DEV)无交叉反应.32例血清HCV抗体检查阴性样本脑脊液有核细胞和PBMC中 HCV 5′NCR正链片段阳性的分别为1例(1/32)和2例(2/32),负链片段阳性的分别为1例(1/32)和0例(0/32).结论 本方法 的构建适用于中枢神经系统感染超低浓度HCV正负链RNA检测,且快速有效、敏感性和特异性较高,不易出现假阳性,可有效提高检出率,进一步完善目前临床常规检测HCV的方法 .     

丙型肝炎病毒不同标志物检测结果的相关性分析

目的分析丙型肝炎病毒(Hepatitis C virus,HCV)抗原、抗体及核酸标志物实验室检测结果之间的关联性,评价适合血源筛查与早期临床确诊联合检测HCV感染的实验室诊断技术。方法用HCV RNA定量试剂、HCV核心抗原试剂及HCV抗体试剂分别检测304份血浆样本中HCV RNA载量、HCV Ag和抗-HCV指标,并对HCV RNA阳性样本进行基因分型。结果在304份血浆样本中,检出HCV RNA阳性样本87份,其HCV RNA载量≥500 IU/m L、500~30 IU/m L之间和<30 IU/m L时,血清学标志物HCV Ag浓度≥3 fmol/L及抗-HCV信号值/判断值≥1的阳性率分别为92.0%(23/25):96.0%(24/25)、58.8%(10/17):82.3%(14/17)及11.1%(5/45):75.6%(34/45),HCV RNA载量低于基因分型试剂盒LOD要求为500 IU/m L时,基因分型检测率为24.2%(15/62)。HCV RNA阴性样本217份中,HCV Ag浓度≥3 fmol/L和抗-HCV信号值/判断值≥1的样本阳性率分别为3.2%(7/217)和32.7%(71/217)。血清学指标在不同HCV RNA载量的阳性率差异具有统计学意义(χ2=197.4,P<0.01),HCV RNA载量与HCV Ag和抗-HCV水平成正相关。结论在中国人群中存在低HCV RNA水平携带者,HCV Ag和基因分型检测能力需要进一步提高。     

浙江省献血员HGV和TTV感染情况的调查

应用逆转录套式聚合酶链反应(RT-Nested PCR)和半套式聚合酶链反应(Semi-nested PCR)分别检测来自浙江省3个地区165例献血员血清标本中的庚型肝炎病毒(HGV)RNA和输血传播性病毒(TTV)DNA.14.6%(24/165)和12.7%(21/165)的血清标本分别检出HGV RNA和TTV DNA,其中3.6%的血清标本(6/165)可同时检出HGV RNA和TTV DNA.实验结果表明,浙江省献血员中HGV和TTV的感染率较高.     

吉林省延边地区丙型肝炎病毒基因型分布

为了解延边地区不同丙型肝炎病毒(HCV)基因型的分布特点,应用逆转录-聚合酶链反应(RT-PCR)技术,检测了48例本地区抗HCV阳性血清,结果有29例出现HCVRNA阳性.再利用限制性片段长度多态性(RFLP)技术,对29例RT-PCR阳性标本进行HCV基因分型.结果延边地区主要流行HCVⅡ型,其次是HCVⅢ型,也存在HCVⅡ/Ⅲ混合型,且HCVⅢ型的感染率较高.     

合肥市蜀山区206例艾滋病高危人群HIV、HCV感染情况调查

目的了解合肥市蜀山区艾滋病高危人群中人类免疫缺陷病毒(HIV)、丙型肝炎病毒(HCV)感染情况,为艾滋病高危人群疾病防治工作提供依据。方法采集合肥市蜀山区206例艾滋病高危人群血清样本,分别运用金标法和酶联免疫吸附法(ELISA)进行HIV抗体、HCV抗体检测。HIV抗体筛查结果阳性或一阴一阳标本再经蛋白印迹法(WB)确证阳性为最终结果,并对结果和不同人群、年龄、性别的感染情况进行统计分析。结果在206份血清样本中检出HIV抗体阳性17例,阳性率为8.73%;检出HCV抗体阳性21例,阳性率10.19%。合并感染病例2例,占0.97%。结论检测结果提示,在高危人群中存在HIV/HCV流行和传播的风险,因此应持续加强高危人群的监测,有效阻止艾滋病和丙型肝炎的流行和蔓延。     

