广西肝癌高发区人群多种肝炎病毒感染的流行病学研究

EPIDEMIOLOGICAL STUDY ON MULTIPLE HEPATITIS VIRUS INFECTION IN THE POPULATION IN A HEPATOCELLULAR CARCINOMA HIGH INCIDENCE AREA IN GUANGXI

目的 :对广西肝癌高发区健康人群及肝癌患者 HBV、 HCV、 HEV、 HGV感染状况及其与肝癌的关系进行血清流行病学研究。方法 :采用 EL ISA方法检测调查对象血清中 HBs Ag、抗 - HCV、抗 - HEV、抗 - HGV,用 RT- PCR方法检测肝癌患者血清中 HGV- RNA;用成组病例 -对照研究方法分析 HBV、 HCV、 HEV及 HGV感染与肝癌的关系。结果 :HBV、 HCV、 HEV、HGV相应的肝炎病毒感染率 ,健康人群分别为 17.8% (5 1/ 2 87)、 7.3% (2 1/ 2 87)、 6 .6 % (19/ 2 87)和 5 .9% (17/ 2 87) ;肝癌患者分别为 77.8% (2 8/ 36 )、 19.4% (7/ 36 )、 8.3% (3/ 36 )、 13.9% (4/ 36 ) ,HGV- RNA检出率为 13.9% (5 / 36 )。肝癌患者 HBV、HCV感染率高于健康人群 (P <0 .0 5 ) ;研究对象 HBV、HCV、HGV感染率高于广西及国内其他地方的自然人群 ;HBV、HCV、HGV、HEV感染者患肝癌的危险性 (OR)分别为 :11.5 2 ,3.38,2 .2 6和 0 .85。结论 :广西肝癌高发地区HBV、 HCV、 HGV流行较严重 ,再次证实 HBV感染是肝癌重要危险因素 ,其次是 HCV,不能排除 HGV感染与肝癌发生有关 ,HEV感染与肝癌发生无关 ,肝炎病毒感染是广西肝癌高发重要原因之一。

Objective:In order to make a seroepidemiological study on multiple hepatitis virus infection in the population in a hepatocellular carcinoma high incidence area in Guangxi Methods:HBsAg,antibodies to HCV,HGV,HEV in sera among 287 general people and 36 patients with HCC from this area were detected by using enzyme linked immunosorbent assay(ELISA);HGV RNA in sera among the patients was assayed by using nested PCR methods,meanwhile A case control study was carried out to determine the relationship between HBV,HCV,HEV and HGV infection and the occurrance of HCC,and the OR value was evaluated Results:The positive rate of HBsAg,anti HCV,anti HEV,anti HGV in the general people are 17 8%,7 3%,6 6%,5 9%,respectively The rates in the patients are 77 8%,19 4%,8 3% and 11 1%,respectively The seropositive rate of HGV RNA in the patients is 13 9% The prevalence of HBsAg and anti HCV in the patients with HCC is higher than in the general people Meanwhile,the positive rate of the HBsAg,anti HCV and anti HGV is higher in the studied subjects than in the other general population in Guangxi and other region in China The OR value for HBV,HCV,HGV,HEV are 11 52,3 38,2 26,0 82,respectively Conclusion:The prevalence of HBV,HCV,HGV in the HCC high incidence region is higher HBV infection is the most important risk factor of HCC in the area,HCV infection is a less important factor,the relationship betwee HGV and HCC can not be debared There is no relationship between HEV and HCC