AIM:To characterize the prevalence of hepatitis C virus(HCV)infection among Chinese intravenous drug users(IDUs).METHODS:A total of 432 adult IDUs(95 women and337 men)in Shanghai were included in the study.The third-g...AIM:To characterize the prevalence of hepatitis C virus(HCV)infection among Chinese intravenous drug users(IDUs).METHODS:A total of 432 adult IDUs(95 women and337 men)in Shanghai were included in the study.The third-generation Elecsys Anti-HCV assay(Roche Diagnostics GmbH,Sandhofer Strasse 116,D-68305,Mannheim,Germany)was used to screen for antibodies against HCV.The RIBA strip,a supplemental antiHCV test with high specificity,was performed on all of the samples that tested positive during the initial screening.All of the anti-HCV positive samples were analyzed with a Cobas TaqMan 48 Analyzer(Roche Diagnostics)for direct detection of HCV RNA.All of the HCV RNA-positive samples were sequenced for genotype determination.RESULTS:The preliminary screening identified 262(60.6%)subjects who were seropositive for HCV.Of the 62 females and 200 males seropositive subjects,16(16.7%)and 65(19.3%),respectively,were confirmed by RIBA,yielding an overall HCV seropositive rate of18.8%.Four female(6.5%)and 14 male(7.0%)subjects tested positive for HCV RNA,indicating an active infection rate of 4.2%for the entire study population.The 18 HCV RNA-positive serum samples were genotyped.Seven individuals were genotype 1b,and four were genotype 1a.One individual each was infected with genotypes 2a,2b and 3a.Four subjects were coinfected with multiple strains:two with genotypes 1a and 2a,and two with genotypes 1b and 2a.The active infection rate among HCV-seropositive individuals was22.2%,which was significantly lower than most estimates.CONCLUSION:The prevalence of HCV is relatively low among IDUs in Shanghai,with a spontaneous recovery rate much higher than previous estimates.展开更多
目的了解郴州地区静脉吸毒人群中乙型肝炎病毒(hepatitis B virus,HBV)、丙型肝炎病毒(hepatitis C virus,HCV)和丁型肝炎病毒(hepatitis D virus,HDV)的感染状况及基因型的分布特征;探究共感染患者病毒载量的水平变化以及HBV/HCV共感...目的了解郴州地区静脉吸毒人群中乙型肝炎病毒(hepatitis B virus,HBV)、丙型肝炎病毒(hepatitis C virus,HCV)和丁型肝炎病毒(hepatitis D virus,HDV)的感染状况及基因型的分布特征;探究共感染患者病毒载量的水平变化以及HBV/HCV共感染中病毒相互作用的影响因素。方法收集2014~2018年郴州市戒毒所和美沙酮门诊中静脉吸毒志愿者血样,排除艾滋、梅毒等感染性疾病后共纳入样本2909例。使用酶联免疫吸附实验(enzyme-linked immunosorbent assay,ELISA)检测血清中乙肝表面抗原(hepatitis B surface antigen,HBsAg)、丙型肝炎IgG抗体(hepatitis C IgG antibody,HCV-IgG)或丁型肝炎IgG抗体(hepatitis D IgG antibody,HDV-IgG)的水平。巢式聚合酶链反应(polymerase chain reaction,PCR)扩增感染样本的脱氧核糖核酸(deoxyribo nucleic acid,DNA)或核糖核酸(ribonucleic acid,RNA),测序鉴定其基因型,并通过Real-time PCR对病毒载量进行定量分析。结果(1)HBsAg、HCV-IgG和HDV-IgG在静脉吸毒人群血清中的阳性率分别为20.49%、34.03%、3.85%。(2)基因型分析发现HBV基因型以B型(86.74%)为主,C型(11.94%)相对少见;HCV基因6a型为主要感染型(51.33%),其次为3a(20.28%)、3b型(16.98%);HDV基因型均为Ⅱ型。(3)HCV单感染患者的HCV RNA病毒载量高于HBV/HCV共感染患者(P=0.007);HBV单感染患者的HBV DNA病毒载量高于HBV/HDV共感染患者(P=0.013)和HBV/HCV/HDV三重感染患者(P=0.042);HBV/HDV共感染患者HBsAg水平高于HBV单感染患者(P=0.003)和HBV/HCV共感染患者(P=0.004)。(4)Logistic回归模型分析结果表明HBsAg水平与慢性HCV感染的自发清除显著相关(OR=1.53,95%CI:1.19~1.96),HCV RNA载量可独立并且准确地预测HBV血清清除(OR=1.36,95%CI:1.03~1.80)。结论HBsAg而非HBV DNA是竞争HCV复制的主要因素,高HCV病毒载量可能有益于HBV感染的自发清除。展开更多
