Peter Medawar Building for Pathogen Research, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom ; Walter+Eliza Hall Institute for Medical Research, Melbourne, Victoria, Australia.
PLoS One. 2013 Aug 20;8(8):e66749. doi: 10.1371/journal.pone.0066749. eCollection 2013.
It has been estimated that there are more than 60 million Hepatitis C virus (HCV) carriers in the World Health Organisation's Western Pacific region (WHO-WPR), where liver cancer is among the top three causes of cancer death. WHO and the US Centres for Disease Control and Prevention report the prevalence of HCV in the South Pacific islands (countries within the WHO-WPR) to be high (5-10% and >2% respectively). However, since HCV is not tested for in many of these countries, there is sparse data available to support this assertion. We screened ∼2000 apparently healthy individuals from Papua New Guinea, Fiji and Kiribati and found a sero-prevalence of 2.0%, 0.1% and 0%, respectively. All sero-positive samples tested negative for HCV RNA. Curious as to why all the sero-positive individuals were negative for HCV-RNA, we also screened them for the HCV protective IL28B SNP markers rs12979860 and rs8099917. All antibody-positive participants bar one had HCV protective haplotypes. Our results suggest that HCV is present in these Pacific island countries, albeit at a prevalence lower than previous estimates. As none of our participants had undergone antiviral treatment, and therefore must have cleared infection naturally, we hypothesise that genotypes 1 and/or 4 are circulating in South Pacific Island people and that these peoples are genetically predisposed to be more likely to spontaneous resolve HCV infection than to become chronic carriers.
据估计，在世界卫生组织西太平洋区域（WHO-WPR）有超过 6000 万的丙型肝炎病毒（HCV）携带者，而肝癌是癌症死亡的三大原因之一。世界卫生组织和美国疾病控制与预防中心报告称，南太平洋岛屿（WHO-WPR 内的国家）的 HCV 流行率很高（分别为 5-10%和>2%）。然而，由于许多国家没有对 HCV 进行检测，因此可用的数据很少支持这一说法。我们对来自巴布亚新几内亚、斐济和基里巴斯的约 2000 名看似健康的个体进行了筛查，发现血清阳性率分别为 2.0%、0.1%和 0%。所有血清阳性样本的 HCV RNA 检测均为阴性。我们对所有血清阳性个体的 HCV RNA 均为阴性感到好奇，于是也对他们进行了 HCV 保护性 IL28B SNP 标志物 rs12979860 和 rs8099917 的筛查。所有抗体阳性的参与者均具有 HCV 保护性单倍型，除了一个人。我们的结果表明，这些太平洋岛国存在 HCV，尽管流行率低于先前的估计。由于我们的参与者都没有接受过抗病毒治疗，因此必须自然清除了感染，我们假设基因型 1 和/或 4 在南太平洋岛民中传播，并且这些人在遗传上更有可能自发清除 HCV 感染，而不是成为慢性携带者。
