摘要
目的 最近在输血后肝炎病人中发现了一种新型肝炎病毒 ,并命名为输血传播的病毒即TTV。我们在一次经肠道传播的非甲非戊型肝炎暴发流行的病人粪便和血清中也检测到了这一病毒。本文旨在于回顾这种新型病毒的流行病学特征和实验感染。方法 主要收集我们的资料 ,并参照世界各地有关论著。结果 在一次经肠道传播的非甲非戊型肝炎的暴发流行中 ,从 381名学生 (6 0 7% )的血清和粪便标本中检测到TTV病毒的片段 ,该职校中无症状携带者的血清阳性率为 32 1% ,而粪便阳性率为 2 4 6 % ,提示有潜在的传染源存在。来自中国北方与南方的两个偏远农村人群流行病学调查 ,其阳性率分别为 9 2 %和 10 6 % ,表明中国是TTV感染的地方性流行区。我们用TTV阳性肝炎病人的粪便滤过液分别经灌胃和静脉接种两种途径成功地使两组恒河猴 (每组 3只 )感染了TTV ,并对其中两只恒河猴进行了研究 ,分别在它们的肝、脾、小肠和结肠组织中检测到TTV ,而单链的复制中间体 ,仅仅在肝和小肠中检测到。结论 这种无包膜的DNA病毒可能经血液和肠道途径传播 ,根据其广泛分布和高的流行率 。
Objective To detect the virus in the feces and sera of patients in an outbreak of enterically transmitted non-A,non-E hepatitis,and this review covers the epidemiologic features and experimental infection of this novel virus.Data sources Data sources come from our own work on this subject,published and unpublished.Study selection Mainly our own work is included,and related literature is collected.Results In an outbreak of enterically transmitted non-A-E hepatitis among students,a total of 381 cases (60.7%)were documented.Viral fragments identical to transfusion transmitted virus(TTV)were detected in both serum and stool samples.Asymptomatic virus carriers among the staff had positive serum(32.1%)and feces(24.6%),clearly a potential source of infection.This viral infection prevalence in 2 remote villages in northern and southern China was 9.2% and 10.6%,respectively,suggesting that China is an endemic area.In this study,groups of 3 Rhesus monkeys were infected via oral or intravenous inoculation with patient feces.Two additional monkeys were infected by passage.The virus was detected in serum,peripheral blood mononuclear cell(PBMC),liver,spleen and small intestine,while the virus positive single strand,which might be a replicative intermediate,was only in liver,intestine and PBMC of all animals.Conclusions This nonenveloped DNA virus might be transmitted both by blood and enteric routes.Considering its wide distribution and high prevalence,we suppose that nonparenteral transmission is more important.
基金
ThisworkwaspartiallyfundedbyagrantfromHealthBureauofPLA(98Z0 73 )
