大学生病毒性肝炎发病规律与防治对策分析

目的：了解大学新生病毒性肝炎感染情况，为防治工作提供依据。方法：采用ELISA法和赖氏法，对2003—2005年入校新生8016人进行HAV、HBV血清学和肝功能检测：结果：病毒性肝炎感染人数为771人，感染率为9．62％，其中HBV感染者为693人，阳性率为8．65％；HAV感染者为78人，阳性率为0.97％。结论：为预防控制病毒性肝炎在高校内传播，应加强新生中HAV、HBV及ALT的检测，并对易感人群及时注射甲、乙肝疫苗，对学生进行健康教育，普及预防肝炎的基本知识及其他综合防治措施。

“非典”再发时期被隔离人员和医学生心理状态调查

目的了解非典型性肺炎再发时期被隔离人员和医学生的心理健康状况及应对方式。方法采用症状自评量表(SCL-90)对在校大学生和被隔离人员进行心理健康状况测试,同时自编问卷调查受试者在非典型性肺炎应激状态下的应对方式。结果被隔离人员的SCL因子评分均低于全国常模,在校学生的SCL因子评分均低于国内青年组常模,心理状态良好。在校学生心理状态无性别差异,被隔离人员中女性焦虑因子高于男性。在校学生和被隔离人员多能采取积极的应对方式。结论面对非典型性肺炎再发的应激事件采取积极的应对方式可缓解应激压力,其中积极的认知评价和应对活动非常重要。

2006—2015年江苏省泗洪县病毒性肝炎流行病学分析

目的了解该县病毒性肝炎的流行病学特征,为制定防制策略提供依据。方法利用国家疾病监测信息管理系统,采用描述流行病学方法对该县2006—2015年病毒性肝炎疫情资料进行统计分析。结果该县2006-2015年共报告病毒肝炎8360例,年均发病率80.41/10万,死亡4例,病死率0.48‰;甲肝总体呈下降趋势,乙肝、丙肝、戊肝总体呈上升趋势,肝炎类型以乙肝为主,占84.53%;戊肝以2—4月份发病较多,占43.89%,甲肝、乙肝、丙肝均无明显季节性;发病年龄以20~49岁较多,占64.44%,男性发病率高于女性（χ2=1655.68,P〈0.01）,职业以农民为主,占81.16%。结论该县病毒性肝炎防控形势依然严峻,防控策略应以乙肝为重点,关注丙肝和戊肝,应针对重点人群,采取综合防控措施。

1991—2009年江阴市病毒性肝炎流行特征分析

目的分析江阴市病毒性肝炎的流行特征,为完善病毒性肝炎防治对策和措施提供依据。方法对1991—2009年江阴市报告的病毒性肝炎资料进行分析。结果 1991—2009年江阴市病毒性肝炎年平均发病率为52.13/10万,2009年发病率最低,为13.10/10万,比最高的1993年下降90.20%;2009年报告乙肝123例(53.48%)。结论 1991—2009年江阴市病毒性肝炎发病总体呈逐年下降趋势,以接种甲肝疫苗、乙肝疫苗为主的综合性防治措施成效显著;乙肝是病毒性肝炎控制的重点。

Comparison of Multiplex Fluorescent PCR with Serum Type-specific Antibody Detection in Diagnosis of Genital Herpes

Objectives: To compare multiplex fluorescent PCRwith serum type-specific antibody detection in thediagnosis of herpes simplex virus (HSV) infection andto evaluate its significance in the diagnosis of genitalherpes.Methods: We detected HSV infection in 121 speci-mens collected from patients with genital herpesusing both multiplex fluorescent PCR and serum type-specific antibody detection. HSV viral isolation wasused as the standard control.Results: When compared with the viral isolation, thesensitivity and specificity for multiplex fluorescentPCR were 100% and 88.89%, respectively afterdiscrepant analysis. The sensitivity and specificity fortype-specific antibody detection was 77.68 % and77.78 %, respectively. However, the type-specificantibody detected HSV in two asymptomatic patientswhile the multiplex fluorescent PCR couldn’t detectany HSV DNA from those specimens.Conclusions: Multiplex fluorescent PCR is a verysensitive and specific method for detection and typingof HSV in the lesion of genital herpes, it failed todetect HSV DNA from the asymptomatic patients.Serum type-specific antibody detection was a lesssensitive and specific test but could detect the specificantibody from some asymptomatic patients. Thecombination of these two techniques would allow rapid,sensitive and accurate detection and typing of HSVand help clinical diagnosis and epidemiologic survey-ing of genital herpes.

