新疆地区猪戊型肝炎血清流行病学调查

戊型肝炎(HE)是一种经粪-口传播的疾病,在发展中国家造成非常严重的健康问题.近年来的研究证实发达国家也存在戊型肝炎问题.该病主要威胁青壮年,孕妇病死率可高达20%.我国自1982年起就有HE的报道,新疆是HE的高流行区.由于HEV的组织培养研究尚不成熟,因此其诊断手段主要是利用RT-PCR检测病毒RNA,或利用酶联免疫吸附试验(ELISA)检测抗体.而用于血清学检测的抗原主要来自HEV ORF2和ORF3的产物,并且用ORF2产物建立的检测法有足够的敏感性和特异性.自Meng[1]1997年从美国猪体内克隆出戊型肝炎病毒(HEV)基因后,我国以及加拿大,西班牙,新西兰,澳大利亚,印度等国家也都克隆出本国猪HEV基因.虽然我国也进行了猪HEV的检测,但在1988年爆发过人源戊型肝炎的新疆地区猪群感染HEV的情况还不清楚.本研究调查了HEV在猪群的感染状况,对新疆不同地区,猪场,年龄段及品种的猪进行HE的血清学检测.     

上海部分地区戊型肝炎病毒(HEV)基因型的分析

为了解戊型肝炎病毒(HEV)在上海部分地区流行的基因型,采用RT-nPCR的方法检验35例急性散发性戊型肝炎患者中HEV RNA,并对阳性产物进行克隆测序,然后对其基因型进行分析.结果显示在35例急性散发性戊型肝炎患者中PCR阳性为9例,测序证实8例为HEV的基因序列;其中1例为HEV 1型,7例为HEV 4型.提示在上海部分地区的急性散发性戊型肝炎中以HEV 4型感染为主.     

上海部分地区戊型肝炎病毒（HEV）基因型的分析

为了解戊型肝炎病毒 (HEV)在上海部分地区流行的基因型 ,采用RT nPCR的方法检验 35例急性散发性戊型肝炎患者中HEVRNA ,并对阳性产物进行克隆测序 ,然后对其基因型进行分析。结果显示在 35例急性散发性戊型肝炎患者中PCR阳性为 9例 ,测序证实 8例为HEV的基因序列 ;其中 1例为HEV 1型 ,7例为HEV 4型。提示在上海部分地区的急性散发性戊型肝炎中以HEV 4型感染为主     

人肝细胞内戊型肝炎病毒结合蛋白的酵母双杂交筛选

为进一步深入研究戊型肝炎病毒(HEV)感染机制以及致病机理,用酵母双杂交系统从人肝细胞cDNA文库中筛选与戊型肝炎病毒衣壳蛋白E2相互作用的蛋白,核酸序列分析及同源性检索表明,4个克隆与E2相互作用,其中一个克隆与P38IP高度同源,细胞免疫共沉淀实验结果显示:在哺乳动物细胞水平仍能够检测到E2与P38IP片段的特异的相互作用。     

戊型肝炎病毒抗体检测的现状、问题与展望

戊型肝炎病毒(Hepatitis E virus,HEV)感染是包括我国在内发展中国家成人急性肝炎的主要原因,在发达国家戊型肝炎的发病率也在不断升高,且在免疫抑制患者中可引起慢性感染,因此对HEV感染的诊断受到广泛重视。血清学检测,包括抗-HEV IgM和IgG,仍是诊断HEV感染的主要手段,但目前存在的最大问题是检测抗-HEV抗体的试剂之间的敏感性和特异性差异很大,检测结果的符合率差。本文着重综述了国内外常用抗-HEV抗体检测试剂的组成以及检测结果,提出了今后可能有利于提高检测敏感性和特异性的研究构思。     

CD63在戊型肝炎病毒感染中的作用机制

本研究旨在寻找戊型肝炎病毒(hepatitis E virus,HEV)衣壳蛋白ORF2的相互作用蛋白,探讨其在HEV感染中的作用。采用酵母双杂交方法从人肝细胞文库中筛选与HEV ORF2相互作用的蛋白,结果显示CD63与HEV ORF2相互作用。Pull-down实验提示原核表达的ORF2与CD63结合较弱,而免疫共沉淀实验提示真核表达的ORF2能与CD63结合。流式细胞术检测结果显示,HEV易感细胞PLC/PRF/5细胞膜表面的CD63表达水平普遍低于HEV非易感细胞。过表达CD63抑制PLC/PRF/5细胞的HEV感染,而小干扰RNA(small interfering RNA,siRNA)干扰CD63表达则促进HEV感染。结果提示,CD63能与HEV ORF2相互作用,可能抑制HEV感染肝细胞。     

