TT virus and hepatitis G virus infections in Korean blood donors and patients with chronic liver disease

AIM:To determine the prevalences of TTV and HGV infections among blood donors and patients with chronic liver disease in Korea,to investigate the association of TTV and HGV infections with blood transfusion,and to assess the correlation between TTV and HGV viremia and hepatic damage. METHODS:A total of 391 serum samples were examined in this study.Samples were obtained from healthy blood donors(n=110),hepatitis B surface antigen(HBsAg)-positive donors(n=112),anti-hepatitis C virus(anti-HCV)-positive donors(n=69),patients with type B chronic liver disease (n=81),and patients with type C chronic liver disease(n=19). Trv DNA was detected using the hemi-nested PCR.HGV RNA was tested using RT-PCR.A history of blood transfusion and serum levels of alanine aminotransferase(ALT)and aspartate aminotransferase(AST)were also determined. RESULTS:TTV DNA was detected in 8.2%of healthy blood donors,16.1%of HBsAg-positive donors,20.3%of anti- HCV-positive donors,21.0%of patients with type B chronic liver disease,and 21.1%of patients with type C chronic liver disease.HGV RNA was detected in 1.8%of healthy blood donors,1.8%of HBsAg-positive donors,17.4%of anti-HCV-positive donors,13.6%of patients with type B chronic liver disease,and 10.5%of patients with type C chronic liver disease.The prevalence of TTV and HGV infections in HBV- or HCV-positive donors and patients was significantly higher than in healthy blood donors(P<0.05), except for the detection rate of HGV in HBsAg-positive donors which was the same as for healthy donors.There was a history of transfusion in 66.7%of TTV DNA-positive patients and 76.9%of HGV RNA-positive patients(P<0.05).No significant increase in serum ALT and AST was detected in the TTV or HGV-positive donors and patients. CONCLUSION:TTV and HGV infections are more frequently found in donors and patients infected with HBV or HCV than in healthy blood donors.However,there is no significant association between TTV or HGV infections and liver injury.

Clearance of HCV RNA in peripheral blood mononuclear cell as a predictor of response to antiviral therapy in patients with chronic hepatitis C

BACKGROUND: The resolution of hepatitis C, evidenced by normalization of liver function and disappearance of hepatitis C virus RNA from serum as determined by conventional laboratory assays, reflects virus eradication. But in interferon treated patients the HCV RNA in serum sometimes could not show the virus in cells. Such factors as virus genotype, HCV RNA contents in serum, HCV specific cellular immunities after treatment were reported to predict the response to interferon therapy. In most patients, HCV RNA could detect the virus in peripheral blood mononucle-ar cell. The aim of this study was to investigate the predictive value of HCV RNA in PBMC of patients with chronic hepatitis C after interferon treatment. METHODS: Sixteen patients with chronic hepatitis C were treated with interferon for 24 weeks, and they all get complete responses at 12 weeks of treatment. At the end of treatment, the HCV RNA in PBMC and serum were detected by RT-PCR, and after stopping treatment, HCV RNA in serum was monitored continually. RESULTS: In 9 patients who were HCV RNA positive in their PBMC at the end of treatment, 8 showed serum HCV RNA positive after 24 weeks and another 1 after 1 year. In 7 patients with negative HCV RNA in their PBMC, only 2 patients relapsed in serum HCV RNA after 1-year follow-up, and others remained viral response after 3.5 years. CONCLUSION: HCV RNA in PBMC at the end of IFN treatment is a predictor of durable response to antiviral therapy in patients with chronic hepatitis C.

TT viral infection through blood transfusion:retrospective investigation on patients in a prospective study of post-transfusion hepatitis