HIV and HCV:from Co-infection to Epidemiology,Transmission,Pathogenesis,and Treatment

Human immunodeficiency virus (HIV) is the infectious agent causing acquired immu-nodeficiency syndrome (AIDS),a deadliest scourge of human society. Hepatitis C virus (HCV) is a major causative agent of chronic liver disease and infects an estimated 170 million people worldwide,resulting in a serious public health burden. Due to shared routes of transmission,co-infection with HIV and HCV has become common among individuals who had high risks of blood exposures. Among hemophiliacs the co-infection rate accounts for 85%; while among injection drug users (IDU) the rate can be as high as 90%. HIV can accelerate the progression of HCV-related liver disease,particularly when immunodeficiency has developed. Although the effect of HCV on HIV infection is controversial,most studies showed an increase in mortality due to liver disease. HCV may act as a direct cofactor to fasten the progression of AIDS and decrease the tolerance of highly active antiretroviral therapy (HARRT). Conversely,HAART-related hepatotoxicity may enhance the progression of liver fibrosis. Due to above complications,co-infection with HCV and HIV-1 has imposed a critical challenge in the management of these patients. In this review,we focus on the epidemiology and transmission of HIV and HCV,the impact of the two viruses on each other,and their treatment.

Anti-hepatitis A seroprevalence among chronic viral hepatitis patients in Kelantan,Malaysia

AIM:To determine the seroprevalence of anti-hepatitis A virus (HAV) antibodies in patients with chronic liver disease (CLD) and to justify the need for hepatitis A vaccination.METHODS:Patients (n=119) were enrolled between July and September 2009.The diagnosis of CLD was based on the presence of viral markers for more than 6 mo.The diagnosis of liver cirrhosis was based on clinical,biochemical and radiological profiles.Patient serum was tested for anti-HAV IgG.RESULTS:The overall anti-HAV seroprevalence was 88.2%.The aetiology of CLD was hepatitis B in 96 patients (80.7%) and hepatitis C in 23 patients (19.3%).Mean age was 44.4 ± 14 years.Patients were grouped according to age as follows:24 (20.2%) patients in the 21-30 years age group,22 (18.5%) in the 31-40 years age group,31 (26.1%) in the 41-50 years age group,23(19.3%) in the 51-60 years age group and 19 (16.0%) patients aged greater than 60 years,with reported seroprevalences of 66.7%,95.5%,93.5%,91.3% and 94.7%,respectively.There was a marked increase of seroprevalence in subjects older than 30 years (P=0.001).CONCLUSION:Our study demonstrated that patients aged greater than 30 years of age were likely to have natural immunity to hepatitis A.Therefore,hepatitis A vaccination may not be routinely required in this age group.

Medical Virology in Malaysia

Virology is a branch of biological science dealing with the study of viruses,and medical virology focuses on the study and control of diseases due to viruses that is of medical importance. The development of medical virology in Malaysia has its beginning in the Institute for Medical Research(IMR) ,following the establishment of the Division of Medical Zoology and Virus Research in the institute on 23 March 1953. The second institution in the country to establish diagnostic and research work in medical virology was Department of Medical Microbiology,Faculty of Medicine,University Malaya. This was followed by University Kebangsaan Malaysia,University Sains Malaysia and University of Sarawak Malaysia. The National Public Health Laboratory(NPHL) is the latest institution to establish a laboratory in 2003 for virus isolation and services to support country surveillance and outbreak investigation of infectious diseases due to viruses. In the field of medical virology,Malaysia contributed substantially in the areas of virus diagnostic services,development and research ranging from survey and documentation on the existence and prevalence of viruses causing diseases in Malaysia,clinical presentation and epidemiological features of virus diseases,evaluation of new diagnostic tests to pathogenesis of viral diseases. Malaysia contributed to the discoveries of at least 12 new viruses in the world. ASEAN plus Three(China,Japan,Republic of Korea) Emerging Infectious Programme was established to overcome the challenges and impact of emerging and re-emerging infectious diseases in this region. Malaysia as the co-ordinator of the laboratory component of the programme,contributed to strengthen the regional laboratory capability,capacity,laboratory-based surveillance and networking. The future of medical virology in Malaysia in terms of integration of diagnostic,reference and research to support the country's need will be enhanced and strengthened with the on-going development of the National Centre for Disease Control and Prevention(CDC Malaysia) which also incorporates a futuristic Special Diagnostic and Reference Laboratory.

Review of AIDS Health Education and Behavioral Interventions in China

Acquired Immune Deficiency Syndrome (AIDS) is an infectious disease caused by HIV It has been epidemic formore than 20 years, but there is no cure of it. Health educationand behavioral interventions are some of the most effectiveapproaches in the control and prevention of AIDS. China isone of the countries with the fastest growing HIVseroprevalence rate, and is facing a widespread epidemic ofAIDS. Currently, high-risk populations such as individualswith multiple sexual partners and intravenous drug users arethe main foci of health education and behavioral interventionsin China. Encouraging results have been observed in manyforms of health education and behavioral intervention. Theapplication of health education and behavioral interventionsmust emerge from scientific evidence, follow a series ofstrategies, be carried out from various perspectives, andrequire the participation of all societal communities.