To investigate the features of various hepatitis virus infection in intravenous drug users （IVDU）, we conducted an epidemiological survey of hepatitis viruses including hepatitis B virus （HBV）, hepatitis C virus ...To investigate the features of various hepatitis virus infection in intravenous drug users （IVDU）, we conducted an epidemiological survey of hepatitis viruses including hepatitis B virus （HBV）, hepatitis C virus （HCV）, hepatitis D virus （HDV） and hepatitis G virus （HGV） in IVDU. The correlation of Tn lymphocyte cytokine and hepatitis virus infection was examined. A. study population of 406 IVDU consisted of 383 males and 23 females. HBV-DNA and HCV-RNA were detected by fluorescence quantitative polymerase chain reaction. HBsAg, HBeAg, anti-HBc, anti-HCV, HDV-Ag and anti-HGV were assayed by ELISA. The levels of cytokines of TH1 and TH2 were measured by ELISA. The similar indices taken from 102 healthy persons served as controls. The infection rate of each virus among IVDU was 36.45% for HBV, 69. 7 % for HCV, 2.22 % for HDV, and 1.97 % for HGV, respectively. The co-infection rate of HBV and HCV was detected in 113 of 406 （27. 83 %）. In contrast, among controls, the infection rate was 17.65% for HBV and 0% for the other hepatitis viruses. The levels of PHA-induced cytokines （IFN-γ and IL-4） and the level of serum IL-2 were obviously decreased in IVDU. On the other hand, the level of serum IL-4 was increased. The IFN-γ level was continuously decreased when the IVDU was infected with HBV/HCV. In conclusion, HBV and HCV infection were common in this population of IVDU and they had led to a high incidence of impaired TH 1 cytokine levels.展开更多
基金Supported by Science and Technology Commission Xuhui District and Xuhui Health Bureau of ShanghaiNo.SHXH201226
文摘AIM:To characterize the prevalence of hepatitis C virus(HCV)infection among Chinese intravenous drug users(IDUs).METHODS:A total of 432 adult IDUs(95 women and337 men)in Shanghai were included in the study.The third-generation Elecsys Anti-HCV assay(Roche Diagnostics GmbH,Sandhofer Strasse 116,D-68305,Mannheim,Germany)was used to screen for antibodies against HCV.The RIBA strip,a supplemental antiHCV test with high specificity,was performed on all of the samples that tested positive during the initial screening.All of the anti-HCV positive samples were analyzed with a Cobas TaqMan 48 Analyzer(Roche Diagnostics)for direct detection of HCV RNA.All of the HCV RNA-positive samples were sequenced for genotype determination.RESULTS:The preliminary screening identified 262(60.6%)subjects who were seropositive for HCV.Of the 62 females and 200 males seropositive subjects,16(16.7%)and 65(19.3%),respectively,were confirmed by RIBA,yielding an overall HCV seropositive rate of18.8%.Four female(6.5%)and 14 male(7.0%)subjects tested positive for HCV RNA,indicating an active infection rate of 4.2%for the entire study population.The 18 HCV RNA-positive serum samples were genotyped.Seven individuals were genotype 1b,and four were genotype 1a.One individual each was infected with genotypes 2a,2b and 3a.Four subjects were coinfected with multiple strains:two with genotypes 1a and 2a,and two with genotypes 1b and 2a.The active infection rate among HCV-seropositive individuals was22.2%,which was significantly lower than most estimates.CONCLUSION:The prevalence of HCV is relatively low among IDUs in Shanghai,with a spontaneous recovery rate much higher than previous estimates.
