郴州地区门诊美沙酮吸毒人群HCV感染状况及基因型分布特征  

Hepatitis C virus infection and genotype distribution among injecting drug users in methadone clinics in Chenzhou,China

作　　者：骆珊[1] 陈菲[1] 张健[1] 吴志辉 欧文胜[1] 黄健[3] 文波[1] 瞿小旺[1] 

机构地区：[1]南华大学附属郴州市第一人民医院南华大学转化医学研究所,湖南郴州423000 [2]郴州市精神病医院,湖南郴州423000 [3]郴州市疾病预防控制中心,湖南郴州423000

出　　处：《临床肝胆病杂志》2015年第11期1841-1844,共4页Journal of Clinical Hepatology

基　　金：国家自然科学基金(81401367;81471959);郴州市第一人民医院院内基金(N2013-012)

摘　　要：目的了解郴州地区美沙酮门诊静脉吸毒人群的HCV感染状况。方法采集2014年8-9月在郴州市美沙酮门诊中具有静脉吸毒史的181例患者血清,通过逆转录聚合酶链反应(RT-PCR)以及ELISA法分别检测HCV核酸和抗体,并通过测序确定HCV基因型。组间比较采用Mann-Whitney U检验。结果 181例患者中HCV核酸或抗体阳性患者160例,阳性率为88.4%(160/181),其中抗体和核酸阳性(Ig G+RNA+)134例(74%),抗体阳性核酸阴性(Ig G+RNA-)19例(10.5%),抗体阴性核酸阳性(Ig G-RNA+)7例(3.9%);HCV和HBV共感染19例(10.5%)。HCV感染患者中Ig G+RNA+组的ALT和AST水平明显高于Ig G-RNA+组和Ig G+RNA-组(P值均<0.01);HCV、HBV单感染患者ALT和AST水平与HBV和HCV共感染患者比较,差异无统计学意义(P值均>0.05)。在133例HCV核酸阳性样本中,6a型81例(60.9%),3型36例(27.1%)。结论静脉吸毒人群具有高HCV感染率,HCV感染以6a型和3型为主,且HCV和HBV共感染并不加重肝损伤。Objective To investigate the status of hepatitis C virus （HCV） infection among injecting drug users （IDUs） in Chenzhou, China. Methods Serum samples from 181 IDUs who were treated in methadone clinics in Chenzhou from August to September, 2014 were collected. RT - PCR and ELISA were applied to detect HCV RNA and antibody, and sequencing was applied to determine the HCV genotype. Mann -Whitney U test was applied for comparison between groups. Results Among these 181 IDUs, 160 were infected with HCV, with a positive rate of 88.4% （ 160/181 ） ; 134 patients had positive antibody and RNA results （ IgG ＋ RNA ＋ ： 74% ）, 19 patients bad positive antibody and negative RNA results （IgG ＋ RNA- ： 10.5% ）, and 7 patients had negative antibody and positive RNA results （IgG- RNA ＋ ： 3.9% ） ; 19 patients had co - infection with HCV and hepatitis B virus （HBV）. The patients infected with HCV in IgG ＋ RNA ＋ group had significantly higher levels of alanine aminotransferase （ALT） and aspartate aminotransferase （AST） levels than those in IgG- RNA ＋ and IgG ＋ RNA - groups （ all P 〈0.01 ） ; ALT and AST levels did not differ significantly between patients with single infection with HCV or HBV and those with co- infection with HBV and HCV （all P 〉0.05）. Among the 133 HCV RNA -positive samples, there were 81 samples of genotype 6a （ 60.9% ） and 36 samples of genotype 3 （ 27.1% ）. Conclusion IDUs have a high HCV infection rate, with main genotypes of 6a and 3, and co - infection with HCV and HBV does not aggravate liver injury.

关 键 词：美沙酮 肝炎病毒属 感染 基因型 

分 类 号：R512.63[医药卫生—内科学]