[成人急性肝炎的血清学诊断：突尼斯中部地区一项前瞻性研究的结果]

[Serodiagnosis of acute hepatitis in adults patients: results of a prospective study in a central region of Tunisia].

作者信息

Hellara Olfa, Melki Wissem, Mastouri Maha, Ben Chaabène Nabil, Loghmari Hichem, Ben Mansour Wafa, Bdioui Fethia, Safer Leila, Saffar Hammouda

出版信息

Tunis Med. 2014 Mar;92(3):201-7.

PMID:24955966

Abstract

UNLABELLED

PRÉREQUIS: Viral hepatitis is a public health problem in many parts of the globe. In Tunisia, the respective responsibility of five viruses (HAV, HDV, HBV, HCV and HEV) in the genesis of acute hepatitis in adults is only roughly indicated in the absence of suitable serological studies, given as important to plan appropriate preventive strategies.

OBJECTIVES

To approach the role of viral hepatitis in all adult with acute hepatitis, identify the current share of each virus A, B, C and E in the genesis of hepatitis and to study the epidemiological and evolution of these diseases.

METHODS

We conducted a prospective study over two years including patients aged from 15 to 65 years old, with clinical and / or biological acute hepatitis. Data were collected through a standard questionnaire wich covered sociodemographic charactereristics and risk factors. Blood samples were collected and were tested for IgM anti-HAV, IgM anti-HEV, HBsAg, IgM anti-HBc, anti-HCV antibodies .When serological tests were negatives, further explorations including immunological test, search for HCV RNA and a pharmacovigilance survey was conducted. Statistical analysis was performed by SPSS version 10.0 RESULTS: 105 patients were included. Acute viral hepatitis was diagnosis in 70 patients (67%). The proportion of patients with acute viral hepatitis A, B, C and E was 51.5% , 38.5%, 4.3% and 5.7% respectively. The risk factors of viral hepatitis A was drinking of untreated water and poor socioeconomic status. In the HBV group, the notion of sexual contact risk was found in 30% of cases. The small numbers of acute hepatitis E and C does not permit us to draw conclusions.

CONCLUSION

Our study confirms the shift in age of onset of hepatitis A to the age of adolescence and young adulthood. The respective responsibilities of the different viruses studied in the genesis of acute hepatitis in adults in our area brings us closer of western populations where HAV infection predominates followed by HBV.

摘要

未标注

前提：病毒性肝炎是全球许多地区的公共卫生问题。在突尼斯，由于缺乏合适的血清学研究，五种病毒（甲型肝炎病毒、丁型肝炎病毒、乙型肝炎病毒、丙型肝炎病毒和戊型肝炎病毒）在成人急性肝炎发病中的各自责任仅大致表明，这对于制定适当的预防策略很重要。

目的

探讨病毒性肝炎在所有成人急性肝炎中的作用，确定每种甲型、乙型、丙型和戊型病毒在肝炎发病中的当前占比，并研究这些疾病的流行病学和演变情况。

方法

我们进行了一项为期两年的前瞻性研究，纳入年龄在15至65岁之间、患有临床和/或生物学急性肝炎的患者。通过一份涵盖社会人口学特征和危险因素的标准问卷收集数据。采集血样并检测抗甲型肝炎病毒IgM、抗戊型肝炎病毒IgM、乙型肝炎表面抗原、抗乙型肝炎核心抗体IgM、抗丙型肝炎病毒抗体。当血清学检测为阴性时，进行进一步检查，包括免疫学检测、丙型肝炎病毒RNA检测和药物警戒调查。使用SPSS 10.0版进行统计分析。结果：纳入105例患者。70例患者（67%）被诊断为急性病毒性肝炎。急性甲型、乙型、丙型和戊型病毒性肝炎患者的比例分别为51.5%、38.5%、4.3%和5.7%。甲型病毒性肝炎的危险因素是饮用未经处理的水和社会经济地位低下。在乙型肝炎病毒组中，30%的病例发现有性接触风险的概念。戊型和丙型急性肝炎病例数较少，无法得出结论。