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台湾的丙型肝炎病毒感染

Hepatitis C virus infection in Taiwan.

作者信息

Chen D S, Wang J T, Chen P J, Wang T H, Sung J L

机构信息

Department of Internal Medicine, National Taiwan University Hospital, Taipei.

出版信息

Gastroenterol Jpn. 1991 Jul;26 Suppl 3:164-6. doi: 10.1007/BF02779290.

Abstract

To investigate the epidemiology of HCV in Taiwan, anti-HCV was studied by radioimmunoassay or enzyme immunoassay in patients with chronic liver disease, healthy adults, and subjects at risk. The anti-HCV prevalence was 0.95% in 420 volunteer blood donors, 90% in 100 hemophiliacs and 81% in 58 parenteral drug abusers. Anti-HCV was present in 6 (7.7%) of 78 HBsAg-positive and 28 (65%) of 43 HBsAg-negative patients with chronic hepatitis, 3 (10%) of 31 HBsAg-positive and 13 (43%) of 30 HBsAg-negative cirrhotics, and 7 (17%) of 42 HBsAg-positive and 15 (63%) of 24 HBsAg-negative patients with HCC. An outbreak of non-A, non-B hepatitis revealed 18% of 57 patients to be positive for anti-HCV. In a prospective study of PTH, 37 or 13% patients contracted hepatitis and 22 (60%) were due to HCV, and at least 17 (77%) of them became chronic. Cloning of HCV genome in a Taiwanese patient with acute posttransfusion non-A, non-B hepatitis by using reverse transcription polymerase chain reaction was performed, and partial characterization of the nucleotide sequences showed 80% and 92% homology as compared to HCV sequences from Chiron and one of the published Japanese isolates, respectively. It is concluded that HCV infection plays a relatively minor role in HBsAg-positive liver decrease in Taiwan, but is strongly associated with HBsAg-negative chronic liver disease and HCC. It is also important in PTH, and the infection is extremely common in hemophiliacs and parenteral drug abusers. The Taiwanese strain of HCV seems more similar to that from Japan, as revealed by nucleotide sequences.

摘要

为研究台湾地区丙型肝炎病毒(HCV)的流行病学,采用放射免疫分析或酶免疫分析方法,对慢性肝病患者、健康成年人及高危人群进行了抗-HCV检测。420名志愿献血者中抗-HCV患病率为0.95%,100名血友病患者中为90%,58名注射吸毒者中为81%。78例HBsAg阳性慢性肝炎患者中有6例(7.7%)抗-HCV阳性,43例HBsAg阴性慢性肝炎患者中有28例(65%)抗-HCV阳性;31例HBsAg阳性肝硬化患者中有3例(10%)抗-HCV阳性,30例HBsAg阴性肝硬化患者中有13例(43%)抗-HCV阳性;42例HBsAg阳性肝癌患者中有7例(17%)抗-HCV阳性,24例HBsAg阴性肝癌患者中有15例(63%)抗-HCV阳性。一次非甲非乙型肝炎暴发显示,57例患者中有18%抗-HCV阳性。在一项对输血后肝炎(PTH)的前瞻性研究中,37例患者(占13%)感染了肝炎,其中22例(占60%)由HCV引起,且至少17例(占77%)转为慢性。采用逆转录聚合酶链反应对一名台湾急性输血后非甲非乙型肝炎患者的HCV基因组进行了克隆,并对核苷酸序列进行了部分鉴定,结果显示与Chiron公司的HCV序列及已发表的一株日本分离株的HCV序列相比,同源性分别为80%和92%。结论是,在台湾地区,HCV感染在HBsAg阳性肝病中作用相对较小,但与HBsAg阴性慢性肝病及肝癌密切相关。在PTH中也很重要,且在血友病患者和注射吸毒者中感染极为常见。核苷酸序列显示,台湾地区的HCV毒株似乎与日本的更相似。

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