浙江省妊娠期妇女戊型肝炎病毒抗体和核酸检测分析  

Detection of antibodies and nucleic acid of hepatitis E virus in pregnant women in Zhejiang Province

作　　者：李爱云[1] 帅江冰 马裕[1] 朱宇宁[1] 张晓峰 

机构地区：[1]浙江大学医学院附属妇产科医院检验科,杭州310006 [2]浙江省检验检疫科学技术研究院动植物检验检疫研究所

出　　处：《中华传染病杂志》2016年第2期88-92,共5页Chinese Journal of Infectious Diseases

基　　金：国家质检总局科研计划项目（2013IK046）;浙江出入境检验检疫局科技项目（2013-ZKZ-03）

摘　　要：目的分析浙江省妊娠期妇女HEV感染状况及分子流行特征。方法采用ELISA对2013年至2015年98236名妊娠期妇女进行HEV IgM抗体筛查，并利用套式PCR法对IgM抗体阳性样本进行HEV核酸检测，进一步扩增核酸阳性样本的HEV开放阅读框（ORF）2全基因，分析其分子流行病学特征。结果共检出352例HEV IgM抗体阳性，总阳性率为0．36％，除2例合并HBV感染外，其余均为单纯HEV IgM抗体阳性。核酸检测有3份IgM阳性血清检出HEV特异性核酸片段。进一步分析发现，3株散发性人HEV毒株均属于基因4型HEV。3株样本毒株虽然核苷酸同源性较高，氨基酸同源性更是超过97％，但在进化关系上却不在同一分支内。样本序列与国内外其他地区的毒株相比变异较大，包含1～460位核苷酸和620-870位核苷酸两个高变区，但其氨基酸位点同义替换率与非同义替换率相似，进化压力以中性选择为主。结论浙江省内妊娠期妇女HEV感染率与已报道的普通人群感染率相似。其中分离的3株HEV毒株均为人畜共患型的HEV4毒株，变异率较高。Objective To analyze the hepatitis E virus （HEV） infection status and the molecular characteristics of HEV isolated from pregnant women in Zhejiang Province. Methods Totally 98 236 serum samples collected from pregnant women during the year 2013 to 2015 were tested for HEV IgM by enzyme-linked immunosorbent assay （ELISA） and samples positive for IgM were detected for nucleic acid of HEV by nested polymerase chain reaction （PCR）. The whole gene of HEV open reading frame 2 （ORF2） was further amplified and the prevalence was analyzed in nucleic acid-positive samples. Results Three hundred and fifty-two out of 98 236 serum samples were tested positive for HEV IgM, with positive rate of 0.36 %. All the samples were simple positive of HEV IgM except for two samples co-infected with hepatitis B virus. HEV specific nucleic acid fragments were detected positive from three serum samples. Further phylogenetic analysis revealed that all the three HEV isolates in this study belonged to HEV genotype 4. Three isolates did not cluster in one branch, although they shared high nucleic acid homology and more than 97 % of amino acid homology. Variations were found significantly between sample sequence and other published HEV 4 isolates, including two variable regions found in the ORF2 gene （1- 460 nucleotide and 620-870 nucleotide）. However, the synonymous and non-synonymous substitutions rates in the two regions were similar, and neutral selection was the main evolutionary pressure. Conclusions HEV infection rate in pregnant women of Zhejiang Province is similar with the published data. The HEV isolates obtained in this study belong to genotype 4 with high variation rate.

关 键 词：妊娠 肝炎病毒 戊型 免疫球蛋白M ORF2 

分 类 号：R714.251[医药卫生—妇产科学] R446.6[医药卫生—临床医学]