医院工作人员丙型病毒性肝炎全球流行情况

丙型肝炎病毒（HCV）是导致非甲、非乙型肝炎的重要原因,属于基因组高度变异的RNA病毒,可逃避宿主免疫监控和免疫清除,且容易进展成为慢性肝脏疾病[1]。HCV可通过血液、性和母婴的传播方式感染健康人群[2]。该型肝炎起病及进展较隐匿,一般（70%）情况下感染初期很少出现乏力、食欲减退、黄疸等临床症状,且仅有约15%感染人群可自发清除病毒,另外约85%感染人群会进展至慢性丙型病毒性肝炎[3],

西安市血液供受者HCV感染状况调查分析

目的:了解西安市血液供-受者人群丙型肝炎病毒(HCV)感染状况,为进一步制订防控措施、保障临床安全用血提供依据。方法:对2000～2009年西安市西京医院约40万份供、受血者HCV抗体检测结果及供血者ALT检测结果,按年份和性别进行统计分析。结果:西安市供血者HCV抗体阳性率为0.47%,女性高于男性,年阳性率逐年下降;受血者HCV抗体阳性率为1.92%,无性别差异,年阳性率逐年下降;供血者ALT阳性率为1.68%,男性高于女性,年阳性率逐年上升。结论:西安地区对HCV防控措施已见成效,供、受血者HCV抗体阳性率逐年降低,临床用血安全进一步得到保障。

Epidemiology of hepatitis C virus infection

Globally, hepatitis C virus (HCV) has infected an estimated 130 million people, most of whom are chronically infected. HCV-infected people serve as a reservoir for transmission to others and are at risk for developing chronic liver disease, cirrhosis, and primary hepatocellular carcinoma (HCC). It has been estimated that HCV accounts for 27% of cirrhosis and 25% of HCC worldwide. HCV infection has likely been endemic in many populations for centuries. However, the wave of increased HCV-related morbidity and mortality that we are now facing is the result of an unprecedented increase in the spread of HCV during the 20th century. Two 20th century events appear to be responsible for this increase; the widespread availability of injectable therapies and the illicit use of injectable drugs.

Epidemiology and transmission of hepatitis B and C viruses in Kazakhstan

AIM: To investigate the epidemiology of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection in the two major ethnic groups in Kazakhstan. METHODS: A cross-sectional prospective study of HBV and HCV seroprevalence was performed among individuals born in Kazakhstan with no history of chronic hepatitis or liver disease. RESULTS: There were 290 volunteers (140 Russians and 150 Kazakhs) aged 10 to 64 years, males accounted for 46%. Active HBV infection (HBsAg positive) was present in 3.8%, anti-HBc in 30%. The prevalence was similar in females and males (33% vs 25%) (P = 0.18). The prevalence of anti-HBc increased from 19% in 10-29 years old volunteers to 53% in 50-years and older volunteers. The prevalence of HBV infection was higher in married than in single adults (38% vs 26%, respectively) (P = 0.2) and more common in Kazakhs (35%) than in Russians (24%) (P = 0.07). HCV infection was present in 9 subjects (3.2%), 5 of them also were positive for anti-HBc in the absence of HBsAg. CONCLUSION: The frequency of active HBV infection (3.8%) coupled with a high prevalence of HBV exposure in those > 50 years of age increases with age, which suggests that horizontal transmission likely relates tothe use of contaminated needles. The low prevalence of HCV infection suggests that HBV and HCV are acquired differently in this group of subjects.

Seroepidemiology of hepatitis C and its risk factors in Khuzestan Province, South-West of Iran:A case-control study

AIM：To evaluate possible risk factors for the spread of hepatitis C infection and to analyze the characteristics of the epidemiological and clinical patterns among the patients with hepatitis C infection. METHODS： During a five-year period a cross-sectional study was conducted among HCV positive individuals referred to the Ahwaz JundiShapour University Hospitals （AJSUH） and Hepatitis Clinic from 1 Sept 1999 to 1 Sept 2003. The control group consisted of first time blood donors referred to the Regional Blood Transfusion organization. Enzyme-linked immunosorbent assay and recombinant immunoblot assay anti-hepatitis C virus （HCV） tests were performed for two groups. Positive serum specimens were retested using polymerase chain reaction （PCR） for HCV RNA. Risk factors were evaluated using a questionnaire. Reported risk factors among infected subjects （＂HCV-positive＂） were compared to those of subjects never exposed （＂HCV-negative＂） to HCV. RESULTS： A total of 514 subjects were studied for HCV, of which 254 were HCV-positive and 260 HCV- negative donors comprised the control group. Mean age of the patients was 28.4 （Std 15.22） years. HCV-positive subjects were more likely to be of male gender （63% versus 37%）. Transfusion 132 （52%）, non-intravenous （n-iv） drug abuse and iv drug abuse 37 （14.5%）, haemodialysis 25 （10%）, receiving wounds at war and extramarital sexual activities （2.4%）, tattooing （3.6%） were found to be independent risk factors of being HCV-positive. No apparent risk factors could be demonstrated in 29 （11.2%） of the positive cases. CONCLUSION： Our data indicate that a history of transfusion and iv drug abuse and haemodialysis are important risk factors for HCV infection in our area and that more careful pretransfusion screening of blood for anti- HCV must be introduced in our blood banks. Improvements in certain lifestyle patterns, and customs in this area may be essential to prevent transmission of the infection.