AIM To investigate the role of bloodtransfusion in TT viral infection(TTV).METHODS We retrospectively studied serumsamples from 192 transfusion recipients whounderwent cardiovascular surgery and bloodtransfusion between July 1991 and June 1992.Allpatients had a follow-up every other week for atleast 6 months after transfusion.Eightyrecipients received blood before screeningdonors for hepatitis C antibody(anti-HCV),and112 recipients received screened blood.Recipients with alanine aminotransferase level】2.5 times the upper normal limit were testedfor serological markers for viral hepatitis A,B,C,G,Epstein-Barr virus and cytomegalovirus.TTV infection was defined by the positivity forserum TTV DNA using the polymerase chainreaction method.RESULTS Eleven and three patients,whoreceived anti-HCV unscreened and screened'blood,respectively,had serum ALT levels】90 IU/L.Five patients(HCV and TTV:1;HCV,HGV,and TTV:1;TTV:2;and CMV and TTV:1)were positive for TTV DNA,and four of them hadsero-conversion of TTV DNA.CONCLUSION TTV can be transmitted viablood transfusion.Two recipients infected byTTV alone may be associated with the hepatitis.However,whether TTV was the causal agentremains unsettled,and further studies arenecessary to define the role of TTV infection inchronic hepatitis.

HCV-RNA positivity in peripheral blood mononuclear cells of patients with chronic HCV-infection: does it really mean viral replication?

AIM: To analyze the association of HCV-RNA with peripheral blood mononuclear cells (PBMC) and to answer the question whether HCV-RNA positivity in PBMC is due to viral replication. METHODS: HCV-RNA was monitored in serum and PBMC preparations from 15 patients with chronic HCV infection before, during and after an IFN-alpha therapy using a nested RT/PCR technique. In a second approach, PBMC from healthy donors were incubated in HCV positive plasma. RESULTS: In the IFN-alpha responding patients,HCV-RNA disappeared first from total RNA preparations of PBMC and then from serum. In contrast, in relapsing patients, HCV-RNA reappeared first in serum and then in PBMC. A quantitative analysis of the HCV-RNA concentration in serum was performed before and after transition from detectable to non detectable HCV-RNA in PBMC-RNA and vice versa. When HCV-RNA was detectable in PBMC preparations, the HCV concentration in serum was significantly higher than the serum HCV-RNA concentration when HCV-RNA in PBMC was not detectable. Furthermore, at no time during the observation period was HCV specific RNA observed in PBMC, if HCV-RNA in serum was under the detection limit. Incubation of PBMC from healthy donors with several dilutions of HCV positive plasma for two hours showed a concentration dependent PCR positivity for HCV-RNA in reisolated PBMC. CONCLUSION: The detectability of HCV-RNA in total RNA from PBMC seems to depend on the HCV concentration in serum. Contamination or passive adsorption by circulating virus could be the reason for detection of HCV-RNA in PBMC preparations of chronically infected patients.

Interleukin-6-174G/C polymorphism is associated with a decreased risk of type 2 diabetes in patients with chronic hepatitis C virus

BACKGROUND Chronic hepatitis C(CHC)is associated with type 2 diabetes mellitus.Although the pathogenesis remains to be elucidated,a growing evidence has suggested a role of pro-inflammatory immune response.Increased serum concentrations of Interleukin 6(IL-6)have been associated with insulin resistance,type 2 diabetes mellitus as well as advanced forms of liver disease in chronic hepatitis C infection.AIM To investigate the frequency of IL-6-174G/C(rs1800795)single nucleotide polymorphism(SNP)in CHC patients and in healthy subjects of the same ethnicity.Associations between type 2 diabetes mellitus(dependent variable)and demographic,clinical,nutritional,virological and,IL-6 genotyping data were also investigated in CHC patients.METHODS Two hundred and forty-five patients with CHC and 179 healthy control subjects(blood donors)were prospectively included.Type 2 diabetes mellitus was diagnosed according to the criteria of the American Diabetes Association.Clinical,biochemical,histological and radiological methods were used for the diagnosis of the liver disease.IL-6 polymorphism was evaluated by Taqman SNP genotyping assay.The data were analysed by logistic regression models.RESULTS Type 2 diabetes mellitus,blood hypertension and liver cirrhosis were observed in 20.8%(51/245),40.0%(98/245)and 38.4%(94/245)of the patients,respectively.The frequency of the studied IL-6 SNP did not differ between the CHC patients and controls(P=0.81)and all alleles were in Hardy-Weinberg equilibrium(P=0.38).In the multivariate analysis,type 2 diabetes mellitus was inversely associated with GC and CC genotypes of IL-6-174(OR=0.42;95%CI=0.22-0.78;P=0.006)and positively associated with blood hypertension(OR=5.56;95%CI=2.79-11.09;P<0.001).CONCLUSION This study was the first to show that GC and CC genotypes of IL-6-174 SNP are associated with a decreased risk of type 2 diabetes mellitus in patients chronically infected with hepatitis C virus.The identification of potential inflammatory mediators involved in the crosstalk between hepatitis C virus and the axis pancreas-liver remains important issues that deserve further investigations.

