Schleicher Sabine, Schieffer Maria, Jürgens Stefan, Wehner Heinz-Dieter, Flehmig Bertram
Children's Hospital, Department I, University of Tuebingen, Germany.
Ig Sanita Pubbl. 2005 Sep-Oct;61(5):435-50.
Injection of illicit drugs is an important risk factor for acquiring parenterally transmitted viral infections. To investigate the prevalence of viral mono- and co-infections in intravenous drug uses (IDUs) postmortem and to evaluate the risk of potential infection to personnel involved in medicolegal practice a total number of 59 known IDUs were tested during necropsy for serological markers of hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) as well as for the nucleic acids of the hepatitis B and C viruses, and the GB virus C (GBV-C), in blood and in the liver. Our findings showed that 90.2% cases were positive for at least one or more serological markers of the tested viruses. Seroprevalence rates of anti-HCV, HBsAg and anti-HIV were 78.4%, 32.4% and 29.7% respectively. Of the IDUs tested for serological infection markers 43.2% were positive for one, 40.5% for two and 5.4% for all three markers. Viral nucleic acids were detected in the sera of 64.4% and in the liver of 81.4% of the cases. HCV, RNA, GBV-C RNA and HBV DNA were found in 33.9%, 28.8% amd 28.8% of the serum samples and in 67.8%, 35.6% and 28.8% of the liver tissue, respectively. Active viral co-infections or triple infections were detectable in the sera of 20.3% and in the liver of 39% of the case. Results show that the sensitivity of viral nucleic acid testing postmortem strongly depends on the quality and source of material used.
注射非法药物是经肠道外传播病毒感染的一个重要风险因素。为了调查静脉吸毒者（IDU）死后病毒单一感染和合并感染的患病率，并评估参与法医实践的人员潜在感染的风险，在尸检期间对59名已知的静脉吸毒者进行了检测，以检测血液和肝脏中乙型肝炎病毒（HBV）、丙型肝炎病毒（HCV）和人类免疫缺陷病毒（HIV）的血清学标志物，以及乙型和丙型肝炎病毒和GB病毒C（GBV-C）的核酸。我们的研究结果表明，90.2%的病例至少有一种或多种检测病毒的血清学标志物呈阳性。抗HCV、HBsAg和抗HIV的血清阳性率分别为78.4%、32.4%和29.7%。在接受血清学感染标志物检测的静脉吸毒者中，43.2%的人有一种标志物呈阳性，40.5%的人有两种标志物呈阳性，5.4%的人三种标志物都呈阳性。在64.4%的病例血清和81.4%的病例肝脏中检测到病毒核酸。在33.9%、28.8%和28.8%的血清样本中以及在67.8%、35.6%和28.8%的肝组织中分别发现了HCV RNA、GBV-C RNA和HBV DNA。在20.3%的病例血清和39%的病例肝脏中可检测到活动性病毒合并感染或三重感染。结果表明，死后病毒核酸检测的灵敏度很大程度上取决于所用材料的质量和来源。
