我国部分地区慢性HBV感染者HDV感染情况调查  

An investigation of hepatitis D virus infection among patients with chronic hepatitis B virus infection in some regions of China

作　　者：刘玉梅 郭小平 张慧敏 白洪霞 王春梅 任姗[5] 蒋永芳[6] 杨胜 彭锋[6] 王晓忠 于雷[8] 廖柏明[9] 宁玲 何英利[11] 杨霞[12] 黄亮 刘学恩 庄辉 LIU Yumei;GUO Xiaoping;ZHANG Huimin;BAI Hongxia;WANG Chunmei;REN Shan;JIANG Yongfang;YANG Sheng;PENG Feng;WANG Xiaozhong;YU Lei;LIAO Boming;NING Ling;HE Yingli;YANG Xia;HUANG Liang;LIU Xueen;ZHUANG Hui(Department of Microbiology and Center of Infectious Diseases,Peking University Health Science Center,Beijing 100191,China;Chifeng Infectious Disease Prevention Hospital of Inner Mongolia Autonomous Region,Chifeng,Inner Mongolia Autonomous Region 024099,China;Inner Mongolia International Mongolian Medical Hospital,Hohhot 010055,China;Hohhot Second Hospital of Inner Mongolia Autonomous Region,Hohhot 010020,China;Department of Hepatology,Beijing YouAn Hospital,Capital Medical University,Beijing 100069,China;Department of Infectious Diseases,The Second Xiangya Hospital of Central South University,Changsha 410011,China;Department of Hepatology,Traditional Chinese Medicine Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830000,China;Department of Infectious Diseases,The Fourth Affiliated Hospital of Harbin Medical University,Harbin 150001,China;Department of Infectious Diseases,The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China;Department of Infectious Diseases,The First Affiliated Hospital of University of Science and Technology of China&Anhui Provincial Hospital,Hefei 230001,China;Department of Infectious Diseases,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China;Jilin Infectious Disease Hospital,Jilin,Jilin 132002,China;Public Health Clinical Center of Chengdu,Chengdu 610066,China)

机构地区：[1]北京大学医学部基础医学院病原生物系暨感染病中心,北京100191 [2]内蒙古自治区赤峰传染病医院,内蒙古赤峰024099 [3]内蒙古自治区国际蒙医医院,呼和浩特010055 [4]内蒙古自治区呼和浩特市第二医院,呼和浩特010020 [5]首都医科大学附属北京佑安医院肝病科,北京100069 [6]中南大学湘雅二医院感染科,长沙410011 [7]新疆维吾尔自治区中医医院肝病科,乌鲁木齐830000 [8]哈尔滨医科大学附属四院感染科,哈尔滨150001 [9]广西医科大学第一附属医院感染科,南宁530021 [10]中国科学技术大学附属第一医院(安徽省立医院)感染科,合肥230001 [11]西安交通大学第一附属医院感染科,西安710061 [12]吉林市传染病医院,吉林吉林132002 [13]成都公共卫生临床医疗中心,成都610066

出　　处：《临床肝胆病杂志》2023年第4期795-803,共9页Journal of Clinical Hepatology

摘　　要：目的了解目前我国部分地区慢性HBV感染者丁型肝炎病毒(HDV)感染流行情况。方法2021年3月—2022年6月从全国10个省市自治区收集3131例慢性HBV感染者血清,用抗-HDV IgG酶联免疫试剂检测全部血清标本。对抗-HDV IgG阳性标本用巢式逆转录聚合酶链式反应(nRT-PCR)法检测HDV RNA。对HDV RNA阳性标本的nRT-PCR扩增产物测序后进行序列分析,确定HDV基因型。分析抗-HDV IgG阳性患者的临床特征。计量资料两组间比较采用Mann-Whitney U秩和检验。计数资料两组间比较采用χ^(2)检验或Fisher精确检验。结果3131例慢性HBV感染者的抗-HDV IgG阳性率为0.70%(22/3131),内蒙古自治区、新疆维吾尔自治区、北京市和湖南省慢性HBV感染者的抗-HDV IgG阳性率分别为1.81%(16/886)、0.88%(2/226)、0.28%(2/708)和1.00%(2/200),其中内蒙古自治区慢性HBV感染者抗-HDV IgG阳性率显著高于北京市(P=0.004),其余地区间比较差异均无统计学意义(P值均>0.05)。对内蒙古自治区慢性HBV感染者临床特征分析发现,抗-HDV IgG阳性组蒙古族患者(P=0.001)、ALT异常患者(P=0.007)和抗病毒治疗患者(P=0.029)的比例显著高于抗-HDV IgG阴性组,而中位HBV DNA水平明显较低(P=0.030)。共检出19例HDV RNA阳性标本,均为HDV基因1型。结论我国不同地区HDV流行率差异较大,内蒙古自治区慢性HBV感染者中HDV流行率较高。我国北方部分省市的HDV流行基因型主要为1型。Objective To investigate the prevalence of hepatitis D virus(HDV)infection among patients with chronic hepatitis B virus(HBV)infection in some regions of China.Methods Serum samples were collected from 3131 patients with chronic HBV infection in 10 provinces,cities,and autonomous regions of China from March 2021 to June 2022,and anti-HDV IgG ELISA was used for the detection of all serum samples.Nested reverse transcription-polymerase chain reaction(nRT-PCR)was used to detect HDV RNA in anti-HDV IgG-positive samples,and the nRT-PCR amplification products of HDV RNA-positive samples were sequenced and analyzed to determine HDV genotype.The clinical features of anti-HDV IgG-positive patients were analyzed.The Mann-Whitney U rank sum test was used for comparison of continuous data between two groups,and the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups.Results The positive rate of anti-HDV IgG in the 3131 patients with chronic HBV infection was 0.70%(22/3131),and that in the patients with chronic HBV infection in Inner Mongolia Autonomous Region,Xinjiang Uygur Autonomous Region,Beijing,and Hunan Province was 1.81%(16/886),0.88%(2/226),0.28%(2/708),and 1.00%(2/200),respectively;the patients with chronic HBV infection in Inner Mongolia Autonomous Region had a significantly higher positive rate of anti-HDV IgG than those in Beijing(P=0.004),and there was no significant difference between the other regions(P>0.05).Clinical features of the patients with chronic HBV infection in Inner Mongolia Autonomous Region showed that compared with the anti-HDV IgG-negative group,the anti-HDV IgG-positive group had a significantly higher proportion of patients with Mongol nationality(P=0.001),abnormal alanine aminotransferase(P=0.007),or antiviral treatment(P=0.029),as well as a significantly lower median HBV DNA level(P=0.030).A total of 19 HDV RNA-positive samples were identified,all of which had HDV genotype 1.Conclusion The prevalence rate of HDV varies greatly across d

关 键 词：乙型肝炎病毒 δ肝炎病毒 抗-HDV IgG 基因型 

分 类 号：R512.62[医药卫生—内科学] R181.3[医药卫生—临床医学]