安徽省不同人群及各型肝炎患者庚型肝炎病毒感染检测分析

应用酶联免疫试验（ＥＩＡ）和逆转录套式聚合酶链反应（ＲＴ－ｎＰＣＲ）对１００ 例一般人群、３８５例献血员、５４ 例血液透析患者、７２ 例乙型肝炎、４１ 例丙型肝炎２７ 例非甲－戊型肝炎患者进行检测。结果抗－ＨＧＶ 阳性率分别为２．００％ 、７．５３％ 、２７．７８％ 、１８．０６％ 、１９．５１％ 和１４．８１％ ;抗－ＨＧＶ 阳性者中ＨＧＶＲＮＡ 阳性率分别为１００．００％ 、６２．０７％ 、６６．６７％ 、６９．２３％ 、７５．００％ 和 １００．００％ ,提示本地区不同人群存在ＨＧＶ 感染。献血员、血透患者、乙型肝炎、丙型肝炎、非甲－戊型肝炎患者的ＨＧＶ 感染率显著高于一般人群,提示献血员,血透患者及ＨＢＶ、ＨＣＶ 感染者是ＨＧＶ 感染的高危人群。ＨＧＶ 常与ＨＢＶ 或ＨＣＶ 重叠／联合感染,也可单独感染。抗－ＨＧＶ 阳性者中ＨＧＶ ＲＮＡ 阳性率为８３．８２％ ,提示抗－ＨＧＶＥＩＡ 可用于ＨＧＶ 感染的检测。ＡＬＴ 正常和异常献血员中抗－ＨＧＶ 阳性率无显著性差异。     

乙型肝炎病人重叠感染丙型肝炎的评价

应用ＥＬＩＳＡ和ＰＣＲ法检测５０２例乙肝病人血清,４０１例ＨＢｓＡｇ阳性血清中,有１１４例（２８．４％）抗－ＨＣＶ和ＨＣＶＲＮＡ双项阳性,２５例（６．２％）ＨＣＶＲＮＡ单项阳性;２１例（５．２％）抗－ＨＣＶ单项阳性。将ＨＢｓＡｇ乙肝病人分成ＨＢＶＤＮＡ,ＨＢｅＡｇ阳性组和ＨＢＶＤＮＡ,ＨＢｅＡｇ阴性组。前者抗－ＨＣＶ阳性率为１１．６％～２０．５％,ＨＣＶＲＮＡ阳性率为１６．２％～２０．５％。后者抗－ＨＣＶ阳性率为２０．２％～５５．６％,ＨＣＶＲＮＡ阳性率为２３％～６０．３％。结果说明长期携带ＨＢＶ者和慢性乙肝病人均可重叠ＨＣＶ感染。ＨＢＶＤＮＡ阳性组抗－ＨＣＶ和ＨＣＶＲＮＡ阳性率明显高于ＨＢＶＤＮＡ阳性组     

HCV感染者抗HCV抗体产生的不均匀性与B细胞优势克隆

本文采用抗原捕捉ＥＬＩＳＡ方法检测了ＨＣＶ感染者血清中抗－ＨＣＶＩｇＧ抗体轻链Κ和λ的比值,发现所检测的抗ＨＣＶ－ＮＳ４、抗ＨＣＶ－ＣＰ１和抗ＨＣＶ－ＣＰ２抗体轻链的表达呈现明显的偏斜,６５例抗ＨＣＶ阳性者中６３例（占９６．９％）,至少一种抗ＨＣＶ抗体К／λ偏离了正常１∶１的比值,尤以λ链较多,分别占６５．６％、８９．９％和７０．２％,但任何一个ＨＣＶ感染者血清抗－ＨＣＶ抗体既可能是Κ链占优势,也     

