新疆地区猪戊型肝炎血清流行病学调查

The purpose of the present study was to determine the prevalence of swine Hepatitis E virus (HEV) infection in Xinjiang. 813 swine serum samples collected from 1 to 12 months of age at 9 swine farms in Xinjiang region were tested by ELISA for the presence of IgG antibodies against HEV. The recombinant protein pUS 166 containing region 452-617aa of the ORF2 of HEV US strain was used as coating antigen. The result showed that anti -HEV IgG were detected in 265 of 405 pigs (65.43%) in one group and 238 of 408 pigs (58.33%) in another group, and that the seropositivity rate was not related to geographic district and breeds, but differed remarkably by age, being 40% among the 1- to 3-month-old piglets, but 77.33% among ones over 3-month-old. It suggested that swine HEV was widespread in different geographic regions of XinJiang.     

连云港市戊型肝炎流行趋势分析

目的分析连云港市戊型肝炎流行特征和变化趋势,为今后制定控制策略提供科学依据。方法采用Excel2007和SPSS13.0软件,用描述流行病学方法进行分析。结果 2004—2012年连云港市戊肝发病率呈上升趋势,年均发病率为3.26/10万,市区发病率高于郊县;病毒性肝炎型别构成中,戊肝的比例逐年上升;发病以中老年为主,45~65岁占52.26%,男性发病率高于女性(5.54∶1),职业构成以农民、工人和离退休人员为主;一年四季均有病例发生,3月、7月出现二个发病小高峰。结论应将戊肝作为该市重点控制的疾病,采取对重点人群预防接种、疫情监测、卫生宣教和饮食、饮水和环境卫生管理等综合性防控措施。     

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.     

新疆阿克苏地区绵羊戊型肝炎血清流行病学调查

对新疆阿克苏地区8县1市7个品种的490份绵羊血清,采用双抗原夹心酶联免疫法检测抗戊型肝炎病毒抗体,比较不同行政区、不同品种及不同年龄段绵羊戊型肝炎病毒抗体阳性率的差异。结果显示,所检测血清总的抗体阳性率为28.98%(142/490)、8县1市的戊型肝炎病毒绵羊抗体阳性率依次为35.44%(28/79)、29.67%(27/91)、20%(4/20)、40%(12/30)、32.5%(26/80)、38%(19/50)、22.5%(9/40)、8%(4/50)、26%(13/50),其中,沙雅县与各行政区之间差异极显著(P0.01);2岁以上绵羊与1岁以下绵羊抗体阳性率依次为38.75%(31/80)和15.45%(17/110),差异极显著(P0.01);不同品种绵羊呈现不同程度的阳性率,其中,蒙古羊与各品种之间差异极显著(P0.01)。由此可见,阿克苏地区所检测绵羊普遍存在HEV既往感染和潜在感染的可能性。     

戊型肝炎研究的若干进展

本文重点简述近年来在戊型肝炎的病原学,临床特征和肝脏病理组织学变化方面的研究进展。     

戊型肝炎检测方法及疫苗研究进展

从ＨＥ及其病原戊肝病毒（ＨＥＶ）研究发现历史开始列举了ＨＥＶ当前主要研究成果。着重论述了有效的检测ＨＥＶ基因、抗原和抗体研究进展。国际上应用于临床诊断、流行病学研究的抗—ＨＥＶ诊断试剂的简况。ＨＥ疫苗的研究已进入临床前阶段,猴体实验结果显示获得高抗体滴度被动免疫可保护试验猴免于ＨＥＶ攻毒后肝炎。主动免疫显示了更完全的保护效果,双剂主动免疫既保护猴免于ＨＥＶ攻毒后肝炎又保护猴免于ＨＥＶ感染     

46例老年性戊型肝炎临床特点

老年性戊型肝炎是一种常见的传染病,临床上以肾功能严重损害为主要表现,肝功能也明显受损,出现黄疸深,瘀胆和皮肤瘙痒等临床表现。我院自1998年8月至2003年6月共收治了老年性戊肝46例,现报告如下。     

