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.     

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。     

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.     

广州地区急性散发性HEV毒株基因特征和生物学性状的研究

利用RT-PCR技术对我国广州地区急性散发性戊型肝炎病毒细 胞培养分离株G93-1、G93-2、G93-3和G93-4基因组聚合酶区部分核苷酸序列(4522～4761nt)进行检测,PCR阳性产物经纯化、克隆后测序。结果G93-1、G93-3和G93-4株 病毒的 这段序列完全相同,且与我国新疆暴发流行的HEV 87A株及亚洲HEV代表株的同源性为100%; 而G93-2株与它们的差异较大,同源性只有79.9%;但是,它与1997年从厦门地区急 性戊型肝炎病人血清中检测的X-S1株同源性很高,达99.2%。并对G93-2株病毒的生物学特性进行了研究,结果与87A株一致。表明我国南方散发性HEV毒株的基因组存在差异,可能同时流行着两种不同的HEV基因型,但生物学性状是相同的。     

福建省2000～2003年戊型肝炎病毒分离株的分子流行病学研究

为研究福建省2000～2003年急性散发性戊型肝炎病毒（HEV）分离株的分子流行病学特征,采用RT—PCR方法扩增HEV ORF2的基因片段,经纯化、克隆、测序后,对其序列用Neighbor-Joining法和Bootstrap法进行基因进化分析。从158例急性散发性戊型肝炎的血清标本中扩增出72份HEV RNA,经基因进化树分析,这72株HEV均属于HEV基因Ⅳ型,且被明显地分为A、B、C、D共4个组群。A群的同源性最高,群内同源性为93．3％～100％;D群的同源性最低,群内同源性在86．6％～100％之间。A群和B群流行株所占比例没有差异;C群流行株所占比例由2002年的7．1％逐渐增加到2003年的26．3％（x^2=10．553,P=0．014）;D群则由85．7％逐渐减少到44．7％（x^2=8．136,P=0．043）。引起福建地区急性散发性戊型肝炎流行的HEV均属于HEV基因Ⅳ型,基因型内存在不同的组群,其中D群的变异较大。     

一株褐家鼠戊型肝炎病毒的发现鉴定及系统发生分析

对云南省大理市小型哺乳动物携带的戊型肝炎病毒（HEV）进行调查,用巢式RT-PCR对捕获的小型哺乳动物样品中的病毒进行检测,用高通量测序对阳性HEV样本进行毒株全基因组测序,用MEGA-X、BESTv1.10.4和Geneious软件进行生物信息学分析。本研究筛查了6属7种共114只小型哺乳动物样本,结果显示：HEV在褐家鼠中的阳性率为8.00%(2/25);高通量测序获得1株编号为DL147的HEV全基因组,经系统发生分析确定其为HEV-C1基因型,与香港1例戊型肝炎患者血清中发现的HEV同源性最高,核苷酸序列一致性达95.21%,两株病毒的最早分歧时间约为2003年。研究证实,云南省大理市褐家鼠存在HEV-C1感染,其与近期报道的人源新发HEV高度同源,有较近的系统发生关系,对戊型肝炎防控有指导作用。     

戊型肝炎病毒感染实验室诊断方法研究进展

戊型肝炎是由戊型肝炎病毒(Hepatitis E Virus,HEV)引起的急性病毒性肝炎,已经成为威胁人群健康的公共卫生问题。HEV主要通过消化道传播,但随着HEV输血传播病例的报道,HEV给输血安全带来的风险也受到人们的重视。通过分析戊型肝炎现有的诊断手段,以对献血员的HEV筛查提供借鉴作用,这对输血安全中戊型肝炎的预防和控制具有重大意义。目前常用的戊型肝炎检测指标主要包括:HEV RNA、HEV抗原、抗-HEV IgM、抗-HEV IgG。核酸检测是戊型肝炎诊断的"金标准",对于慢性戊型肝炎患者、免疫缺陷人群及无肝炎症状的HEV感染者都有着特别优势。HEV抗原作为HEV现症感染指标,对于血站HEV筛查和急性戊型肝炎诊断有很好的应用价值。抗-HEV IgM是HEV近期感染的标志,不能作为HEV现症感染的单一指标。而抗-HEV IgG只能指示HEV既往感染,不适用于急性戊型肝炎的诊断。目前,献血员HEV检测主要以核酸检测为基础,而HEV抗原检测可能弥补HEV RNA的检测不足。在未来,抗原检测和抗体检测对于献血员HEV筛查的价值还有待更多的研究评价。     