HBIG,无环鸟苷,干扰素联合对慢性乙型肝炎抗病毒效应观察

本文报道血清ＨＢＶ复制标志阳性的慢乙肝５４例,随机分为治疗组及对照组各２７例进行ＨＢＩＧ、无环鸟苷、干扰素联合近、远期抗病毒效应观察。治疗组为无环鸟苷第一周按２５～２０ｍｇ／ｋｇ／ｄ计后改１７～１５ｍｇ／ｋｇ／ｄ×５３天,共６０天;人白细胞干扰素１×１０６Ｕ肌注每周３次×４周,后改１．０×１０６Ｕ肌注每周２次×６周,共１０周;ＨＢＩＧ４００Ｕ肌注隔日１次,共１０周,对照组仅给予一般“保肝”药物。其中治疗组１８例,对照组１９例进行治后半年到２年追踪观察,结果近、远期ＨＢｃＡｇ、ＤＮＡＰ、ＨＢＶ－ＤＮＡ阴转率治疗组均高于对照组,其中治疗组近、远期ＨＢｃＡｇ,ＨＢＶ－ＤＮＡ阴转率均达４０％以上,明显高于对照组（Ｐ＜０．０５～０．０１）,治疗组近、远期各有４例及２例ＨＢｓＡｇ阴转,而对照组则无一例阴转,从近、远期综合抗病毒效应观察,治疗组全阴率分别为３３．３％、４４．４％,而对照组分别为３．７９％及０％,Ｐ＜０．０１,治疗组无明显毒副反应。对比单用无环鸟苷,全阴率３１．８％;无环鸟苷加干扰素两药联合全阴率３７．５％,均有所提高,达到４４．４％,值得进一步研究。     

逆转录-聚合酶链反应技术诊断丙型肝炎病毒感染

本文采用逆转录－聚合酶链反应（ＲＴ-ＰＣＲ）技术对２１２例住院及门诊病人其中肝病患者９８例（慢性肝炎４３例、肝炎后肝硬化４７例、原发性肝细胞癌８例）进行ＨＣＶ－ＲＮＡ检测。结果９８例慢性肝病患者血清中ＨＣＶ-ＲＮＡ-ＰＣＲ阳性２７例（２７．６％）,１１４例非肝病患者血清中ＨＣＶ-ＲＮＡ-ＰＣＲ阳性９例（７．９％）,两组间差异非常显著（Ｐ（０．０１）,各种肝病患者的ＨＣＶ-ＲＮＡ-ＰＣＲ阳性率均高于非肝病组。６８例患者同时进行了ＨＣＶ-ＲＮＡ-ＰＣＲ检测和抗－ＨＣＶ检测,２５例抗－ＨＣＶ阳性的患者中ＨＣＶ－ＲＮＡ-ＰＣＲ,２１例阳性（８４％）,４３例抗－ＨＣＶ阴性的患者中ＨＣＶ-ＲＮＡ-ＰＣＲ,９例阳性（２０．１％）、有输血及血制品史者４８例,其中ＨＣＶ-ＲＮＡ-ＰＣＲ阳性１６例（３３．３％）,１６４倒无输血史者中ＨＣＶ-ＲＮＡ-ＰＣＲ阳性２０例（１２．２％）,两组间差异非常显著（Ｐ（０．０１）。结果表明：１．ＨＣＶ感染与慢性肝病有密切联系,说明ＨＣＶ感染是慢性肝炎、肝硬化、肝癌的致病因素;２．ＨＣＶ-ＰＣＲ法具有特异性好、灵敏度高、简便快速等特点,弥补了抗－ＨＣＶ检测的不足之处,是目前确定ＨＣＶ感染的主要手段;３．ＨＣＶ感染与输血关系密切,因此对献血员进行常规ＨＣＶ检测对预防由输血所致ＨＣＶ感染有着极其重要的临床意义。     

丙肝病毒IgM抗体检测方法的初步研究

选择东燃公司的重组结构区和非结构区抗原建立的抗ＨＣＶ－ＩｇＭ检测方法,简便、快速、特异性强、重复性好、敏感性高。只在丙肝病人组检出而健康献血员均为阴性,与抗ＨＡＶ、ＨＢＶ的ＩｇＭ抗体无交叉反应,且排除了ＲＦ干扰和ＩｇＧ占位引起的假阳性和假阴性,适用于抗ＨＣＶ－ＩｇＭ的临床检测。对２４例丙肝病人的抗ＨＣＶ－ＩｇＭ检测结果显示,急性丙肝病人血清抗ＨＣＶ－ＩｇＭ检出率较高（７５％,６／８）,且随ＡＬＴ正常而消失或滴度下降。慢性病人抗ＨＣＶ－ＩｇＭ检出率为５６．３％（９／１６）,其中７例ＩｇＭ持续阳性者为慢性活动性丙肝,说明慢性病人抗ＨＣＶ－ＩｇＭ与疾病的活动性密切相关。结果提示抗ＨＣＶ－ＩｇＭ的检测在急性肝炎的诊断及慢性丙肝的预后和转归上具有临床意义。     