Distribution of different hepatitis C virus genotypes in patients with hepatitis C virus infection

AIM:To investigate the presence of mixed infection and discrepancy between hepatitis C virus(HCV) genotypes in plasma,peripheral blood mononuclear cells(PBMCs),and liver biopsy specimens.METHODS:From September 2008 up to April 2009,133 patients with chronic hepatitis C referred to Firouzgar Hospital for initiation of an antiviral therapy were recruited in the study.Five milliliters of peripheral blood was collected from each patient and liver biopsy was performed in those who gave consent or had indications.HCV genotyping was done using INNO-LiPATM HCV in serum,PBMCs,and liver biopsy specimens and then conf irmed by sequencing of 5'-UTR fragments.RESULTS:The mean age of patients was 30.3 ± 17.1 years.Multiple transfusion was seen in 124(93.2%) of patients.Multiple HCV genotypes were found in 3(2.3%) of 133 plasma samples,9(6.8%) of 133 PBMC samples,and 8(18.2%) of 44 liver biopsy specimens.It is notable that the different genotypes found in PBMCs were not the same as those found in plasma and liver biopsy specimens.CONCLUSION:Our study shows that a signif icant proportion of patients with chronic hepatitis C are affected by multiple HCV genotypes which may not be detectable only in serum of patients.

Hepatitis C virus antibodies among transfused children with sickle cell anaemia at University of Ilorin Teaching Hospital

Background: Hepatitis C is an infectious disease of the liver caused by the Hepatitis C virus (HCV) resulting to a chronic Hepatitis. Chronic HCV infection constitutes a serious health challenge in places where prevalence is substantial. In Nigeria, there is a high risk because donor blood is not routinely screened for HCV. Patients with sickle cell anaemia (SCA) are considered a subset of the population at higher risk of acquiring the virus, due to their frequent needs for transfusion of blood and its products. However, the magnitude of HCV infection has not been adequately measured in our general population and specific data on HCV in SCA patients are scanty, hence a prospective case controlled study to determine the prevalence of HCV antibodies in transfused SCA patients attending the sickle cell anaemia clinic in the University of Ilorin Teaching Hospital (UITH), Ilorin was taken. Objective: To determine the prevalence of Hepatitis C virus antibodies among transfused children with SCA in Ilorin. Subjects and Method: Eighty two transfused SCA children aged 6 months to 14 years were recruited consecutively from February 2008 to January 2009 while eighty four non transfused SCA children of the same age range recruited over the same period served as controls. Hepatitis C virus antibody screening was done using a second generation ELISA method. Results: The overall prevalence of HCV antibody was 3.0%, while it was 3.7% and 2.4% in the transfused and non transfused SCA patients respectively (χ2 = 0.23, p = 0.68). The patients were also comparable across the social class when subcategorized into high and low social class (χ2 = 0.37, p = 1.00 (subjects), χ2 = 0.42, p = 1.00 (controls). Conclusion: The prevalence of Hepatitis C virus anti- bodies in transfused SCA patients is low. The difference in prevalence between transfused and nontransfused SCA patient was not statistically significant. This was cautiously interpreted due to the hospital based premise of the work. Therefore, Hepatitis C virus antibody acquisition might be from sources other than transfusion of unscreened blood.