戊型肝炎治疗的进展

戊型肝炎(Hepatitis E,HE)是常见的急性病毒性肝炎之一,它由戊型肝炎病毒(Hepatitis E virus,HEV)感染引起。患者以中青年以及老年人居多,老年人、孕妇和肝脏疾病患者若感染HEV可能引发重症肝炎且病死率高。孕妇感染戊型肝炎病毒后,病死率可高达20%-30%[1,2]。戊型肝炎呈全球性分布,以散发多见,流行主要发生在亚洲、非洲和中美洲的发展中国家。1986-1988年新疆南部地区发生的戊型肝炎水型流行是迄今世界上最大一次流行,共计发病119 280例,死亡707例[3]。近些年来包括美国、日本、中国和印度等在内的一些发达及发展中国家或地区,戊型肝炎发病率有逐渐上升趋势,重型肝炎发病率和病死率逐年增加。控制该病已刻不容缓,但目前临床上还没有戊型肝炎标准化的治疗方案,本文针对戊型肝炎治疗方面进行介绍。     

三株散发性戊型肝炎病毒变异株的部分序列比较

对三株散发性戊型肝炎病毒Ch-T11、Ch-T21、Ch-T40的部分基因组做克隆测序,经比较发现与其它国内外HEV株ORF2部分相应核苷酸序列同源性在78.3-81.3%,Ch-T21与Ch-T40的核苷酸同源性为98.8%,而Ch-T11与前两者的同源性则分别为89.8%和90.2%.Ch-T11、Ch-T21、Ch-T40与其它HEV株相应氨基酸序列同源性在95.8-97.9%,它们之间的氨基酸同源性则为100%.系统进化树分析显示,这三株HEV可能代表着一新型HEV.     

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。     

基因Ⅰ、Ⅳ型戊型肝炎病毒高灵敏度通用引物的设计和初步应用

设计针对国内流行的戊型肝炎病毒(HEV)基因Ⅰ、Ⅳ型,在这两型序列的保守区域设计了一套RT-PCR引物——E引物,并将E引物与目前较常用的3对通用引物(Meng、ConORF1和ConORF2引物)比较了检测基因Ⅰ、Ⅳ型HEV的灵敏度。对基因Ⅰ型HEV,E引物能检出的稀释度为105,参考引物能检出的稀释度为10^2～10^4;对基因Ⅳ型HEV,E引物能检出的稀释度为10^2,参考引物能检出的稀释度为10^1～10^2。在17份HEV-IgM阳性血清中,E引物检出5份,检出率为29．4％;参考引物只能检出1份或2份,检出率最高为11．8％。E引物在33份HEV-IgM阳性的隐性感染血清中检出6份,阳性率18．2％;在79份HEV-IgM阳性的临床肝炎血清中检出36份,阳性率45．6％。以上结果初步表明,对于在国内流行的基因Ⅰ、Ⅳ型HEV,E引物的检测灵敏度要高于目前常用的通用引物。     

Diagnosis of HEV infection by serological and realtime PCR assays: a study on acute non-A-C hepatitis collected from 2004 to 2010 in Italy

