肝病患者肝炎病毒感染状况的血清学调查

Seroepidemiological Investigation of Hepatitis C Virus Infection in Patients With Liver Diseases in China

应用第二代抗ＨＣＶ试剂对我国不同地区肝病患者血清抗ＨＣＶ进行了检测，同时调查了ＨＢＶ和 ＨＡＶ感染状况。 ２０１６例肝病患者血清中抗 ＨＣＶ检出率为 １２． ２５％，ＨＢＶｍ 检出率为 ７４． ５５％，抗 ＨＡＶ－ＩｇＭ检出率为２９．３１％。各型肝病患者抗ＨＣＶ检出情况分别是：急性肝炎６２／７５２（８．２４％）；慢迁肝４８／５４１（８．８７％）；慢活肝９３／５２３（１７．７８％），慢性重症肝炎５／３２（１５．６３％）；肝硬化３４／１４３（２３．７８％）；肝癌５／２５（２０． ００％）。对不同年龄组肝病患者抗 ＨＣＶ检出率的比较表明，抗 ＨＣＶ检出率随患者年龄增加而增高。受血史及其他经血液暴露史与 ＨＣＶ感染密切相关，但仍有近半数肝病患者 ＨＣＶ感染途径不明。各型肝病患者中仅４７／２０１６（２．１３％）为单纯ＨＣＶ感染，其他ＨＣＶ感染者则为重叠感染。不同地区肝病患者血清抗ＨＣＶ检出率间差异较大（２．１５％～３０．９５％），北方地区较高，对其影响因素进行了探讨。

Using the second generation anti- HCV ELISA kits, the antibody to hepatitis C virus have been detected in sera of patients with liver diseases in different area of China, meanwhile the status of HBV and HAV infection also have been investigated. Of 2016 liver disease patients, 12. 25% were positive for anti - HCV, 74. 55% were positive for HBV marks,while anti -HAV IgM was detected in 29. 13 %. The prevalence for anti-HCV in different group of patients were: 8. 24% among acute hepatitis, 8. 89% among chronic persistent hepatitis, 17. 78% among chronic active hepatitis, 15. 63% among chronic severe hepatitis, 23. 78% among liver cirrhosis and 20. 00% among hepatocellular carcinoma. Furthermore, the positive rate of anti - HCV among elder patients was higher than that of younger. HCV infection was closely related to transfusion and other direct exposure to blood, but inapparent transmission of HCV was documented in almost fifty percent of the patients. Most of HCV infected patients in this study were superinfected with HBV and/ or HAV, except 2. 13% of the subjects were infected with HCV only. The differences of anti-HCV prevalence in patients from different area of China were apparent and presented a tendency which showed the anti - HCV prevalence was higher in northern area and lower in southern area of China.