A 10 Years Comparative Study to Assess Trends in Seroprevalence of Transfusion Transmitted Infections among Blood Donors at Gwalior, India

Introduction: Transfusion Transmitted Infections (TTIs) threaten safety of the recipients and the community as a whole and are the subject of real concern worldwide. Aims and Objectives: To know the prevalence of transfusion transmitted infections amongst the blood donors, to evaluate the changing trends of TTIs and to compare these observations within the study as well as with the other relevant studies. Place and Duration of Study: This study was carried out at Blood Bank, Department of Pathology, Gajra Raja Medical College, Gwalior, India, from January 2004 to December 2013 (ten years). Materials and Methods: In this study 122,006 voluntary and replacement donations were screened for TTIs;HIV, HBV, HCV, Syphilis, Malaria and their seroprevalence was calculated. Further study was divided in Group “A” (from 2004 to 2008) and Group “B” (from 2009 to 2013) to compare the results. Results: Out of total 122,006 blood units collected, 79,750 (65.3%) were voluntary and 42,256 (34.7%) were replacement donors. The seropositivity of TTIs in the entire study, in group “A” and in Group “B” was 3.26% (3985/122,006) (p = 0.000005), 2.25% (1238/54,874) (p = 0.000005) and 4.09% (2747/67,123) (p = 0.000005) respectively. In Group “A” and “B” seroprevalence of HIV, HBV, HCV, Syphilis and Malaria was 0.29%, 1.16%, 0.61%, 0.06%, 0.11% and 0.13%, 3.15%, 0.24%, 0.17%, 0.03% respectively. Conclusion: Our study concluded that there was significant increase in seroprevalence of HBV and syphilis whereas decreasing pattern in HIV, HCV and Malaria was observed in last five years as compared to previous five years among the blood donors.

Follow-up study of hepatitis C virus infection in uremic patients on maintenance hemodialysis for 30 months

INTRODUCTIONA high prevalence of antibodies to hepatitis C virus(HCV)(range from 3.3%-80%)has beenreported in hemodialysis(HD)patients,andworrisome as it often becomes chronic and induceschronic liver disease,therefore thenephrologists face a major challenge of how toprevent it.The main route of HCV transmission

Hepatitis C virus in Pakistan:A systematic review of prevalence,genotypes and risk factors

In Pakistan more than 10 million people are living with Hepatitis C virus (HCV), with high morbidity and mortality. This article reviews the prevalence, genotypes and factors associated with HCV infection in the Pakistani population. A literature search was performed by using the keywords; HCV prevalence, genotypes and risk factors in a Pakistani population, in Pubmed, PakMediNet and Google scholar. Ninetyone different studies dating from 1994 to May 2009 were included in this study, and weighted mean and standard error of each population group was calculated. Percentage prevalence of HCV was 4.95% ± 0.53% in the general adult population, 1.72% ± 0.24% in the pediatric population and 3.64% ± 0.31% in a young population applying for recruitment, whereas a very high 57% ± 17.7% prevalence was observed in injecting drug users and 48.67% ± 1.75% in a multi-transfused population. Most prevalent genotype of HCV was 3a. HCV prevalence was moderate in the general population but very high in injecting drug users and multi-transfused populations. This data suggests that the major contributing factors towards increased HCV prevalence include unchecked blood transfusions and reuse of injection syringes. Awareness programs are required to decrease the future burden of HCV in the Pakistani population.

Management of occult hepatitis B virus infection:An update for the clinician

Occult hepatitis B virus(HBV) infection(OBI) is defined by the presence of HBV DNA in the liver tissue of individuals who test negative for hepatitis B surface antigen(HBsAg).Patients who have recovered from acute hepatitis B can carry HBV genomes for a long time and show histological patterns of mild necro-inflammation,even fibrosis,years after the resolution of acute hepatitis,without showing any clinical or biochemical evidence of liver disease.At least in conditions of immunocompetence,OBI is inoffensive itself,but when other relevant causes of liver damage are present it might make the course of the liver disease worse.The risk of HBV transmission through transfusion is related to blood donations negative for HBsAg that have been collected during the pre-seroconversion period or during chronic OBI.Use of HBV nucleic acid amplification testing and multivalent anti-HBs antibodies in the HBsAg assays is recommended for detection of true and false OBI,respectively.It is not known if prior hepatitis B immunization with an optimal anti-HBs response in cases of HBV transmission through organ transplantation can effectively modulate or abort the infection.Use of anti-viral agents as prophylaxis in patients with serological evidence of past HBV infection prevents reactivation of OBI after transplantation in most cases.Reactivation of OBI has been observed in other conditions that cause immunosuppression,in which antiviral therapy could be delayed until the HBV DNA or HBsAg becomes detectable.OBI might contribute to the progression of liver fibrosis and hepatocellular carcinoma development in patients with chronic liver disease.

