Hepatitis C virus(HCV)infection represents a major public health issue.Hepatitis C can be cured bytherapy,but many infected individuals are unaware of their status.Effective HCV screening,fast diagnosis and characteri...Hepatitis C virus(HCV)infection represents a major public health issue.Hepatitis C can be cured bytherapy,but many infected individuals are unaware of their status.Effective HCV screening,fast diagnosis and characterization,and hepatic fibrosis staging are highly relevant for controlling transmission,treating infected patients and,consequently,avoiding end-stage liver disease.Exposure to HCV can be determined with high sensitivity and specificity with currently available third generation serology assays.Additionally,the use of point-of-care tests can increase HCV screening opportunities.However,active HCV infection must be confirmed by direct diagnosis methods.Additionally,HCV genotyping is required prior to starting any treatment.Increasingly,high-volume clinical laboratories use different types of automated platforms,which have simplified sample processing,reduced hands-on-time,minimized contamination risks and human error and ensured full traceability of results.Significant advances have also been made in the field of fibrosis stage assessment with the development of non-invasive methods,such as imaging techniques and serum-based tests.However,no single test is currently available that is able to completely replace liver biopsy.This review focuses on approved commercial tools used to diagnose HCV infection and the recommended hepatic fibrosis staging tests.展开更多
The study aimed to describe the epidemiological,virological and clinical features of sporadic HEV infection in eastern China.A total of 6112 patient sera were tested for anti-HEV IgG or anti-HEV IgM during one consecu...The study aimed to describe the epidemiological,virological and clinical features of sporadic HEV infection in eastern China.A total of 6112 patient sera were tested for anti-HEV IgG or anti-HEV IgM during one consecutive year(between August 2018 and July 2019).HEV RNA presence was evaluated by RT-PCR and HEV sequences were phylogenetically analyzed.Clinical features of confirmed HEV-infected patients were delineated.The sero-positivity rate of anti-HEV IgG maintained stable around 40%,while an obvious winter spike of anti-HEV IgM prevalence was observed.A total of 111 patients were confirmed of HEV viremia by molecular diagnosis.Subtype 4d was predominant.Phylogenetic analyses suggest that certain strains circulate across species and around the country.Subjects with confirmed current HEV infection had a high median age(58 years)and males were predominant(62.2%).Most patients presented with jaundice(75.7%)and anorexia(68.0%).Significantly elevated levels of liver enzymes and bilirubin were observed.Remarkably,the baseline bilirubin level was positively correlated with illness severity.Pre-existing HBV carriage may deteriorate illness.The clinical burden caused by locally acquired HEV infection is increasing.Surveillance should be enforced especially during the transition period from winter to spring.Patients with higher level of bilirubin at disease onset had slower recovery from HEV infection.展开更多
基金Supported by A Miguel Servet contract No.MS09/00044 funded by FIS-ISCIII(Spanish Government)to MartróEgrant PI10/01734 within the"Plan Nacional de I+D+I"co-financed by"ISCIII-Subdirección General de Evaluación y el Fondo Eu-ropeo de Desarrollo Regional"(FEDER)to González V,Saludes V,MartróE
文摘Hepatitis C virus(HCV)infection represents a major public health issue.Hepatitis C can be cured bytherapy,but many infected individuals are unaware of their status.Effective HCV screening,fast diagnosis and characterization,and hepatic fibrosis staging are highly relevant for controlling transmission,treating infected patients and,consequently,avoiding end-stage liver disease.Exposure to HCV can be determined with high sensitivity and specificity with currently available third generation serology assays.Additionally,the use of point-of-care tests can increase HCV screening opportunities.However,active HCV infection must be confirmed by direct diagnosis methods.Additionally,HCV genotyping is required prior to starting any treatment.Increasingly,high-volume clinical laboratories use different types of automated platforms,which have simplified sample processing,reduced hands-on-time,minimized contamination risks and human error and ensured full traceability of results.Significant advances have also been made in the field of fibrosis stage assessment with the development of non-invasive methods,such as imaging techniques and serum-based tests.However,no single test is currently available that is able to completely replace liver biopsy.This review focuses on approved commercial tools used to diagnose HCV infection and the recommended hepatic fibrosis staging tests.
基金This study was funded by grants from the National Natural Science Foundation of China(No.81501733)the Shanghai Municipal Key Clinical Specialty(shslczdzk01103)Key Projects in the National Science&Technology Pillar Program during the Thirteenth Five-year Plan Period(2017ZX10203201-008,2018ZX09201016-003-001,2017ZX10202202-005-004).
文摘The study aimed to describe the epidemiological,virological and clinical features of sporadic HEV infection in eastern China.A total of 6112 patient sera were tested for anti-HEV IgG or anti-HEV IgM during one consecutive year(between August 2018 and July 2019).HEV RNA presence was evaluated by RT-PCR and HEV sequences were phylogenetically analyzed.Clinical features of confirmed HEV-infected patients were delineated.The sero-positivity rate of anti-HEV IgG maintained stable around 40%,while an obvious winter spike of anti-HEV IgM prevalence was observed.A total of 111 patients were confirmed of HEV viremia by molecular diagnosis.Subtype 4d was predominant.Phylogenetic analyses suggest that certain strains circulate across species and around the country.Subjects with confirmed current HEV infection had a high median age(58 years)and males were predominant(62.2%).Most patients presented with jaundice(75.7%)and anorexia(68.0%).Significantly elevated levels of liver enzymes and bilirubin were observed.Remarkably,the baseline bilirubin level was positively correlated with illness severity.Pre-existing HBV carriage may deteriorate illness.The clinical burden caused by locally acquired HEV infection is increasing.Surveillance should be enforced especially during the transition period from winter to spring.Patients with higher level of bilirubin at disease onset had slower recovery from HEV infection.
