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罗马尼亚丙型肝炎病毒株的分子流行病学研究。

Molecular epidemiology of hepatitis C virus strains from Romania.

机构信息

Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.

出版信息

J Gastrointestin Liver Dis. 2011 Sep;20(3):261-6.

Abstract

BACKGROUND AND AIMS

A high seroprevalence of Hepatitis C Virus (HCV) infection has been reported in Romania, with limited data on the viral subtypes' distribution. In order to detect any changes in the genetic composition of the epidemic, a survey on the recent profile of circulating HCV genotypes was conducted.

METHODS

241 hepatitis C infected patients with active viral replication diagnosed between September 2004 - October 2008 were included in a retrospective study. Genotyping using commercial Line Probe Assay (Innogenetics) was confirmed by sequencing of Core PCR products followed by phylogenetic analysis.

RESULTS

HCV subtype 1b was found in 92.6% of the samples, subtype 1a in 5.4 % of the samples, subtype 4a in 1.2%, and subtype 3a in 0.8% of the samples. Chronic hepatitis C infections with subtype 1b were found in women aged 40-60 years old with a history of blood transfusions received during surgical/obstetrical interventions. No geographical clustering was evident for HCV 1b sequences. The new emerging non-1b genotypes were detected mainly in younger patients with a history of intravenous drug use. The genetic distances among the HCV 1a strains are very homogeneous and small, with a high sequence identity with other European strains, suggesting the recent entrance of this subtype in Romania from singular or limited sources of infection.

CONCLUSION

The introduction of new HCV genotypes in Romania stimulates a continuous epidemiological surveillance, suggesting shifts in the transmission pathways and risk factors, with the possible emergence of recombinant strains in patients with multiple infections.

摘要

背景与目的

罗马尼亚曾报道过丙型肝炎病毒(HCV)感染的高血清流行率,但关于病毒亚型分布的数据有限。为了检测该流行病毒的遗传组成是否发生变化,我们对目前流行的 HCV 基因型进行了调查。

方法

2004 年 9 月至 2008 年 10 月期间,我们对 241 例经诊断为丙型肝炎病毒复制活跃的患者进行了回顾性研究。采用商业线探针分析(Innogenetics)进行基因分型,并对核心聚合酶链反应产物进行测序和系统进化分析进行确认。

结果

92.6%的样本中发现 HCV 亚型 1b,5.4%的样本中发现 HCV 亚型 1a,1.2%的样本中发现 HCV 亚型 4a,0.8%的样本中发现 HCV 亚型 3a。40-60 岁女性慢性丙型肝炎感染患者,有手术/产科干预期间接受输血的病史,发现 HCV 1b 亚型。HCV 1b 序列无明显地理聚集。新出现的非 1b 基因型主要在有静脉吸毒史的年轻患者中检测到。HCV 1a 株之间的遗传距离非常接近,与其他欧洲株的序列同源性很高,提示该亚型最近从单一或有限的感染源进入罗马尼亚。

结论

罗马尼亚新 HCV 基因型的引入刺激了持续的流行病学监测,提示传播途径和危险因素发生变化,可能导致多重感染患者中出现重组株。

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