新肝炎病毒TTV在各类高危人群中的感染状况和分子流行病学研究

目的观察新肝炎病毒TTV在各类高危人群中的感染状况、基因分型及其在肝病发生和发展过程中的作用。方法在日本株TTVORF1保守区设计了两对套式引物,采用巢式聚合酶链反应扩增血清TTVDNA,并对产物进行分子克隆和部分基因序列分析。结果在非甲-戊型和非庚型肝炎病人、血清HBsAg阳性的肝炎病人、正常献血员、肝炎肝硬化病人、原发性肝癌病人、静脉内吸毒者和女性与男性性乱者中,血清TTVDNA阳性率分别为43.2％(16/37)、28.8％(15/52)、9.3％(4/43)、51.9％(14/27)、38.5％(5/13)、35.0％(14/40)、17.3％(8/45)和18.8％(3/16)。其中非甲-戊型和非庚型肝炎病人、血清HBsAg阳性肝炎病人的ALT平均为(472士276)u·L-1和(385士218)u·L-1;肝炎肝硬化病人TTVDNA阳性率显著高于HBsAg阳性肝炎病人。同时,从非甲-戊型和非庚型肝炎病人、血清HBsAg阳性肝炎病人、正常献血员、静脉内吸毒者和女性性乱者中,分别获得6份TTVDNAORF1克隆,其基因序列与日本株TTVORF1部分基因核苷酸序列同源性为97％～99％,均属于TTV1a型。结论TTV感染和ALT升高存在一定的关系;我国各类高危人群感染TTV以1a型为主,TTV基因型与疾病发生和传播方式关系不大。国内首次报导性传播的TTVDNA基因型。     

广西地区野鼠戊型肝炎病毒感染情况调查

从广西壮族自治区5个市采集256份野鼠肝脏和对应的血清211份,采用HEV抗体(HEV-Ab)酶联免疫试剂盒(双抗原夹心法)对血清样本进行抗-HEV检测,并对不同地区HEV抗体阳性率进行χ2检验。采用HEV核酸荧光PCR试剂盒对肝脏样本进行HEV核酸检测。结果显示,211份野鼠血清抗-HEV的抗体阳性率为6.6%,其中百色市的抗体阳性率最高,为14.1%,其他地区抗体阳性率均在10%以下。256份野鼠肝脏中未检测到HEV核酸。由此可见,广西壮族自治区5个市的野鼠中存在HEV感染,但其是否为HEV的自然宿主及在戊型肝炎传播中起何作用需进一步研究。     

苏南地区1b型丙型肝炎病毒包膜区变异进化研究

本研究旨在了解本地区丙型肝炎病毒(Hepatitis Cvirus,HCV)基因型构成的前提下,分析1b型丙型肝炎病毒包膜2(second envelope glycoprotein E2)区的变异和种系进化,并研究其准种变异与临床肝病活动度的关系.对宜兴市人民医院收集的抗HCV抗体阳性患者166名,RT-PCR方法检测HCVRNA,HCVRNA阳性患者采用型特异性引物分型法确定病毒基因型;选择其中未经干扰素治疗的43例1b型慢性丙型肝炎患者的血清标本,扩增E2区,从中选取肝硬化患者4例,慢性非肝硬化患者6例的E2区PCR产物纯化测序,序列采用CLUSTALW与GENBANK上多株不同型别的HCV序列进行比对分析,结果采用Phylip软件构建遗传进化树;并观察E2区高变区1(HVR-1)的氨基酸(amino acid,aa)残基序列的变异特征;采用单链构象多态性垂直电泳检测43例患者个体内HCV E2区准种的变异情况,比较不同肝病活动度患者准种变异情况.结果表明本地区HCV以1b型为主(84.3%),对E2区基因序列和氨基酸序列变异的分析显示其变异具有一定的规律性,种系进化树提示本地区HCV病毒序列与上海、湖南、日本等地的HCV株有较近的亲缘性.43例患者中ALT高于正常的丙型肝炎患者准种复杂程度明显高于ALT正常者(P＜0.05).故本地区HCV基因变异符合中国东南部的特点,基因变异与临床肝病活动度具有相关性.     

Co-infections with hepatitis G and TT virus in patients with chronic hepatitis C in Hungary

The significance of co-infections with novel hepatitis viruses Hepatitis G (GBV-C, HGV) and TT virus (TTV) in chronic hepatitis C is not clear. We determined the prevalence of HGV RNA and TTV DNA in chronic hepatitis C patients and in asymptomatic hepatitis C virus (HCV) carriers, and assessed the influence of these agents on the course of HCV infection. Seventy-seven patients with chronic hepatitis C--50 of them treated with interferon (IFN)--and 33 HCV carriers with normal alanine aminotransferase have been investigated. Previous HBV infection was detected by testing serum HBsAg and aHBc. HGV RNA and TTV DNA were detected by PCR. In the healthy population, the prevalence of anti-HCV was 0.3%, HGV RNA 8.0% and TTV DNA 18.5%. In chronic hepatitis C HGV RNA occurred in 9.09% and TTV DNA in 40.25% of cases. In IFN-treated patients with sustained remission, the frequency of TTV was 20% vs. 45.7% found in non-responders. Among asymptomatic HCV-carriers, the prevalence of HGV RNA was 9.09% and TTV DNA 75.7%. Neither HGV RNA nor TTV DNA had apparent effect on the HCV infection. TTV was detected with the lowest frequency in persons with sustained remission due to IFN, suggesting antiviral effect of IFN on TTV.     