器官移植病人戊型肝炎病毒慢性化感染及治疗

戊型肝炎是由戊型肝炎病毒(Hepatitis E virus,HEV)感染引起的急性病毒性肝炎,其发病率居急性病毒性肝炎之首。戊型肝炎通常呈急性感染病程,2008年以来陆续发现器官移植病人等免疫抑制患者感染HEV后可能迁延为慢性化。在无抗病毒药物治疗的情况下,器官移植病人感染HEV后迁延为慢性感染的比例超过60%,其中10%的病人慢性感染HEV后可能出现肝纤维化,并且在较短的时间内进展为失代偿性肝硬化导致死亡。本文简要综述器官移植病人HEV慢性化感染及治疗。     

戊型肝炎病毒研究新进展

戊型肝炎病毒(hepatitis E virus,HEV)是引起全球多地区大规模流行和散发病例的急性病毒性肝炎的病原体,发展中国家尤为突出;我国是戊型肝炎(hepatitis E,HE)流行的高发区.HE是一种人畜共患病,猪是人HEV病毒的主要储库,因而HE已成为一个全球性的的公共卫生问题.对HEV的病毒学和基因组特征、临床表征、流行病学、主要抗原表位以及HEV诊断试剂和疫苗研制的进展进行了综述.     

西北农林科技大学动物医学院，兽医免疫学研究所，杨凌712100

禽戊型肝炎病毒(Hepatitis E virus,HEV)与人、猪HEV同属于肝炎病毒属,它们在遗传性和抗原性上有一定的相关性。自禽HEV被分离鉴定以来,许多国家从血清学或分子流行病学方面证实了该病毒的存在和流行。目前,GenBank上共有5个禽HEV的全基因组或接近全基因组的序列,分为3个基因型,并且其全基因组包含3个ORFs,其中ORF2基因编码病毒的衣壳蛋白,包含病毒主要的抗原表位,是血清学检测和疫苗设计的主要靶蛋白。禽HEV由于其对家禽养殖业的危害以及人畜共患的可能性,正被引起越来越多的关注。本文结合国内禽HEV的分离鉴定从禽HEV病原学、致病性以及衣壳蛋白抗原性等方面进行了总结概述。     

戊型肝炎病毒分子生物学与疫苗研究进展

戊型肝炎病毒（HEV）是80年代发现的又一新型肝炎病毒,近年来对戊型肝炎病毒病原学、流行病学、实验室诊断、基因结构等方面研究取得了重大进展,本文就戊型肝炎病毒（HEV）的分型、分子生物学特性、蛋白组份、疫苗研究等作一简要概述。     

福州地区庚型肝炎病毒重叠感染

为研究庚型肝炎病毒在福州地区的重叠感染,采用ＥＬＩＳＡ法检测本院住院的２８６例病毒性肝炎（ＨＶ）患者和５００名供血员的抗－ＨＧＶ。结果表明,甲、乙、丙、戊型肝炎患者和供血员的抗－ＨＧＶ检出率分别为２．０％、２．２％、４．０％、１０．０％和０．２％。急性肝炎、慢性肝炎、慢性重型肝炎、肝硬化、原发性肝癌和抗－ＨＣＶ阳性供血员的检出率分别为７．９％、４．３％、３３．３％、０％、７．１％和６．３％,慢性重型肝炎检出率较慢性肝炎显著升高（Ｐ＜０．０５）。各型肝炎患者和供血员均存在庚型肝炎病毒重叠感染,以慢性重型肝炎为著。     

siRNA抑制乙肝病毒的研究进展

乙型肝炎作为一种发病率高、死亡率高的传染性疾病,已严重威胁人类健康,乙肝病毒（hepatitis B virus,HBV）是诱发乙型肝炎的重要病因。目前,最主要的治疗方法是运用抗病毒药物控制病情,但这些药物都不能完全治愈乙型肝炎且复发率高。近年来,RNA干扰技术（RNA interference, RNAi）逐渐成为有效、快速治疗乙型肝炎的新疗法。利用RNA干扰技术体外合成针对HBV基因的siRNA,选择适当的载体将其运送至靶细胞,使HBV基因沉默,从而抑制病毒复制,可有效达到治疗乙肝的效果。本文围绕siRNA沉默HBV基因的设计原理、递送载体、靶向策略、以及治疗效果与应用前景等方面进行了系统综述,为今后siRNA治疗乙肝的临床应用提供参考。     