Transfusion-transmitted hepatitis E:What we know so far?

Hepatitis E virus(HEV)is a major cause of viral hepatitis globally.There is growing concern about transfusion-transmitted HEV(TT-HEV)as an emerging global health problem.HEV can potentially result in chronic infection in immunocompromised patients,leading to a higher risk of liver cirrhosis and even death.Between 0.0013%and 0.281%of asymptomatic blood donors around the world have HEV viremia,and 0.27%to 60.5%have anti-HEV immunoglobulin G.HEV is infectious even at very low blood concentrations of the virus.Immunosuppressed patients who develop persistent hepatitis E infection should have their immunosuppressant regimen reduced;ribavirin may be considered as treatment.Pegylated interferon can be considered in those who are refractory or intolerant to ribavirin.Sofosbuvir,a nucleotide analog,showed modest antiviral activity in some clinical studies but sustained viral response was not achieved.Therefore,rescue treatment remains an unmet need.The need for HEV screening of all blood donations remains controversial.Universal screening has been adopted in some countries after consideration of risk and resource availability.Various pathogen reduction methods have also been proposed to reduce the risk of TT-HEV.Future studies are needed to define the incidence of transmission through transfusion,their clinical features,outcomes and prognosis.

High frequencies of HGV and TTV infections in blood donors in Hangzhou

AIM: To determine the frequencies of HGV and TTV infections in blood donors in Hangzhou. METHODS: RT-nested PCR for HGV RNA detection and semi-nested PCR for TTV DNA detection in the sera from 203 blood donors, and nucleotide sequence analysis were performed. RESULTS: Thirty-two (15.8%) and 30 (14.8%) of the 203 serum samples were positive for HGV RNA and TTV DNA, respectively. And 5 (2.5%) of the 203 serum samples were detectable for both HGV RNA and TTV DNA. Homology of the nucleotide sequences of HGV RT-nested PCR products and TTV semi-nested PCR products from 3 serum samples compared with the reported HGV and TTV sequences was 89.36%, 87.94%, 88.65% and 63.51%, 65.77% and 67.12%, respectively. CONCLUSION: The infection rates of HGV and/or TTV in blood donors are relatively high, and to establish HGV and TTV examinations to screen blood donors is needed for transfusion security. The genomic heterogeneity of TTV or HGV is present in the isolates from different areas.

High prevalence of occult hepatitis C infection in predialysis patients

BACKGROUND Occult hepatitis C virus(HCV) infection(OCI) may be associated with extrahepatic diseases and it is known that the patients with chronic kidney disease(CKD) who are on hemodialysis(HD) present a higher prevalence of this type of infection than the general population, with a worse clinical outcome.However, there are no data in the literature to assess the presence of OCI in patients prior to the initiation of renal replacement therapy(RRT). Therefore, this study aimed to evaluate the occurrence and epidemiological aspects of OCI in patients with Predialysis CKD. We hypothesize that this infection could occur before RRT initiation.AIM To research the status in predialysis patients when HD patients have high prevalence of OCI.METHODS A cross-sectional study was conducted between 2015 and 2017. Adults with creatinine clearance < 60 mL/min·1.73 m^2(predialysis patients) were recruited to the study. Pregnant and postpartum women, patients with glomerulopathies,and patients showing positivity for serological markers of hepatitis B virus(HBV), HCV or human immunodeficiency virus infection were excluded. Patients were diagnosed with OCI according to test results of anti-HCV antibody negativity and HCV RNA positivity in either ultracentrifuged serum or, if serumnegative, in peripheral blood mononuclear cells.RESULTS Among the 91 total patients included in the study, the prevalence of OCI was 16.5%. Among these 15 total OCI patients, 1 was diagnosed by 14 ultracentrifuged serum results and 14 were diagnosed by peripheral blood mononuclear cell results. Compared to the non-OCI group, the OCI patients presented higher frequency of older age(P = 0.002), patients with CKD of mixed etiology(P = 0.019), and patients with markers of previous HBV infection(i.e.,combined positivity for anti-hepatitis B core protein antibody and anti-hepatitis B surface protein antibody)(P = 0.001).CONCLUSION Among predialysis patients, OCI involved the elderly, patients with CKD of mixed etiology, and patients with previous HBV infection.