中国西藏部分地区猪戊型肝炎病毒流行病学调查

戊型肝炎病毒(Hepatitis E Virus,HEV)感染是一个重要的全球公共卫生问题,而猪被认为是HEV的天然宿主。HEV可以跨种间传播,且已经证实生吃感染的猪肉会导致人感染。在中国西藏许多地区仍然有生吃猪肉、猪肝等的习惯,且不同种家畜混合饲养,极易造成HEV感染和传播。然而中国西藏地区猪HEV流行情况报道甚少。文中对中国西藏5个地区市(拉萨、日喀则、山南、那曲和昌都)猪血清进行HEV Immunoglobulin-M(Ig M)和Ig G抗体检测,并通过逆转录巢氏PCR(RT-n PCR)进行HEV RNA检测和定量RT-PCR(q RT-PCR)进行病毒拷贝计算,首次报道了藏猪血清HEV RNA阳性率。结果显示,在西藏猪中HEV有较高的流行趋势。猪血清HEV Ig M抗体阳性率高达7.6%(26/340),HEV Ig G抗体阳性率为1.8%(6/340),HEV RNA阳性率高达7.6%(26/340),血清中病毒拷贝高达1.7×107 copies/m L,而且5个地区有不同的流行趋势。结果表明西藏猪HEV感染情况严重。有关部门应加强管理,以避免人与动物之间的交叉感染和暴发。     

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。     

Genotype Analysis of Hepatitis C Virus among Blood Donors and Inmates in Metro Manila,The Philippines

Antibodies against hepatitis C virus (HCV) were detected in 18 (2.3%) of 800 sera from commercial blood donors and 23 (4.6%) of 502 sera from inmates in Metro Manila, the Philippines. The difference in the antibody prevalence between the two groups was statistically significant (P<0.05). HCV RNA was detected in 14 (78%) of the 18 antibody-positive sera from blood donors and 19 (83%) of the 23 antibody-positive sera from inmates. Genotype analysis revealed that HCV-1b (50%) was most common among blood donors, followed by HCV-1a (36%) and HCV-2a (7%). Among inmates, on the other hand, HCV-1a (68%) was most common, followed by HCV-1b (11%), HCV-2a (5%) and HCV-2b (5%). Overall, HCV-1a and HCV-1b appeared to be predominant among them. Thus, the genotype prevalence in the Philippines was distinct from those in other Southeast Asian countries such as Thailand, Vietnam and Indonesia, and also distinct from those in the Far East including Taiwan, Mainland China and Japan.     

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。     

Hepatitis C Virus Infection-Associated Markers in Sera from Blood Donors in Surabaya,Indonesia

Among 2,233 sera obtained from volunteer blood donors, 259 (11.6%) showed elevated alanine aminotransferase (ALT) levels. A second-generation enzyme-linked immunosorbent assay (ELISA) revealed that 23 (8.9%) of the 259 sera were positive for antibodies against hepatitis C virus (HCV), whereas only 9 (1.4%) of 646 sera randomly collected from blood donors with normal ALT levels were positive (P<0.001). The overall prevalence of anti-HCV antibodies among blood donors was estimated to be 2.3%. HCV RNA was detected in 19 (83%) of the 23 anti-HCV-positive sera with elevated ALT levels, and 8 (89%) of the 9 sera with normal ALT levels. Among the anti-HCV-positive sera, IgM anti-HCV was detected in 5 (22%) of 23 sera with elevated ALT levels and in 2 (22%) of 9 sera with normal ALT levels. All of the IgM anti-HCV-positive sera were positive for HCV RNA, irrespective of ALT levels.     

