农村抗-HIV阴性既往有偿献血者HBV、HCV感染情况调查  

Epidemiological investigation on HBV and HCV among anti-HIV negative and former paid blood donors in rural Hubei

作　　者：邓莉平[1] 熊勇[1] 王胜勇 李继武 桂希恩[1] 

机构地区：[1]武汉大学中南医院感染科,湖北武汉430071 [2]孝感市孝南区疾病预防控制中心 [3]武穴市疾病预防控制中心

出　　处：《中国输血杂志》2015年第7期815-817,共3页Chinese Journal of Blood Transfusion

基　　金：湖北省自然科学基金(2013CFB254)

摘　　要：目的了解湖北农村既往有偿献血者(FPBDs)中乙肝、丙肝的流行及疾病现状。方法采用酶联免疫吸附法(ELISA)检测237名FPBDs外周血中抗-HIV、抗-HCV、HBs Ag;实时荧光定量PCR检测其外周血HCV RNA,PCR扩增HCV core区分析HCV基因型。结果本组农村FPBDs的抗-HIV阴性率100%(237/237)、抗-HCV阳性率为54.85%(130/237)、HBs Ag阳性率6.75%(16/237),其中4例同时合并HBV、HCV感染。单一抗-HCV阳性患者中,HCV RNA仍为阳性者74.60%(94/126),丙肝的自发清除率为25.4%(32/126)。HCV基因分型成功的83例中,HCV-1b型占71.1%(59/83)、2a型25.3%(21/83)、1b/2a型3.6%(3/83)。肝功能异常者占32.54%(41/126),其中HCV RNA阳性者ALT异常率明显增加。上腹部彩超检查107例:脂肪肝19.62%(21/107)、肝硬化9.34%(10/107)。结论湖北农村既往有偿献血者中,乙肝并未造成大流行,但丙肝的感染率明显增高,部分病例已进展至肝硬化,亟需采取措施,加强对该人群丙肝筛查。Objective To investigate of hepatitis B and hepatitis C status among anti-HIV negative and former paid blood donors（ FPBDs） in rural aveas of Hubei Province,China. Methods Serum samples were screened for anti-HIV,anti-HCV and hepatitis B virus surface antigen（ HBs Ag） using an enzyme-linked immunosorbent assay（ ELISA）. HCV-RNA was detected in all positive for anti-HCV by the HCV real-time PCR kit. HCV genotype were tested by reverse transcription nested polymerase chain reaction（ RT-nested PCR） amplification and DNA sequencing. Results Among 237 FPBDs,all were negative for anti-HIV. The prevalence of anti-HCV and HBs Ag were 54. 9%（ 130 /237） and 6. 8%（ 16 /237）,respectively. Among 126 cases of a single anti-HCV positive patients,94 cases（ 74. 6%） HCV-RNA virus remained positive. The HCV genotypes were found to be 1b（ 71. 1%） and 2a（ 25. 3%）. HCV mixed genotypes 1b /2a were also detected among the blood donors. Abnormal liver function was observed in 41 cases（ 32. 5%）. The rate of ALT abnormal was significantly higher in HCV-RNA positive cases than in HCV-RNA negative cases. Among 107 cases with abdominal ultrasound examination,21 cases had fatty liver,while 10 cases had cirrhosis（ 10 / 107,9. 3 %）. Conclusion FPBDs has a high risk of HCV infection. Some cases have been progressed to liver cirrhosis. Urgent measures should be taken to screen hepatitis c among FPBDs.

关 键 词：丙型肝炎病毒 农村有偿供血者 抗-HCV HBsAg HCV RNA 基因分型 自发清除率 

分 类 号：R446.62[医药卫生—诊断学] R512.63[医药卫生—临床医学]