某院输血前患者HBV、HCV、HIV、梅毒感染状况及临床意义

目的了解某院患者输血前乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)、人类免疫缺陷病毒(HIV)、梅毒(TP)感染状况及探讨感染标志物检测的临床意义。方法选取2020年1月—2022年12月收治500例因手术、血液成分异常、重大外伤等情况拟输血患者作为研究对象,在输血前所有患者行四项感染标志物检查,即乙型肝炎表面抗原(HBsAg)、丙型肝炎病毒抗体(HCV-Ab)、人类免疫缺陷病毒抗体(抗HIV)、梅毒螺旋体特异性抗体(抗TP)。记录患者四项指标阳性率检验结果。结果(1)男性患者HBsAg、HCV-Ab、抗HIV、抗TP四项指标总阳性率高于女性患者(P<0.05);(2)女性患者中,0~20岁、21~40岁、41~60岁、>60岁4个年龄段HBsAg、HCV-Ab、抗HIV、抗TP四项指标总阳性率分别为1.61%、13.11%、10.34%、3.08%,21~40岁相较于其他年龄段均更高(P<0.05);(3)男性患者中,0~20岁、21~40岁、41~60岁、>60岁4个年龄段HBsAg、HCV-Ab、抗HIV、抗TP四项指标总阳性率分别为3.17%、20.31%、18.33%、10.45%,21~40岁相较于其他年龄段均更高(P<0.05)。(4)儿科四项指标感染率最低,而传染科、肿瘤科、肾内科四项指标感染率较高。结论输血前对患者进行HBsAg、HCV-Ab、抗HIV、抗TP四项指标检查,有利于识别输血患者感染情况,对于减少医疗纠纷、预防医务人员职业暴露及减少院内感染具有重要意义。

慢性丙型肝炎合并2型糖尿病患者HCV载量与糖代谢指标的相关性分析

【目的】探讨慢性丙型肝炎(CHC)合并2型糖尿病(T2DM)患者丙型肝炎病毒(HCV)载量与糖代谢指标的相关性。【方法】选取2019年3月至2021年2月本院收治的98例CHC合并T2DM患者(合并组)、76例单纯CHC患者(CHC组),另外选取在本院体检的80例健康志愿者为对照组,比较三组临床资料、糖代谢指标。将CHC合并T2DM患者依据HCV载量的不同分为病毒阴性组、低病毒载量组、中病毒载量组和高病毒载量组四个亚组,比较不同HCV载量的CHC合并T2DM患者糖代谢指标水平;采用Pearson相关性分析CHC合并T2DM患者HCV载量与糖代谢指标的关系。【结果】三组体重指数(BMI)及总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平比较,差异有统计学意义(P<0.05);合并组BMI及TC、LDL-C水平高于CHC组和对照组(P<0.05)。三组空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)和空腹胰岛素(FINS)水平比较,差异有统计学意义(P<0.05);合并组FPG、2hPG、HbA1c和FINS水平均高于CHC组和对照组(P<0.05)。不同HCV载量CHC合并T2DM患者FPG、2hPG、HbA1c和FINS水平比较,差异有统计学意义(P<0.05);低病毒载量组、中病毒载量组和高病毒载量组FPG、2hPG、HbA1c和FINS水平均高于病毒阴性组(P<0.05);高病毒载量组FPG、2hPG、HbA1c和FINS水平又均高于低病毒载量组和中病毒载量组(P<0.05)。CHC合并T2DM患者HCV载量与2hPG、FINS水平无相关性(P>0.05),与FPG、HbA1c水平均呈正相关(P<0.05)。【结论】相比单纯CHC患者和健康者,CHC合并T2DM患者糖代谢存在明显异常,且CHC合并T2DM患者HCV载量与FPG、HbA1c存在一定的相关性。