Detection of TTV in peripheral blood cells from patients with altered ALT and AST levels

This work analyzes the prevalence of TTV DNA in peripheral blood cells from patients with hepatic alterations and healthy blood donors and measures levels of sodium, potassium, urea, creatinine, phosphatase alkaline, total and direct bilirubin, gamma glutamyl transferase (GGT), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in certain randomly selected patients. DNA samples from 111 individuals were evaluated. They were divided into two groups, "A" (study) and "B" (control), including 54 patients with liver enzyme alterations (ALT/AST) presenting non-B-non-C hepatitis and 57 blood donors, respectively. TTV DNA was determined by nested PCR. Certain products of the second-round PCR were sequenced. Serum biochemical assay was performed and disclosed TTV in 31.48% (17/54) of patients in group A and 5.26% (3/57) in the control group B. TTV prevalence was significantly higher in patients with liver disease than in healthy donors. In group A, sodium, potassium, urea, creatinine, phosphatase alkaline, total and direct bilirubin, gamma glutamyl transferase (GGT), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were analyzed in certain randomly selected patients and no significant difference in biochemical levels (p>0.05) was found when TTV infected and noninfected individuals were compared. Knowledge related to TTV has rapidly increased, but many fundamental aspects remain unclear. This led us to question the role of TTV and doubt remains as to whether or not it is just a commensal virus. Further studies are necessary to confirm and extend these findings.     

PCR—微孔板杂交法检测不同人群TTV DNA

根据报道的TTV全序列设计引物和探针,建立PCR－微孔板杂交法,检测81例正常人群、92例职业献血员123例甲－庚型肝炎、32例非甲－庚型肝炎、48型发性肝癌患者的TTV DNA。结果表明TTV在以上五种人群中的阳性率分别为3．7％、4．3％、21．1％、28．1％、52．0％,前者与后三者比较有显著性差异（P＜0．05）,TTV合并HBV二重感染重叠感染的54．0％,这揭示不同人群均存在TTV感染,正常人群和职业献血员存在健康携带状态,甲－庚型肝炎和非甲－庚肝炎病人为高危人群,TTV可与各型肝炎存在重叠感染,TTV除经血传播外,存在其它传播途径,TTV感染与ALT及TBIL的升高密切相关。     

闽南地区TT病毒的变异及经输血传播的初步证据

TT virus(TTV)DNA was tested by nested-PCR from sera of hepatitis patients and volunteer blood donors in Minnan area. The amplified segment was a 189 base pair region in TTV ORF2. A total of six sequences were obtained from three non-A to G hepatits patients and two from volunteer blood donors. The sequences were found to be with 82.9% to 99.3% homology to TTV Japanese strain and Chinese strain. The divergence of sequence in these six segments varied from 0.7% to 17.1%, which indicated that the TTV had been existing for a long time in this area. In the serum of a non-A to G hepatitis patient who was negative for TTV DNA in the 14th day of disease course turned to be positive in the 30th day, two TTV sequences were obtained which showed 92.1% nucleotide homology. It indicated that different TTV strains can co exist in the same person. This patient's blood had been transfused ten times between the collection of his TTV negative sample and his positive serum sample. Seven of the blood donors were traced and sampled for sera, of which three were positive for TTV. For all 161 patients tested, the history of exposure to blood products was associated with an increased risk of TTV infection(relative risk, 3.0; 95% confidence intervals, 1.89～4.81).     

Prevalence of TT virus in patients with hepatitis B,C and hepatitis of unknown etiology

Discovery of TT virus in 1997 gave raise to intensive subsequent studies to learn about its structure, features and, what is the most important, about its role in pathogenesis of liver disease. The aim of the work was to analyze prevalence of TTV DNA in patients with diagnosed hepatitis B, C, that of unknown etiology and in healthy blood donors as well. Additionally the divergence of TTV sequence was estimated in selected cases. TTV DNA was detected by PCR technique using specific oligonucleotide primers for coding regions. TT virus has been detected in 25.6% (32/125) HBsAg positive patients and in 23.9% (51/213) HCV infected patients. In healthy blood donors the frequency of TTV was 24.3% (34/140) similarly to that found in HCV and HBV infected patients. The frequency of TTV DNA among patients with hepatitis of unknown etiology was 9.1%. This result was statistically significant lower than in the other groups. When detected sequences have been compared to these from NCBI base the homology result was 71% to 95%, and among different patients and groups of patients identity was 46% to 73%. On the basis of the obtained results it can be concluded that it is very unlikely that TTV coinfection plays any significant role in HCV or HBV infection. The hypothetical role of TTV infection in the etiopathogenesis of cryptogenic chronic hepatitis has not been confirmed. The results obtained in the small group of patients with hepatitis of unknown etiology are not conclusive and should be taken with some precaution. The final conclusion is the TTV coinfection does not contribute to the liver pathology. The divergence of TTV sequences may explain the various frequency of TTV viremia reported by other authors.     