Hepatitis E Virus: An emerging enigmatic and underestimated pathogen

Hepatitis E virus (HEV) is an RNA virus causing hepatitis E disease. The virus is of one serotype but has diverse genotypes infecting both humans and animals. Based on evidence from seroprevalence studies, about 2 billion people are estimated to have been infected with HEV globally. HEV, therefore, poses a significant public health and economic challenge worldwide. HEV was discovered in the 1980s and was traced back to the 1955 – 1956 outbreak of hepatitis that occurred in India. Subsequently, several HEV epidemics involving thousands of individuals have occurred nearly annually in different countries in Asia and Africa. Initially, the virus was thought to be only enterically transmitted, and endemic in developing countries. Due to the environmental hygiene and sanitation challenges in those parts of the world. However, recent studies have suggested otherwise with the report of autochthonous cases in industrialised countries with no history of travel to the so-called endemic countries. Thus, suggesting that HEV has a global distribution with endemicity in both developing and industrialised nations. Studies have also revealed that HEV has multiple risk factors, and modes of transmission as well as zoonotic potentials. Additionally, recent findings have shown that HEV leads to severe disease, particularly among pregnant women. In contrast to the previous narration of a strictly mild and self-limiting infection. Studies have likewise demonstrated chronic HEV infection among immunocompromised persons. Consequent to these recent discoveries, this pathogen is considered a re – emerging virus, particularly in the developed nations. However, despite the growing public health challenges of this pathogen, the burden is still underestimated. The underestimation is often attributed to poor awareness among clinicians and a lack of routine checks for the disease in the hospitals. Thus, leading to misdiagnosis and underdiagnosis. Hence, this review provides a concise overview of epidemiology, diagnosis, and prevention of hepatitis E.     

戊型肝炎病毒ORF2编码多肽抗原的表达及其特性研究

迄今所发现的唯一的戊型肝炎病毒（HEV）中和表位定位于开放读码框架2（ORF2）编码蛋白的第578和第607氨基酸（aa）之间的区域。将对应此区域的基因片段通过一段柔性的甘氨酸铰链与乙型肝炎病毒（HBV）表面抗原（HBsAg）基因的3′端相连,构建成HBV/HEV融合基因。该融合基因在毕赤酵母细胞内的表达产物物为分子量约29kDa的融合蛋白,具有组装成嵌合病毒样颗粒（VLP）的能力。此嵌合VLP具有与HBsAgVLP相似的特性且保留了天然HBV/HEV双重抗原性。对此嵌合VLP特性的初步研究提示其可能具有HBV/HEV双价重组疫苗的潜在应用前景。     

Hepatitis E virus infection in Europe: regional situation regarding laboratory diagnosis and epidemiology

Hepatitis E virus (HEV) was first identified in the excreta of an experimentally infected human volunteer and further confirmed by similar findings in clinical specimens from patients with acute jaundice disease different from hepatitis A and B. The HEV is a 27- to 34-nm spherical non-enveloped virus obviously represented by a single serotype; however, its final taxonomic definition remains to be established. Studies on molecular biology of this virus revealed some peculiar characteristics showing no homologies in its nucleotide sequence to any entries in the Genbank database. The HEV infection was experimentally transmitted to non-human primates producing a disease in many features similar to that occurring in humans. Recently cell lines persistently infected with the HEV have also been obtained. These studies provided valuable virus-specific reagents which were used in diagnostic tests. Currently immune electron microscopy, fluorescent antibody technique, latex agglutination, cDNA hybridization, and Western blotting are employed to prove the etiological involvement of HEV in suspected hepatitis cases; serological tests with synthetic substances analogous to HEV antigens are expected to be available soon. Reliable diagnostic procedures can be carried out in a number of laboratories with the locally produced reagents. The HEV infection is common in many hot climate countries being responsible for more than 50% of jaundice cases among young adults. The European region is considered to be free of natural foci of this infection, however, several sporadic cases of HEV disease were reported to occur in Europeans who developed jaundice shortly after returning from endemic areas. It is suspected that in the Mediterranean countries (Italy and Spain) the cases of HEV infection could be causatively related to the consumption of shell-fish cultivated in sewage-polluted waters.     