两例丙型肝炎病毒(HCV)和乙型肝炎病毒(HBV)重叠感染者的HCV核心区cDNA序列分析

从临床肝病患者中选择两例ＨＣＶ和ＨＢＶ重叠感染者ＨＳＱ和ＳＺＨ,他们血清中的生化指标丙氨酸转氨酶（ＡＬＴ）持续异常,肝活检病理示有严重的肝损伤。在ＡＬＴ异常期,血清学检测结果为ＨＢｓＡｇ、ＨＢｅＡｇ阳性,抗ＨＣＶＩｇＧ（包括Ｃ２２、Ｃ３３ｃ）阴性,但套式ＰＣＲ检测ＨＣＶＲＮＡ阳性,核心区ｃＤＮＡ序列分析发现该区有１个密码子（ＧＧＣｎｔ３８５—３８７）缺失,对应缺失的氨基酸是甘氨酸（ＧＬＹ）,从血清学检测和序列分析结果推测,在ＨＣＶ和ＨＢＶ重叠感染中,ＨＢＶ和ＨＣＶ均可处于持续复制状态,抗ＨＣＶＩｇＧ抗体阴性可能是ＨＣＶ的多蛋白前体翻译和病毒颗粒装配受到ＨＢＶ干扰的结果。     

戊型肝炎病人血清抗—HEV IgG与IgM和HEV RNA的动态变化

利用酶联免疫试验（ＥＩＡ）及逆转录－聚合酶链反应（ＲＴ－ＰＣＲ）,检测了２１０份急性非甲非乙非丙肝炎患者血清和４０例戊型肝炎（戊肝）病人系列血清。在急性非甲非乙非丙肝炎血清中,抗－ＨＥＶ ＩｇＧ、抗－ＨＥＶ ＩｇＭ和ＨＥＶ ＲＮＡ阳性率分别为６２．８６％、４５．２３％和４０．４８％。在戊肝系列血清检测中,抗－ＨＥＶ ＩｇＧ阳性率发病１个月内为９２．５％,发病２￣６个月１００％,１２个月９４．７％,     

生物素标记GFV－cDNA探针的制备及在检测葡萄扇叶病毒上的应用

以整合到质粒中的ＧＦＶ－ｃＤＮＡ为模板经ＰＣＲ合成了生物素标记的ＧＦＶ单、双链探针。用合成的探针对提纯的ｃＦＶ－ＲＮＡ＿２、感染ＣＦＶ的昆诺藜叶及１８株而萄进行ＤＮＡ－ＲＮＡ杂交检测表明：检测提纯病毒ＲＮＡ＿２的灵敏度为１．５ｐｇ／斑点,感染ＧＦＶ的昆诺藜提取液最高稀释度可达４０９６０倍;１１株显示典型扇叶症状的样品杂交结果均为阳性,且汁液稀释４００～８００倍仍能测出,７株不显示典型扇叶症状的葡萄中３株受到ＧＦＶ的侵染。单、双链探针最适使用浓度分别为１／２００及１／１００。     

腹腔注射重组腺病毒诱导的免疫反应

为研究重组腺病毒接种实验动物后的免疫反应性,利用ＲＴ－Ｐ　Ｃ　Ｒ方法,从ＨＡＶ的ＲＮＡ中克隆了结构蛋白基因插入穿梭质粒ｐＸＣＸ２Ｎｏｔ　Ｉ,通过磷酸钙－ＤＮＡ共　沉淀技术,将复制缺陷型腺病毒载体与线形化的ｐＸＣＸ２－ＣＭＶ－ＨＡＶ共转染２９３细胞。一系列检测方法证明产生了重组腺病毒ｒＡｄＨＡＶ。纯化后的ｒＡｄＨＡＶ滴度为１×１０９ＴＣＩＤ５０／ｍＬ　,腹腔注射免疫昆明种小白鼠后,可诱导产生抗ＨＡＶ　ＩｇＧ和ＨＡＶ中和抗体。复制缺陷型腺病毒　可作为发展基因工程病毒疫苗载体的有效系统。     