文摘目的了解郴州地区静脉吸毒人群中乙型肝炎病毒(hepatitis B virus,HBV)、丙型肝炎病毒(hepatitis C virus,HCV)和丁型肝炎病毒(hepatitis D virus,HDV)的感染状况及基因型的分布特征;探究共感染患者病毒载量的水平变化以及HBV/HCV共感染中病毒相互作用的影响因素。方法收集2014~2018年郴州市戒毒所和美沙酮门诊中静脉吸毒志愿者血样,排除艾滋、梅毒等感染性疾病后共纳入样本2909例。使用酶联免疫吸附实验(enzyme-linked immunosorbent assay,ELISA)检测血清中乙肝表面抗原(hepatitis B surface antigen,HBsAg)、丙型肝炎IgG抗体(hepatitis C IgG antibody,HCV-IgG)或丁型肝炎IgG抗体(hepatitis D IgG antibody,HDV-IgG)的水平。巢式聚合酶链反应(polymerase chain reaction,PCR)扩增感染样本的脱氧核糖核酸(deoxyribo nucleic acid,DNA)或核糖核酸(ribonucleic acid,RNA),测序鉴定其基因型,并通过Real-time PCR对病毒载量进行定量分析。结果(1)HBsAg、HCV-IgG和HDV-IgG在静脉吸毒人群血清中的阳性率分别为20.49%、34.03%、3.85%。(2)基因型分析发现HBV基因型以B型(86.74%)为主,C型(11.94%)相对少见;HCV基因6a型为主要感染型(51.33%),其次为3a(20.28%)、3b型(16.98%);HDV基因型均为Ⅱ型。(3)HCV单感染患者的HCV RNA病毒载量高于HBV/HCV共感染患者(P=0.007);HBV单感染患者的HBV DNA病毒载量高于HBV/HDV共感染患者(P=0.013)和HBV/HCV/HDV三重感染患者(P=0.042);HBV/HDV共感染患者HBsAg水平高于HBV单感染患者(P=0.003)和HBV/HCV共感染患者(P=0.004)。(4)Logistic回归模型分析结果表明HBsAg水平与慢性HCV感染的自发清除显著相关(OR=1.53,95%CI:1.19~1.96),HCV RNA载量可独立并且准确地预测HBV血清清除(OR=1.36,95%CI:1.03~1.80)。结论HBsAg而非HBV DNA是竞争HCV复制的主要因素,高HCV病毒载量可能有益于HBV感染的自发清除。
基金This project was supported by a grant from the NationalNatural Science Foundation of China (No .30160083)
文摘To investigate the features of various hepatitis virus infection in intravenous drug users （IVDU）, we conducted an epidemiological survey of hepatitis viruses including hepatitis B virus （HBV）, hepatitis C virus （HCV）, hepatitis D virus （HDV） and hepatitis G virus （HGV） in IVDU. The correlation of Tn lymphocyte cytokine and hepatitis virus infection was examined. A. study population of 406 IVDU consisted of 383 males and 23 females. HBV-DNA and HCV-RNA were detected by fluorescence quantitative polymerase chain reaction. HBsAg, HBeAg, anti-HBc, anti-HCV, HDV-Ag and anti-HGV were assayed by ELISA. The levels of cytokines of TH1 and TH2 were measured by ELISA. The similar indices taken from 102 healthy persons served as controls. The infection rate of each virus among IVDU was 36.45% for HBV, 69. 7 % for HCV, 2.22 % for HDV, and 1.97 % for HGV, respectively. The co-infection rate of HBV and HCV was detected in 113 of 406 （27. 83 %）. In contrast, among controls, the infection rate was 17.65% for HBV and 0% for the other hepatitis viruses. The levels of PHA-induced cytokines （IFN-γ and IL-4） and the level of serum IL-2 were obviously decreased in IVDU. On the other hand, the level of serum IL-4 was increased. The IFN-γ level was continuously decreased when the IVDU was infected with HBV/HCV. In conclusion, HBV and HCV infection were common in this population of IVDU and they had led to a high incidence of impaired TH 1 cytokine levels.
