我国丙型和戊型肝炎人群流行病学调查及流行因素的研究

Studies on epidemiology of the population with HCV and HEV infections and their epidemic factors in China

为阐明丙型和戊型肝炎在我国的流行严重度和流行规律 ,采用描述流行病学、血清流行病学和分子流行病学相结合的研究方法 ,对两型肝炎的流行特征和流行因素进行了研究。结果发现 :一般人群调查近 9万人丙型肝炎和戊型肝炎的流行率各为 2 .2 %和 9.7% ,散发性急性病毒性肝炎感染比率各为 2 .15%和 16.4 %。丙型肝炎在我国主要经血传播 ,与血液接触密切人群中 HCV感染率高达 50 %～70 % ,慢性化比例高达 4 0 %～ 60 % ,目前供血者中 2 0 % HCV感染者不能用抗 - HCV检出。HEV则以粪 -口途径传播为主 ,孕妇病死率高达 12 %以上。我国 HCV基因型以 1b和 2 a为主 ,HEV毒株接近缅甸株。结果提示我国也是丙型和戊型肝炎高发区 ,当前对丙型肝炎的控制除了供血员全面筛查抗 - HCV外 。

To study the seriousness of epidemic, epidemiological features of HCV and HEV in China, a combination methodology of descriptive epidemiology, sero epidemiology and molecular epidemiology was employed. Results showed that the HCV and HEV prevalences were 2.2% and 9.7% respectively in the general population (about 90 000 persons investigated), whereas the ratio of HCV and HEV infections in sporadic acute viral hepatitis cases was 2.15% and 16.4% respectively. The major mode of transmission of HCV was blood contacts, the HCV infection rates in the groups with frequent blood contacts were up to 50%～70%. The chronicity from acute HCV hepatitis was between 40%～60%, and about 20% of HCV infections in blood doners could not be detected. The oral fecal route of fransmission was predominant in HEV and the morbidity rate of HEV in pregnant women reached more than 12%. It was noted that the genotyping of HCV isolates in China was mainly of 1b and 2a, whereas the molecular epidemiology of Chinese HEV strains was close to that of Burmese. In conclusion, China is also proved to be a hyperendemic area of HCV and HEV. At present the control of HCV infection in china should be emphasized to strengthen overall directions of blood management and rapid establishment of non paid donation as well as all blood donors for HCV screening.