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。     

HGV RNA基因组感染HepG2细胞的研究

为了观察HGV RNA基因组在HepG2细胞中的复制和表达并建立HGV感染的细胞模型,体外转录制备HGV RNA基因组,Lipfectamin介导转染HepG2细胞。取HGV RNA阳性培养上清液传代感染HepG2细胞,采用RT-PCR、免疫组化和Western blot等技术检测HGV在HepG2细胞中的复制和表达。HepG2细胞地转染后24h便可在培养上清液中检测到HGV负链RNA,传代感染的细胞及培养上清液中可检测到HGV正、负链RNA。在90d内传代20余次,均能检测到HGV的复制。免疫组化和Western blot可检测到 HGV E2蛋白在感染细胞中的表达。HGV感染细胞经冻存后复苏,仍能检测到HGV RNA。故HGV RNA基因组能够在HepG2细胞中复制和表达,此细胞模型有可能用于HGV的复制与感染防治的研究。     

Hepatitis G virus (GBV-C) infection among Brazilian patients with chronic liver disease and blood donors

Background: The recently discovered hepatitis G virus (HGV) belongs, as hepatitis C virus (HCV), to the Flaviviridae family. HGV has been isolated from the serum of patients with non A-E hepatitis. However, the association of HGV with hepatitis is uncertain.Objective: To determine the HGV prevalence in blood donors and in patients with liver disease and to evaluate a possible correlation between HGV infection and liver disease.Study design: Sera from a total of 113 consecutive patients with chronic liver disease were submitted to a series of liver enzymes and function tests and analyzed for the presence of HBsAg, anti-HBs, anti-HBc, anti-HCV, HCV RNA and HGV RNA. Prevalence of HGV RNA was determined in a group of 87 blood donors.Results: Nine (10%) sera from blood donors and 15 (13%) sera from patients with chronic liver disease were HGV RNA positive. Some 28 (25%) patients were HCV RNA positive, with genotypes 1a, 1b and 3 present in 10, 12 and 5 patients, respectively. A total of 20 (18%) patients were HBsAg carriers. Five (4%) patients were double infected (one with HBV+HCV, one with HBV+HGV and three with HCV+HGV).Conclusion: The proportion (10%) of HGV-infected blood donors was very high when compared with other countries. The results did not allow to establish HGV as an etiologic agent for chronic liver disease. The parenteral route was the presumed means of HGV transmission for only one-third of the patients.     

Genomic variability of hepatitis G virus/GBV-C at the NS3 region: clinical implications

A new hepatitis virus, named GBV-C or hepatitis G virus (HGV), closely related to the hepatitis C virus (HCV), was identified in 1994. The existence of quasispecies in HCV is very important. In this work polymerase chain reaction amplification of the NS3 region of the genome of GBV-C/HGV and heteroduplex mobility assay (HMA) were combined to investigate the presence of quasispecies in patients with chronic infection by GBV-C/HGV. Patients with chronic infection by HCV were used to validate the method. The HMA was also used to investigate the similarity between the cited genomic region of GBV-C/HGV in different infected patients. A high degree of heterogeneity was found for HGV existing as quasispecies and as differences between samples. This is of extreme importance because of the intrinsic clinical and pathogenic implications of quasispecies of a virus capable of producing disease, and is in accord with other studies which report on the genomic variability of the NS3 region.     

Prevalence and genotypes of GB virus C/hepatitis G virus among blood donors in Central Brazil

A survey was conducted in a blood donor population of Central Brazil aiming to investigate the prevalence of GB virus C (GBV-C)/hepatitis G virus (HGV) infection and also to analyze the virus genotypes distribution. A total of 241 voluntary blood donors were interviewed at the State Blood Bank in Goiania, State of Goiás, Brazil. Blood samples were collected and serum samples tested for GBV-C/HGV RNA by polymerase chain reaction. Genotypes were determined by restriction fragment length polymorphism (RFLP) analysis. Seventeen samples were GBV-C/HGV RNA-positive, resulting in a prevalence of 7.1% (95% CI: 4.2-11.1). A significant trend of GBV-C/HGV RNA positivity in relation to age was observed, with the highest prevalence in donors between 29-39 years old. Ten infected individuals were characterized by reporting parenteral (30%), sexual (18%), both (6%) and intrafamiliar (6%) transmission. However, 7 (40%) GBV-C/HGV RNA-positive donors did not mention any potential transmission route. RFLP analysis revealed the presence of genotypes 1 and 2 of GBV-C/HGV; more precisely, 10 (58.9%) samples were found belonging to the 2b subtype, 4 (23.5%) to the 2a subtype, and 3 (17.6%) to genotype 1. The present data indicate an intermediate endemicity of GBV-C/HGV infection among this blood donor population, and a predominant circulation of genotype 2 (subtype 2b) in Central Brazil.     

