肝病患者中庚型肝炎病毒感染的检测

Detection of GBV-C/HGV infection in patients with liver diseases

目的探讨临床肝病病人中庚型肝炎病毒（ＧＢＶ－Ｃ／ＨＧＶ）感染情况及临床特点。方法应用庚型肝炎病毒基因组５’ＵＴＲ两对寡核苷酸作为引物，建立逆转录套式聚合酶链反应，检测１６９例不同肝病患者血清标本中ＧＢＶ－Ｃ／ＨＧＶＲＮＡ，并对其中１例ＰＣＲ扩增产物进行克隆及测序。结果１６９例各型肝病病人ＧＢＶ－Ｃ／ＨＧＶＲＮＡ总的检出率为９５％（１６／１６９）。在２９例有手术输血史患者中，３１０％（９／２９）ＧＢＶ－Ｃ／ＨＧＶＲＮＡ呈阳性，明显高于无手术输血史组（５％，Ｐ＜００１）。序列分析显示１株庚肝病毒５’ＵＴＲ部分基因片段与已知庚肝病毒株核苷酸同源性在８９１４％～９８９１％之间。结论ＧＢＶ－Ｃ／ＨＧＶ感染普遍存在于临床肝病患者中，病人感染ＧＢＶ－Ｃ／ＨＧＶ的临床表现未发现有特殊性，ＧＢＶ－Ｃ／ＨＧＶ可能不是非甲～戊型肝炎的主要致病因子。

The aim of this article is to study the prevealence of GBV-C/HGV in patients with liver diseases and the clinical features in patients with (GBV-C/HGV infection. The serum samples were obtained from 169 patients with liver diseases in You An Hospital). Serum GBV-C/HGV RNA was detected by reverse transcription nested polymerase chain reaction (RT-nPCR) using two primer pairs of 5' untranslated region (5'UTR) of HGV. Serum anti-HGV was detected by ELISA simultaneously. The partial GBV-C/HGV genome isolated from one patient was cloned into T vectors and sequenced by dideoxy-mediated chain termination methods. Among 169 patients with various liver diseases, the GBV-C/HGV RNA positive rate was 9.5%(16/169), including 11.1%(1/9) of AHA, 4.1%(3/73) of CHB, 16.2%(6/37) of CHC, 13.3%(2/15) of AH(nonA-E) 12.5%(1/8) of CH(nonA-E) 15.4%(2/13) of LC and 33.3%(1/3) of SH cases. Of 29 patients having a history of surgical operation and transfusion, 9(31.0%) was positive for GBV-C/HGV RNA, which was remarkably higher than those cases without surgical operation and transfusion. The sequence analysis showed that there was 89.14%～98.91% nucleotide identity between our isolate and published GBV-C/HGV isolates. The results also suggested that infection rate of GBV-C/HGV was around 9.5% in patients from Beijing region, patients with GBV-C/HGV infection might show various clinical features and GBV-C/HGV might not be the major cause of hepatitis nonA-E.