天津铁路疾控中心辖区内戊型肝炎病毒感染状况

Infection status of HEV in the area under jurisdiction of Tianjin Railway CDC

目的调查天津铁路疾病预防控制(疾控)所辖区内从业人员戊型肝炎病毒(HEV)感染情况,探讨戊型肝炎感染与人群年龄、性别、地区及职业分工、水源环境之间的关系。方法选取2012—2013年在北京铁路局天津铁路疾控中心进行预防性健康检查的从业人员共计9 897人,按照年龄、性别、地区、职业分工、水源环境不同分组,检测血清中抗HEV-Ig M和抗HEV-Ig G,以及丙氨酸氨基转移酶(ALT)和总胆红素(TBil),并对血清中抗HEV-Ig M阳性者血清和粪便标本进行HEV RNA的提取。结果辖区内从业人群抗HEV-Ig M阳性率为0.283%,性别、年龄组地区间差异均无统计学意义(均P>0.05)。抗HEV-Ig G的阳性率为36.05%,男性HEV感染率明显高于女性(P<0.05),随着年龄增加阳性率也增长(P<0.05)。而抗HEV-Ig G阳性率在地区间差异有统计学意义。ALT和TBil 2项生化指标,抗HEV-Ig M阳性组比阴性组显著降低(P<0.05),而抗HEV—Ig G阳性组与阴性组无显著差异(P<0.05)。从事食品工作组抗HEV-Ig M阳性率最高,而供水组抗HEV-Ig G阳性率最高,各组有显著差异(P<0.05)。集中式供水组和分散式供水组之间抗HEV-Ig M阳性率无明显差异,但抗HEV-Ig G阳性率差异有统计学意义。28例抗HEV-Ig M阳性血清标本中有1份血清标本HEV RNA阳性,有4例粪便标本HEV RNA阳性。结论该辖区内HEV的新近感染率在性别、年龄间无显著差异,但既往感染率男性高于女性,并随年龄增长而增高。辖区内从业人群感染HEV均为隐性感染。HEV新近感染可能主要通过食物传播,而既往感染可能以水源传播为主。HEV的主要传播方式为粪—口途径,但血液传播的可能并不能排除。

[Objective]To investigate hepatitis E virus （HEV） infection situation of employees in the area under the jurisdiction of Tianjin Railway CDC, and explore the relationship between HEV infection and age, gender, region , occupation and division, water-supply environment.[Methods]A total of 9 897 employees, who received preventive health examination in Tianjin Railway CDC of Beijing Railway bureau from 2012-2013, were selected and divided into different groups, according to different ages, genders, occupation, region division, water-supply environment, to detect serum anti HEV-IgM, anti HEV-IgG, alanine aminotransferase （ALT） and total bilirubin （TBil）, while the serum and feces samples of employees with anti HEV-IgM positive were extracted for HEVRNA. [Results]The positive rate of anti HEV-IgM was 0.283% , there was no significant differences between the genders, age groups, regions （all P〉0.05 ）.The positive rate of anti HEV-IgG was 36.05%, the male infection rate of HEV was significantly higher than that of female （P〈0.05）. The positive rate increased with the growth of age （P〈0.05）. The positive rate of anti HEVIgG was significantly different between regions. The biochemical indexes of ALT and Tbil in anti HEV- IgM positive group was significantly lower than the negative group （P〈0.05）, while no significant difference was found between anti HEV-IgG positive group and negative group （P〉0.05）. Anti HEV-IgM positive rate in the food group was the highest, while anti HEV-IgG positive rate in the water-supply group was the highest. There was significant difference in each group （P〈0.05）. There was no significant difference of anti HEV-IgM positive rate between the centralized water-supply group and decentralized water-supply group, while the difference of anti HEV-IgG positive rate in 2 groups was significant（P〈0.05 ）. Twenty eight cases of anti HEV-IgM positive serum samples and feces samples was detected in order to extract HEY RNA, 1 serum sample was HEV RNA positive, 4 feces samples were HEV RNA positive. [Conclusion]The HEV infection rate has no significant difference in gender, age, but the past infection rate is higher in male than female, and increased with age growth. HEV infection of employees in the jurisdiction was recessive. HEV recent infection may spread by food, while the past infection may spread mainly by water. The major way of HEV transmission is fecal-oral route, but blood transmission may not be excluded.