各型肝炎病毒单纯及重叠感染的研究

Detection and analysis of HAV-HEV, HGV infection in patients with viral hepatitis

目的 探讨病毒性肝炎患者甲～戊、庚型肝炎病毒(HAV～HEV、HGV)单纯感染及重叠感染情况。方法 采用EIA法检测病毒性肝炎患者血清抗-HAV IgM、HBV标志物、抗-HCV IgM、抗-HDV IgM、抗-HEV IgM、抗-HGV IgM。结果 共检测210例病毒性肝炎患者HAV～HEV、HGV血清标志物,20例未检出(9.5％),190例患者检出标志物阳性(90.5％)。HBV感染率89.5％(188/210,其中有34例为既往感染,占16.2％,现症感染154例,占73.3％);HAV感染率29.0％(61/210),HCV、HDV感染率均为8.1％(17/210)、HEV、HGV感染率依次为10.0％(21/210)、7.1％(15/210)。各临床类型中单纯感染占61.4％(129/210),二重感染占32.4％(68/210),以HAV+HBV、HBV+HDV、HBV+HEV感染模式最常见,三重感染占6.2％(13/210),以HAV+HBV+HDV感染模式最常见;临床上以肝炎肝硬化、重型肝炎重叠感染常见,急性肝炎最少见。结论 病毒性肝炎中HBV感染最常见,其次为HAV感染;单纯感染、二重感染多见,三重感染少见;重叠感染发生率随病情加重而增加。

Objective To study the simple infection and super/co-infection of HAV-HEV, HGV in patients with viral hepatitis. Method Using EIA method to detect anti-HAV IgM, HBV serum markers, anti-HCV IgM, anti-HDV IgM, anti-HEV IgM, anti-HGV IgM in viral hepatitis patients with different clinical types. Results Seventy-three percent patients(154/210) had HBV infection markers, twenty-nine percent patients(61/210) had HAV infection marker, eight percent patients(17/210) had HCV, HDV infection markers, ten percent patients(21/210) had HEV infection and seven percent patients(15/210) had HGV infection. Only nine percent patients(20/210) had viral hepatitis serum markers negative. In all clinical types, sixty-one percent patients had only one type hepatitis virus infection, thirty-two percent patients had two types of hepatitis virus super/co-infection, six percent patients had three types of hepatitis virus super/ co-infection. Super/co-infection often occurred in patients who had cirrhosis or hepatic failure. Conclusions HBV and HAV infection is very common in viral hepatitis patients, whereas HCV, HDV, HEV and HGV infection is relatively low; double super/co-infection of HAV-HEV, HGV frequently occurs in severe patients with viral hepatitis.