慢性丙肝患者HCV-RNA载量与血清25-OH-D_(3)、铁代谢表达相关性的分析

目的:探讨慢性丙型肝炎患者核糖核酸(HCV-RNA)载量与末梢血血清25羟维生素D3(25-OH-D_(3))、铁代谢表达的相关性,以期为临床提供有效的诊治依据。方法:选取2019年11月-2020年11月我院接受的83例慢性丙型肝炎患者作为研究对象,根据HCV-RNA水平将病例分为高载量组(n=48,1×10^(6)~1×10^(8)copy/mL)与低载量组(n=35,1×10^(3)~1×10^(6)copy/mL),采用酶联免疫吸附检测各组血清25-OH-D3,自动生化分析法检测铁代谢相关指标,对上述结果进行统计学分析。结果:高载量组中阳性45例,阳性率为93.75%,低载量组中阳性12例,阳性率为34.29%;高载量组25-OH-D_(3)水平明显低于低载量组(P<0.05);高载量组血清铁(SI)、血清铁蛋白(SF)明显高于低载量组,总铁结合力(TIBC)明显低于低载量组(P<0.05);经Pearson相关性分析显示慢性丙型肝炎患者HCV-RNA与25-OH-D3水平、TIBC呈显著的负相关(P<0.05),与SI、SF呈显著的正相关(P<0.05)。结论:慢性丙型肝炎患者HCV-RNA载量与血清25-OH-D_(3)、铁代谢指标均具有明显相关性,均可作为其长期治疗的重要观察指标,而且也提示25-OH-D_(3)可能是慢性丙型肝炎的保护因素,能通过补充25-OH-D_(3)改善患者临床症状。

血液透析患者感染丙型病毒性肝炎因素的Logistic回归分析

目的 分析影响维持性血液透析患者感染丙型肝炎的危险因素。方法 收集 12 0例血透患者的临床资料 ,采用第二代 EL ISA法检测血抗 - HCV;临床资料包括 :年龄、性别、血透时间、每周透析时间、输血和血制品史和量、合并 HBV感染、肾脏移植史、CAPD史、AL T异常史、肝炎史、结核史以及医院感染史等。结果 单因素分析表明 HCV感染与透析时间、每周透析时间、输血、血制品史和量、肾移植史、医院感染史、AL T增高史显著性相关 ;L ogistic逐步回归分析证实 HCV感染的原因为输血和医源性传播。结论 结果提示要采取严格的预防措施 ,减少输血和隔离抗 - HCV阳性患者 ,对控制 HCV感染意义重大。

献血员人群HCV感染状况及其输血传播的调查

采用ELISA对1572份献血员血清进行抗HCV检测,阳性率为12.15％。其中女性献血员抗HCV阳性率较男性为高、单采浆献血员者较单纯献血全血者为高,抗HCV检测阳性率随献血员年龄增长而增高。近期ALT升高的单采浆献血者血清抗HCV阳性者显著地高于无近期ALT升高史的同类单采浆献血员。结果证实严格开展献血员HCV感染者筛选将有助于输血相关性的丙肝的预防。

受血者受血前HIV、HBV、HCV、梅毒感染及其重叠感染研究

目的研究受血者受血前人免疫缺陷病毒（HIV）、乙型肝炎病毒（HBV）、丙型肝炎病毒（HCV）、梅毒感染及其重叠感染现状与特点。方法对2007年10月-2008年6月间某院需输注血制品的9694例患者进行检测；采用酶联免疫吸附试验检测血清HBV标志物、血清抗HCV，双抗原夹心酶联免疫法检测血清抗HIV和梅毒抗体。结果9694例受血者受血前血清HBV标志物阳性1549例（15．98％），抗HCV阳性59例（0．61％），抗HIV阳性34例（0．35％），梅毒抗体阳性495例（5．11％）。重叠感染者中，HBV与HCV57例（0．59％），HBV与梅毒94例（0．97％），HCV与梅毒3例（0．03％）；血清抗HIV阳性患者中，重叠感染HBV13例（0．13％），HCV10例（0．10％），梅毒4例（0．04％）；HIV、HBV和HCV重叠，HIV、HBV和梅毒重叠感染各2例（1．08％），HIV、HBV、HCV和梅毒重叠感染1例（0．54％）。结论部分受血者在受血前就已有感染，特别是HBV和梅毒的感染率较高。对受血者于受血前进行全面检查不仅可避免相关医疗纠纷，还可为患者治疗和医务人员的职业防护提供帮助。