接触猪职业人群和对照人群戊型肝炎感染率比较研究

近年来戊型肝炎（Hepatitis E,HE）被怀疑是一种人兽共患病,猪是其重要的宿主.通过在HE流行区比较接触猪人群和对照人群HE感染率,评价接触猪对人群的HE感染的风险.在浙江省北部某县采用限制研究对象的群组匹配的横断面调查,对同地区同年龄段的接触猪人群和对照人群进行问卷调查,采集血液并检测抗HE抗体.研究发现,接触猪人群和对照人群的年龄大致相当,但前者男性比例较高.接触猪人群抗HE抗体感染率（254/340,74.71%）明显高于对照人群（319/512,62.30%）.经过分层分析和多因素非条件Logistic回归分析,平衡性别和年龄因素后,接触猪仍能增加约50%人群的HE感染风险.随着接触年数的增加,其风险也增加,接触猪5～14年和15年以上人群分别比对照人群增加65%和157%的HE感染风险.接触猪人群男性、女性和合计的标化感染率分别为72.30%、65.67%和70.92%,均高于对照人群（69.87%、51.82%和60.80%）,尤其以女性更为明显.在HE流行区,接触猪可能增加人群HE感染风险,对女性的影响可能较大,随着接触猪年数的增加HE感染的风险也增加.由于本研究采用病因和结果同时出现的横断面研究,确切的接触猪和HE感染的关系需要建立合适的接触猪人群队列并结合详细的接触猪暴露调查得到阐明.     

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。     

A Bayesian Meta-Analysis on Prevalence of Hepatitis B Virus Infection among Chinese Volunteer Blood Donors

Background

Although transfusion-transmitted infection of hepatitis B virus (HBV) threatens the blood safety of China, the nationwide circumstance of HBV infection among blood donors is still unclear.

Objectives

To comprehensively estimate the prevalence of HBsAg positive and HBV occult infection (OBI) among Chinese volunteer blood donors through bayesian meta-analysis.

Methods

We performed an electronic search in Pub-Med, Web of Knowledge, Medline, Wanfang Data and CNKI, complemented by a hand search of relevant reference lists. Two authors independently extracted data from the eligible studies. Then two bayesian random-effect meta-analyses were performed, followed by bayesian meta-regressions.

Results

5957412 and 571227 donors were identified in HBsAg group and OBI group, respectively. The pooled prevalence of HBsAg group and OBI group among donors is 1.085% (95% credible interval [CI] 0.859%∼1.398%) and 0.094% (95% CI 0.0578%∼0.1655%). For HBsAg group, subgroup analysis shows the more developed area has a lower prevalence than the less developed area; meta-regression indicates there is a significant decreasing trend in HBsAg positive prevalence with sampling year (beta = −0.1202, 95% −0.2081∼−0.0312).

Conclusion

Blood safety against HBV infection in China is suffering serious threats and the government should take effective measures to improve this situation.     

Prevalence of Antibody to Hepatitis E Virus among Healthy Individuals in Southern Taiwan

The seroprevalence of hepatitis E virus (HEV) among 997 healthy individuals aged 6 to 84 years, collected between July 1993 and June 1994 at Kaohsiung-Pingtung area in Southern Taiwan was studied. Of the study populations of vegetable farmers, elementary school children, volunteer blood donors and college students, the prevalence of IgG anti-HEV ranged from 6.4% to 8.8%. In suburban elemantary school children of Mang-Chou Village at Pingtung-Hsien, the seroprevalence rate (9.6%) was significantly higher than the positive rate (1.5%) found in rural aboriginal elementary school of San-Min Village at Kaohsiung-Hsien. IgG anti-HEV antibodies were widely distributed among all age groups, with a significantly higher percentage (13.1%) in the age group of 46-55 years old.     

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.     

人类T淋巴细胞白血病病毒流行区无偿献血人群筛查研究

人类T淋巴细胞白血病病毒(human T-lym-photropic virus,HTLV)是最早发现的人类逆转录病毒,分为I型和II型。HTLV感染后,会在人体内长期存在,潜伏期长达20年以上,并在多年后引起白血病或下肢瘫痪等致死性或致残性疾病,迄今有效的治疗药物和预防性疫苗仍未研制成功[1]。因此,唯一积极的控制办法就是及时发现HTLV感染者,并采取措施切断其传播途径。由于HTLV可经血传播,日本、美国、澳大利亚、法国及其它一些国家和地区已将其列为献血员必检项目之一,但我国各地均一直未开展此项目。自1986年以来,我国先后在多个省、市发现了HTLV感染…