Hayashi J, Kishihara Y, Yamaji K, Yoshimura E, Kawakami Y, Akazawa K, Kashiwagi S
Department of General Medicine, Kyushu University Hospital, Japan.
Am J Gastroenterol. 1995 May;90(5):794-9.
The prevailing route of hepatitis C virus (HCV) transmission in Japan is unclear, so we expected that a survey of routes of HCV infection in an endemic area might clarify the mode of transmission.
We screened 2049 inhabitants in an isolated rural village of Fukuoka, Japan using HCV markers. All serum samples were assayed for antibody to HCV (anti-HCV) (ELISA), and anti-HCV-positive samples were assayed for HCV RNA and genotype (polymerase chain reaction).
The prevalence of anti-HCV was 19.7% and increased with advancing age, from zero in the under 19 yr of age group to 30.7% in the 60-69 yr of age group. HCV RNA was detected in 82.9% of the anti-HCV-positive inhabitants, and 88.3% of them had genotype II. Anti-HCV was detected in 17.8% of the children of HCV-carrier mothers, similar to the rate (15.4%) for all inhabitants in the 40-49 yr of age group, the same age group for the mean age of the anti-HCV-positive children. Anti-HCV was detected in 34.8% of husbands of female HCV carriers and in 22.2% of wives of male HCV carriers, similar to the rates (36.2% in males and 26.6% in females) for all inhabitants in 60-69 yr of age group, the same age group for the mean ages of carriers' spouses. The prevalence of anti-HCV was the highest in inhabitants of one of three distinct areas of this village where patients had often been injected with insufficiently sterilized syringes and needles for treatment in the same clinic.
These observations suggest that medical intervention probably played a more important role in the spread of the HCV infection in the village studied than did familial transmission.
日本丙型肝炎病毒（HCV）的主要传播途径尚不清楚，因此我们期望对一个流行地区的HCV感染途径进行调查，以明确传播方式。
我们使用HCV标志物对日本福冈一个偏远乡村的2049名居民进行了筛查。所有血清样本均检测了抗HCV抗体（抗-HCV）（酶联免疫吸附测定法），抗-HCV阳性样本检测了HCV RNA和基因型（聚合酶链反应）。
抗-HCV的患病率为19.7%，且随年龄增长而升高，从19岁以下年龄组的零患病率升至60 - 69岁年龄组的30.7%。在82.9%的抗-HCV阳性居民中检测到HCV RNA，其中88.3%为II型基因型。在HCV携带母亲的子女中有17.8%检测到抗-HCV，这与40 - 49岁年龄组所有居民的患病率（15.4%）相似，该年龄组也是抗-HCV阳性儿童的平均年龄所在组。在女性HCV携带者的丈夫中有34.8%检测到抗-HCV，在男性HCV携带者的妻子中有22.2%检测到抗-HCV，这与60 - 69岁年龄组所有居民的患病率（男性为36.2%，女性为26.6%）相似，该年龄组也是携带者配偶的平均年龄所在组。在这个村庄三个不同区域之一的居民中，抗-HCV患病率最高，该区域的患者常在同一诊所接受使用未充分消毒的注射器和针头进行的治疗。
这些观察结果表明，在所研究的村庄中，医疗干预在HCV感染传播中可能比家庭传播发挥了更重要的作用。