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.     

GB virus-C/hepatitis G virus infection in Taiwan: A virus that fails to cause a disease?

Recently, an RNA virus designated GB virus-C or hepatitis G virus (GBV-C/HGV) was identified; however, its clinical significance remains uncertain. This discovery prompted us to investigate the virological, epidemiological and clinical implications of GBV-C/HGV infection in Taiwan where chronic liver diseases and liver cancer are endemic. Our results showed that genetic heterogeneity of GBV-C/HGV isolates exists, and primers from the highly conserved 5 untranslated region of viral genome can efficiently detect GBV-C/HGV RNA. Epidemiological surveys showed that GBV-C/HGV infection is common in high-risk groups in Taiwan, and its coinfection does not aggravate the course of chronic hepatitis B or C. A prospective study of transfusion-transmitted GBV-C/HGV infection also showed GBV-C/HGV does not cause classic hepatitis in most patients. In addition, GBV-C/HGV plays a minimal role in causing fulminant hepatitis. Like hepatitis C virus, sexual transmission of GBV-C/HGV exists. The risk increases with prolonged duration of exposure. In addition, high-titered maternal viremia and mode of delivery are associated with the mother-to-infant transmission of GBV-C/HGV. Interestingly, we found that GBV-C/HGV exerts no suppression on levels of chronic hepatitis B or hepatitis C viremia, and GBV-C/HGV responds to interferon; however, ribavirin plus interferon does not induce a higher sustained response. As to the replication sites of GBV-C/HGV, our preliminary results showed liver and peripheral blood mononuclear cells are not the major sites for GBV-C/HGV replication, and thus GBV-C/HGV is not a primary hepatotropic virus. In conclusion, transfusion and exchange of body fluids indeed can transmit GBV-C/HGV; however, current lines of evidence suggest that GBV-C/HGV fails to cause a disease.     

Lack of evidence for hepatitis G virus replication in the livers of patients coinfected with hepatitis C and G viruses.

The pathogenic implications of hepatitis G virus (HGV) infection are still unclear. We searched for the presence of HGV RNA and HCV RNA sequences in liver and serum samples from 10 patients with chronic liver disease, 9 of whom were coinfected with HCV. All livers were negative for the presence of the HGV RNA minus strand and only six were positive for the presence of the positive strand, albeit at low levels. In striking contrast, the HCV RNA positive strand was detectable in the liver samples from all nine HCV-positive patients in titers ranging from 10(2) to 10(8) genomic eq/microg of RNA, and the negative HCV RNA strand was present in all but two of these patients. However, the positive-strand RNA titers in serum for the two viruses had similar ranges. These findings imply that the liver is not the primary replication site for HGV, at least in the population of HCV/HGV-coinfected patients. Absence of replication in liver tissue may explain the reported lack of influence of HGV coinfection on the course of chronic hepatitis C.     

GB virus C/hepatitis G virus infection in dialysis patients and kidney transplant recipients in Central Brazil

In order to investigate the prevalence of GB virus C (GBV-C)/hepatitis G virus (HGV) infection in dialysis patients and kidney transplant recipients in Central Brazil and also to analyze the virus genotypes distribution, a total of 123 patients including 98 on hemodialysis, 13 on continuous ambulatory peritoneal dialysis treatment, and 12 who received kidney transplantation were interviewed in one unit of dialysis treatment in Goiania city. Blood samples were collected and serum samples tested for GBV-C/HGV RNA by polymerase chain reaction. Genotypes were determined by restriction fragment length polymorphism (RFLP) analysis. Eighteen samples were GBV-C/HGV RNA-positive, resulting in an overall prevalence of 14.6% (95% CI: 9.2-21.7). A high positivity for GBV-C/HGV RNA was observed in patients who had received kidney transplant (16.7%), followed by those on hemodialysis (15.3%), and peritoneal dialysis (7.7%). RFLP analysis revealed the presence of genotypes 1, 2, and 3 of GBV-C/HGV; more precisely, 9 (50%) samples were found belonging to the 2b subtype, 4 (22%) to the 2a subtype, 3 (17%) to genotype 1, and 2 (11%) to genotype 3. The present data indicate an intermediate prevalence of GBV-C/HGV infection among dialysis patients and kidney transplant recipients in Central Brazil. Genotype 2 (subtype 2b) seems to be the most prevalent GBV-C/HGV genotype in our region.