印度西北部疑似病毒性肝炎疫情调查。

Investigation of suspected viral hepatitis outbreaks in North West India.

作者信息

Singh Mini P, Majumdar Manasi, Goyal Kapil, Lakshmi P V M, Bhatia Deepak, Ratho R K

机构信息

Department of Virology, Postgraduate Institute of Medical Education & Research, Chandigarh, India 160012.

School of Public Health, Postgraduate Institute of Medical Education & Research, Chandigarh, India 160012.

出版信息

Diagn Microbiol Infect Dis. 2016 Apr;84(4):309-14. doi: 10.1016/j.diagmicrobio.2015.12.002. Epub 2015 Dec 12.

DOI:10.1016/j.diagmicrobio.2015.12.002

PMID:26853491

Abstract

Hepatitis E (HEV) infection is diagnosed on the basis of serum anti-HEV IgM detection. In outbreaks, early diagnostic method is important for prompt control measures. This study compared 3 diagnostic methods in 60 serum samples collected in suspected HEV outbreaks. The suitability of saliva samples for antibody detection was also evaluated in 21 paired serum saliva samples. The anti-HEV IgM, HEV-Ag, and HEV-RNA were detected in serum samples of 52 (86.66%), 16 (26.66%), and 18 (30%) patients, respectively. The concordance between serum and saliva IgM was found to be 76.91%. The positivity of PCR and HEV-Ag detection was 100% within 1 week of illness which declined to 5-10% thereafter. The outbreak was attributed to HEV genotype 1, subtype 1a, and the clinical and environmental strains clustered together. HEV-antigen and RNA were an early diagnostic marker with 96.66% concordance. Saliva samples can be used as an alternative in outbreak setting.

摘要

戊型肝炎（HEV）感染通过血清抗HEV IgM检测来诊断。在疫情暴发时，早期诊断方法对于及时采取控制措施至关重要。本研究对在疑似戊型肝炎疫情中采集的60份血清样本中的3种诊断方法进行了比较。还在21对血清唾液样本中评估了唾液样本用于抗体检测的适用性。分别在52例（86.66%）、16例（26.66%）和18例（30%）患者的血清样本中检测到抗HEV IgM、HEV-Ag和HEV-RNA。血清和唾液IgM之间的一致性为76.91%。PCR和HEV-Ag检测在发病1周内的阳性率为100%，此后降至5%-10%。此次疫情归因于HEV基因型1、亚型1a，临床菌株和环境菌株聚集在一起。HEV抗原和RNA是早期诊断标志物，一致性为96.66%。在疫情暴发情况下，唾液样本可作为替代检测样本。