ABSTRACT: BACKGROUND: The impact of hepatitis E in developed countries, like Italy, still requires a clear definition. In the present study, we evaluated HEV infection in patients with acute non-A-C hepatitis by an approach comparing data from Real-time PCR and serological assays. METHODS: In a first analysis, sera from 52 patients hospitalized with a diagnosis of acute viral non-A-C hepatitis in Italy were tested by in-house Real-Time PCR assay for identification of Hepatitis E Virus (HEV) RNA and by anti-HEV IgM and IgG assays. In a subsequent analysis, selected samples were evaluated by additional IgM tests to confirm diagnosis. RESULTS: Among the 52 samples, 21 showed positive results for all three markers (IgM, IgG and HEV RNA). One patient showed HEV RNA as single marker. Uncertain results were found in 8 samples while the remaining 22 were negative for all markers. Further analysis of the 8 undefined samples by additional IgM tests confirmed HEV infection in 1 patient. Overall, acute HEV infections were reliably identified in 23 (44.2%) out of 52 patients. CONCLUSIONS: In the present paper, we performed a study evaluating HEV infection in 52 sporadic non-A-C acute hepatitis cases. All samples were collected from 2004 to 2010 in Italy. By a diagnostic strategy based on genomic and serological assays we identified HEV infections in 23 out of 52 patients (44.2%), a percentage higher than previous estimates. Thus, the actual impact of HEV infections in Italy needs to be further evaluated on a national scale by a diagnostic strategy based on multiple and last generation assays.     

新疆奶牛戊型肝炎病毒RNA检测及序列分析

从新疆两个奶牛场的戊型肝炎病毒(Hepatitis E virus,HEV)抗体检测阳性的奶牛中分别采集牛粪便或肛拭子样品,利用反转录套式聚合酶链反应(RT-nPCR)检测所采集样品中的HEV RNA,结果来自第一个奶牛场的7份牛粪便样品为阳性,阳性率11.67%,来自第二奶牛场的1份肛拭子样品为阳性,阳性率为3.23%。将PCR扩增产物克隆、测序并进行序列分析,结果表明,对应于HEV ORF2 189bp核苷酸序列的8个牛源HEV基因组扩增片段的同源性为96.3%~100.0%,应当属于相同的基因型;它们与HEV 1、2、3和4型ORF2 189bp核苷酸平均同源性分别为78.5%~86.4%,81.7%~83.8%,79.1%~85.3%和84.3%~95.8%,与4型的同源性最高达93.2%~95.8%。基于这些已测序核酸片段绘制的基因进化树显示:本研究中的8株牛源HEV ORF2 189bp核苷酸序列与HEV 4型人源C5株、猪源swC3与swXJ株位于同一进化枝上,同属HEV基因4型,提示新疆奶牛中可能存在HEV感染,并且奶牛可能是人类HEV传染源中除猪之外的新宿主。     

猪戊肝病毒存在准种现象

为研究猪戊肝病毒准种存在情况,采用逆转录-巢式聚合酶链反应法(RT-nested-PCR)对四株猪戊肝病毒(Hepatitis E virus)第2可读框(ORF2)部分序列进行PCR扩增,将产物克隆后,每个毒株分别随机挑取20个阳性克隆测序,进行DNA序列分析。结果显示4株HEV不同克隆间的ORF2核苷酸序列同源性分别为96.8%~99.7%、98.8%~99.7%、98.8%~99.7%和100%,有变异的克隆核苷酸序列与上海株(SAAS-JDY5)同源性为96.8%~100%。由此证实感染戊肝病毒的猪个体内存在HEV准种。     

广州地区急性散发性HEV毒株基因特征和生物学性状的研究

利用ＲＴ－ＰＣＲ技术对我国广州地区急性性戊型肝炎病毒细胞培养分离株Ｇ９３－１、Ｇ９３－２、Ｇ９３－３和Ｇ９３－４基因组聚合酶区部分核苷序列进行检测,ＰＣＲ阳性产物经纯化、克隆后测定。结果Ｇ９３－１、Ｇ９３－３和Ｇ９３－４株病毒的这段序列完全相同,且与我国新疆暴发流行的ＨＥＶ８７Ａ株及ＨＥＶ代表株的同源性为１００％;而Ｇ９３－２株与它们的差异较大,同源性只有７９．９％;但是,它与１９９７年厦门地区急     