Prevalence of hepatitis B and C markers among refugees in Athens

AIM: To assess the prevalence of hepatitis B and C serological markers in a population of refugees living in Athens.METHODS: One hundred and thirty refugees (81 males and 49 females, mean age ±SD: 31.7±8 years) were included in the study. The hepatitis B virus surface antigen (HBsAg),the hepatitis B virus core antibody (anti-HBc) and the hepatitis C virus antibody (anti-HCV) were detected using a third-generation immunoassay.RESULTS: Twenty individuals (15.4%) were HBsAg positive and 69 (53.1%) were anti-HBc positive. The prevalence of HBsAg and anti-HBc was higher among refugees from Albania and Asia (statistical significant difference, P＜0.008 and P＜0.001 respectively). The prevalence of these markers was found irrelevant to age or sex. Anti-HCV was detected in the serum of 3 individuals (2.3 %). No differences among age, sex or ethnicity regarding anti-HCV prevalence were found.CONCLUSION: It can be concluded that refugees living in Athens are an immigrant population characterized by a high incidence of HBV infection. The prevalence of HBV markers is higher among refugees from Albania and Asia. It is therefore believed that the adherence to general precautions and the initiation of HBV vaccination programs will be necessary in the future, especially in these communities.Although the prevalence of HCV infection seems to be relatively low, extended epidemiological surveys are needed to provide valid results.

Prevalence of hepatitis C virus infection and its related risk factors in drug abuser prisoners in Hamedan-Iran

AIM:Recent studies in Iran has shown that prevalence of hepatitis C virus (HCV) infection among Iranian prisoners is high, in spite of low HCV seroprevalence in general population. METHODS: This study was carried out in the central prison of Hamedan - Iran, in year 2002. Inmates were interviewed using a standard questionnaire including demographic, imprisonment history and HCV-related risk behaviors items. Thereafter, the sera drawn from the participants were tested for anti-HIV and anti-HCV antibodies. RESULTS: A total number of 427 drug abuser inmates participated in our study. Three hundred and ninety-seven (93%) were men and 30 (7%) were women. Total number of IV drug abusers (IDA) and non-IV drug abusers (NIDA) was 149 (34.9%) and 278 (65.1%), respectively. The overall rate of antibody positivity among inmates was 0.9% for HIV and 30% for HCV. Of all IDAs, 31.5% and of NIDAs, 29.1% had serological evidence of HCV infection. CONCLUSION: The seroprevalence of HCV infection among drug abuser prisoners in comparison with the general population in Iran, is very high (30% vs in italics 0.2%). Our results indicate the importance of policies to prevent transmission of HCV infection during and following incarceration.

Sustained virological response based on rapid virological response in genotype-3 chronic hepatitis C treated with standard interferon in the Pakistani population

AIM:To document the sustained virological response (SVR) in rapid virological responders (RVR) of genotype-3 chronic hepatitis C with standard interferon (SdIF). METHODS:Hepatitis C genotype-3 patients during the period July 2006 and June 2007 were included. Complete blood counts, prothrombin time, ALT, albumin, qualitative HCV RNA were done. SdIF and ribavirin were given for 4 wk and qualitative HCV RNA was repeated. Those testing negative were allocated to group-A while the rest were allocated to group-B. Treatment was continued a total of 16 and 24 wk for group A and B respectively. HCV RNA was repeated after 24 wk of treatment. End virological and sustained virological responses were compared by χ2 test. ROC of pretreatment age, ALT and albumin were plotted for failure to achieve SVR. RESULTS:Of 74 patients treated, RCV RNA after 16 wk of therapy became undetectable in 34 (45.9%) and was detectable in 40 (54.1%) and were allocated to groups A and B respectively. SVR was achieved in 58.8% and 27.8% in groups A and B respectively. SVR rates were significantly higher in patients who had RVR as compared to those who did not (P = 0.0;γ = 2). Both groups combined ETR and SVR were 70% and 33% respectively. ROC plots of pretreatment age, ALT and albumin for SVR showed only ALT to have a significantly large area under the curve.CONCLUSION:SVR rates were higher in patients who had RVR with SdIF and high pre treatment ALT values correlated to probability of having RVR.

吸毒人群ALT异常与丙肝病毒感染情况调查

目的:了解静脉吸毒人群丙氨酸氨基转氨酶(ALT)异常与丙型肝炎病毒(HCV)感染之间的关系,为控制丙型肝炎的传播提供科学依据。方法:用连续监测法检测ALT,同时用酶联免疫吸附法试验(ELISA)进行丙型肝炎病毒抗体(抗-HCV)的检测,并与同期检测的ALT,抗-HCV的对照组进行比较。结果:215例吸毒人员ALT异常,显著高于300例对照组,两组比较结果的差异有统计学意义(P<0.05)。215例吸毒人员HCV感染率为56%与对照组感染率1.3%之间的差异有统计学意义(P<0.05)。结论:吸毒者有明显的肝功能损害,吸毒者HCV感染情况比较严重,吸毒者ALT的异常与HCV感染有显著的关系。