Prime/Boost Immunization with DNA and Adenoviral Vectors Protects from Hepatitis D Virus (HDV) Infection after Simultaneous Infection with HDV and Woodchuck Hepatitis Virus

Hepatitis D virus (HDV) superinfection of hepatitis B virus (HBV) carriers causes severe liver disease and a high rate of chronicity. Therefore, a vaccine protecting HBV carriers from HDV superinfection is needed. To protect from HDV infection an induction of virus-specific T cells is required, as antibodies to the two proteins of HDV, p24 and p27, do not neutralize the HBV-derived envelope of HDV. In mice, HDV-specific CD8⁺ and CD4⁺ T cell responses were induced by a DNA vaccine expressing HDV p27. In subsequent experiments, seven naive woodchucks were immunized with a DNA prime and adenoviral boost regimen prior to simultaneous woodchuck hepatitis virus (WHV) and HDV infection. Five of seven HDV-immunized woodchucks were protected against HDV infection, while acute self-limiting WHV infection occurred as expected. The two animals with the breakthrough had a shorter HDV viremia than the unvaccinated controls. The DNA prime and adenoviral vector boost vaccination protected woodchucks against HDV infection in the setting of simultaneous infection with WHV and HDV. In future experiments, the efficacy of this protocol to protect from HDV infection in the setting of HDV superinfection will need to be proven.     

不同戊肝抗原检测抗-HEVIgM反应性研究

目的　比较不同戊肝抗原检测抗 -HEVIgM反应性。方法用HEVE30、E42、E33合成肽和HEVORF 2重组抗原建立酶免疫试验 (EIA)检测肝病患者和健康人群中抗 HEVIgM。结果 6 0份抗 HEV阳性血清中 ,用E30、E42、E33及重组抗原包被检测抗 HEVIgM ,阳性率分别为 76 .6 % ,2 6 .6 % ,18.3 % ,6 6 .7%。用E30抗原进一步检测戊肝急性期及恢复期血清 ,抗HEVIgM阳性率为 90 %及 3 .3 %。结论以HEVE30为抗原的EIA特异性强、灵敏度高 ,是戊型肝炎早期诊断实用可靠的方法。     

南京地区戊型肝炎病毒基因型鉴定和变异分析

为了解南京地区戊型肝炎病毒(Hepatitis E virus,HEV)基因型的分布以及变异状况,本研究采用逆转录套式聚合酶反应(RT-nPCR)的方法检测南京地区40份急性散发性戊型肝炎患者的粪便标本,对PCR产物进行测序,利用生物信息学软件比较核苷酸的同源性、遗传距离,进行基因分型和变异分析。40份粪便标本中检测到14份阳性HEV、RNA,检出率为35%,基因分型均为HEV IV型,且分属2个不同的亚型;利用生物信息学软件对国内I型和IV型毒株加以比较,发现HEV IV型毒株比I型变异程度高,不同年份的HEV IV型毒株变异更大,有新的亚型出现,且变异有随时间推移而增大的趋势。     

利用基因芯片分析拉米夫定治疗过程中HBV DNA的基因变异

依据乙型肝炎病毒(Hepatitis B virus;HBV)聚合酶基因序列研制HBV基因芯片,此芯片可分析HBV的7个基因型、4种血清型和HBV聚合酶基因rtV173、rtL180、rtM204和rtV207位点的突变。利用此芯片对A、B两组共计45例拉米夫定治疗12个月的患者进行服药前和服药后3、6、9、12个月的动态检测,其中C基因型39例,且血清型均为adr;B基因型6例,其血清型均为adw。在完成全程检测的38例患者中,17例ALT升高的A组出现1例拉米夫定耐药变异株,而21例ALT正常的B组出现4例变异株,且所有变异株均为rtM204 V／rtL180M,其中2例野生株和变异株共存。rtM204V变异最早在服药6个月时出现,随后出现rtL180M变异。10份PCR产物测序分析表明,芯片检测结果与测序结果基本一致,仅在rtL173位点出现1例差异。进一步分析HBV DNA变异与HBV DNA含量、ALT水平和HBeAg血清转换率的相关性,初步结果表明变异株的出现与治疗过程中的DNA反弹呈正相关,而与起始HBVDNA水平、ALT值无关联。HBV基因芯片可初步用于HBV DNA检测,可能是临床追踪评价抗病毒治疗效果的较好方法之一。