Evaluation of an enzyme immunoassay for hepatitis C virus antibody detection using a recombinant protein derived from the core region of hepatitis C virus genome

This study was undertaken to evaluate an enzyme immunoassay (EIA) for hepatitis C virus antibody detection (anti-HCV), using just one antigen. Anti-HCV EIA was designed to detect anti-HCV IgG using on the solid-phase a recombinant C22 antigen localized at the N-terminal end of the core region of HCV genome, produced by BioMérieux. The serum samples diluted in phosphate buffer saline were added to wells coated with the C22, and incubated. After washings, the wells were loaded with conjugated anti-IgG, and read in a microtiter plate reader (492 nm). Serum samples of 145 patients were divided in two groups: a control group of 39 patients with non-C hepatitis (10 acute hepatitis A, 10 acute hepatitis B, 9 chronic hepatitis B, and 10 autoimmune hepatitis) and a study group consisting of 106 patients with chronic HCV hepatitis. In the study group all patients had anti-HCV detected by a commercially available EIA (Abbott), specific for HCV structural and nonstructural polypeptides, alanine aminotransferase elevation or positive serum HCV-RNA detected by nested-PCR. They also had a liver biopsy compatible with chronic hepatitis. The test was positive in 101 of the 106 (95%) sera from patients in the study group and negative in 38 of the 39 (97%) sera from those in the control group, showing an accuracy of 96%. According to these results, our EIA could be used to detect anti-HCV in the serum of patients infected with hepatitis C virus.     

TT virus infection in children and adults who visited a general hospital in the south of Brazil for routine procedure

TT virus (TTV) is a newly described nonenveloped human virus, with a circular, negative-stranded DNA genome, that was first identified in the blood of a patient with posttransfusion hepatitis of unknown etiology. PCR primers and conditions used for TTV DNA amplification may greatly influence the level of TTV detection in serum. Three PCR assays, with different regions of the genome as targets, were used to test TTV DNA in 130 sera from children and adults visiting a hospital in the south of Brazil, most of them for routine procedure. Forty-four percent of adult sera and 73% of sera from children aged 0-10 years were TTV positive with at least one PCR assay. However, the three assays were able to detect only 33%, 35%, and 70% of the total positive samples. Our results showed a high prevalence of TTV infection in the south of Brazil, particularly among young children, and confirmed the necessity of performing several PCR assays to assess the true TTV prevalence in a determined population.     

Visualization of TT virus particles recovered from the sera and feces of infected humans

TT virus (TTV) has not yet been cultured or visualized. We attempted to recover and visualize TTV-associated particles from the serum samples and feces of infected humans. Serum samples were obtained from 7 human immunodeficiency virus (HIV)-infected patients. Three patients had a high TTV DNA titer (10(8) copies/ml), three had a low TTV DNA titer (10(2) copies/ml), and one was negative for TTV DNA. Fecal supernatant was obtained from a different TTV-infected subject. The serum samples were fractionated by high-performance liquid chromatography, and TTV DNA-rich fractions were subjected to floatation ultracentrifugation in cesium chloride. Virus-like particles, 30-32 nm in diameter, were found in the 1.31-1.33 g/cm(3) fractions from each of the three serum samples with high TTV DNA titer, but not in any fraction from the four serum samples that either were negative for TTV DNA or had low TTV DNA titer. The TTV particles formed aggregates of various sizes, and immunogold electron microscopy showed that they were bound to human immunoglobulin G. Similar virus-like particles with a diameter of 30-32 nm banding at 1.34-1.35 g/cm(3) were visualized in fecal supernatant with TTV genotype 1a by immune electron microscopy using human plasma containing TTV genotype 1a-specific antibody.     

血液透析患者输血传播肝相关病毒感染的调查

使用PCR结合微板杂交-ELtSA及DNA序列分析技术,分别研究了维持性血液透析患者输血传播性HBV、HCV、HDV、HGV、TTV感染状况,并对HBV、TTV进行基因分型、TTV基因变异状况进行分析。除HDV外,发现血液透析患者中存在多重感染。HBV基因型以C型为主,B型次之。TTV分离株中,G1型为主,G2型次之。TTV基因变异可达39．7％。