Risk Factors of Condom Use among Clients of Commercial Sex Workers in Saunas and Beauty Parlors in China

Objectives: To describe and analyze risk factors associatedwith disuse of condoms during commercial sexual intercourseamong clients attending sauna and massage centers. Methods: Selected female sex workers from saunas andbeauty parlors were trained as interviewers. They surveyedclients during provision of sexual services. Informationcollected included customers' demographics, knowledge ofSTDs, rationale for and history of condom use. Risk factorsfor condom usage were assessed though logistical modeling.Results: A total of 50 clients were interviewed. The rates ofcondom usage for last sexual intercourse with commercial andnon-commercial partners were 57% and 53% for clients ofsauna centers and 30% and 40% for clients of beauty parlors,respectively. The choice to use a condom was influenced byclients 60.8% of the time, sex workers 30.4%, and otherfactors 8.8%. The choice against using a condom was decidedupon by clients 69.7% of the time, sex workers 9.1%, andother factors 21.2%. Multivariate analysis showed thateducational level and perception of risk of infection werefactors for condom use. Clients with a high school educationhad a higher condom use rate than those with a middle schooleducation or less. Furthermore, clients who perceived risk ofdisease used condoms more frequently than those who did not.Conclusions: Clients played a significant role in decidingwhether or not to use a condom during commercial sex. Lackof perception of risk is a major factor for not using condoms.A program for promotion of prophylactics targeting bothcommercial sex workers and their clients is recommended.

Epidemiological Investigation and Genetic Characterization of Type 2 PCV2 （Type 2 Porcine Circovirus） in Mexican Commercial Herds

PCV2 （Porcine circovirus type 2） is considered as the essential infectious agent of PMWS （post weaning multisystemic wasting syndrome） in pigs. Serological studies have shown that the virus is ubiquitous. Currently, there are many reports about the epidemiology and genetic characteristics of this virus around the world, but in Mexico it has not been studied. More than 3,500 samples of serum, rectal swabs, tissues and semen of 34 Mexican porcine farms from 10 important producer regions were analyzed by PCR. Results show that 97% of the farms were positive. Both genotypes, PCV2a and PCV2b were detected. It also found that the most prevalent genotype in Mexico is PCV2b. Regarding to amino acid sequence; three major heterogenic regions were present in the positions 59-91,123-136 and 185-210.

Molecular epidemiological characteristics of norovirus gastroenteritis outbreaks in Guangdong province

The purpose of this work is to study the molecular epiderniological characteristics of norovirus gastroenteritis outbreaks in Guangdong. During October 2003 and December 2004, fecal and anal swabs specimens collected from 13 outbreaks of non-bacterial gastroenteritis were tested for nomvirus. Specimens were detected by RT-PCR and sequenced. The descriptive data were also collected. Eight in 13 outbreaks of gastroenteritis were positive for nomvirus. All of 8 virus strains were identified as genogroup Ⅱ but belonged to 3 genotypes. Six strains were G Ⅱ -4 genotype. Nomvirus is a major cause of outbreaks of nonbacterial gastroenteritis in Guangdong province and has a wide distribution. The illness happended from late autumn to winter. The prevalent strains were genogroup Ⅱ virus.

Zika virus and Zika fever

An emerging mosquito-borne arbovirus named Zika virus(ZIKV), of the family Flaviviridae and genus Flavivirus, is becoming a global health threat. ZIKV infection was long neglected due to its sporadic nature and mild symptoms. However, recently, with its rapid spread from Asia to the Americas, affecting more than 30 countries, accumulating evidences have demonstrated a close association between infant microcephaly and Zika infection in pregnant women. Here, we reviewed the virological, epidemiological, and clinical essentials of ZIKV infection.

An update on the management of chronic hepatitis D

Hepatitis D virus(HDV)infection is associated with severe liver-related morbidity and mortality.The prevalence of HDV is rising especially among people who abuse drugs and immigrants from endemic areas.Reliable diagnostic assays with enhanced sensitivity and specificity are essential for screening at-risk populations.Until recently,interferon has been the only treatment for hepatitis D.Its efficacy is,however,limited and it is associated with significant side effects.A number of novel antiviral agents that target various stages of the HDV life cycle show promising results.They are currently in different phases of clinical development.This review focuses on the changing epidemiology,novel therapeutic agents,and updated management of chronic hepatitis delta.