Profile of acute infectious markers in sporadic hepatitis E

Laboratory diagnosis of acute infection of hepatitis E virus (HEV) is commonly based on the detection of HEV RNA, IgM and/or rising IgG levels. However, the profile of these markers when the patients present have not been well determined. To clarify the extent of misdiagnosed sporadic hepatitis E in the initial laboratory detection, serial sera of 271 sporadic acute hepatitis cases were collected, detected and the dynamics of each acute marker during the illness course were analyzed. 91 confirmed cases of hepatitis E were identified based on the presentation of HEV RNA, IgM or at least 4 fold rising of IgG levels. 21 (23.1%) hepatitis E cases were false negative for the viral RNA and 40 (44.0%) for rising IgG, because occurrence of these markers were confined to acute phase of infection and viremia had already subsided and antibody level peaked when these patients presented. IgM was detected in 82 (90.1%) cases. It is the most prevalent of the three markers, because the antibody persisted until early convalescence. Nine cases negative for IgM were positive for rising IgG and one was also positive for the viral RNA; all of these nine cases showed high avid IgG in their acute phase sera, which indicated re-infection. In summary, it is not practicable to determine the true occurrence of sporadic hepatitis E. Nevertheless, it could be closely approximated by approach using a combination of all three acute markers.     

Understanding animal welfare

Background

Hepatitis E virus (HEV) is a zoonotic pathogen of which swine was reported as major reservoirs. HEV has been divided into 4 different genotypes according to phylogenetic analysis. Recent reports showed that genotype 4 HEV is freely transmitted between humans and swine in eastern China, including Shanghai area. This paper investigated the recent infection status of HEV among swine population of Shanghai area in China.

Methods

480 swine faecal specimens were collected from 23 farms which distribute all over Shanghai from September to November, 2007 and tested for the presence of HEV RNA by the polymerase chain reaction (PCR).

Results

Our results showed that 26.1% (6/23) of the swine farms were positive for HEV RNA and the positive rate of the six farms were ranged from 9.1% to 33.3%. The HEV RNA positive rate for total samples were 5% (24/480). The resulted positive band specific for HEV was sequenced and sequence analysis indicated that all of these isolates belonged to genotype 4 HEV. Phylogenetic analysis showed that the 24 isolates clustered into 4 distinct subgroups, sharing 83.3–89.7% inter-subgroup and 97–99% intra-subgroup identities. More over, isolates in three of the four subgroups closely clustered with previous identified strains, sharing up high to 97% identity with them.

Conclusion

These results suggested that there were 4 different subgenotypes of HEV prevalent in Shanghai, and some of them may not be indigenous to Shanghai but introduced from other geographic regions.     

First isolation of hepatitis E virus genotype 4 in Europe through swine surveillance in the Netherlands and Belgium

Hepatitis E virus (HEV) genotypes 3 and 4 are a cause of human hepatitis and swine are considered the main reservoir. To study the HEV prevalence and characterize circulating HEV strains, fecal samples from swine in the Netherlands and Belgium were tested by RT-PCR. HEV prevalence in swine was 7-15%. The Dutch strains were characterized as genotype 3, subgroups 3a, 3c and 3f, closely related to sequences found in humans and swine earlier. The HEV strains found in Belgium belonged to genotypes 3f and 4b. The HEV genotype 4 strain was the first ever reported in swine in Europe and an experimental infection in pigs was performed to isolate the virus. The genotype 4 strain readily infected piglets and caused fever and virus shedding. Since HEV4 infections have been reported to run a more severe clinical course in humans this observation may have public health implications.     

TT virus in Hungary: sequence heterogeneity and mixed infections

The majority of the viral hepatitis cases is caused by five hepatitis viruses (A,B,C,D,E). In 1997, TT virus was discovered. It was supposed that a number of the unknown hepatitis cases was caused by the TT virus. The aim of this study was to characterize TT viruses carried by healthy individuals and patients suffering from hepatitis of unknown origin in Hungary. TTV DNA was detected by seminested PCR with the commonly used N22 primers. Twenty of the 108 sera (18.5%) taken from healthy persons and 115 of the 228 sera (50.4%) of patients with hepatitis of unknown origin were found to be positive. The nucleotide sequences of 26 clones derived from 17 hepatitis patients and 15 clones from nine healthy persons were determined and a phylogenetic tree was constructed. Genotype 2 (group 1) was found to be the most frequent, but other group 1 genotypes (1, 6) and genotypes 8 and 17 of group 2 were also detected. Mixed TTV infections were found in eight cases (two healthy persons and six hepatitis patients). Variants belonging to the same group were carried in seven cases, and the presence of group 1 (genotype 2) and group 2 (genotype 8) TTV sequences were found in one single hepatitis patient.