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目的测定我国深圳地区献血者中的丙型肝炎病毒(hepatitis C virus,HCV)感染者自然清除和病毒血症,即自然康复与慢性感染者比率及其人群特征,为丙型肝炎防治研究提供数据。方法对深圳献血者中抗-HCV初筛阳性的血清标本采用2种EIA方法进行抗体再测定,以定量PCR方法测定病毒载量,并采用巢式PCR对核酸进行确认,进而将标本分为3种HCV感染状态,即病毒自然清除(RNA-/Ab+)、病毒血症(RNA+/Ab+)和假阳性(RNA-/Ab-),通过统计学方法分析3种感染状态献血者在临床信息(性别、年龄)、ALT、抗-HCV的差异。HCV RNA阳性标本通过分析5’-NCR序列进行基因分型。结果 152份初筛抗-HCV阳性的标本中,病毒自然清除标本45份、病毒血症51份、假阳性56份。50份HCV定量PCR阳性标本病毒载量范围从[(12.6～2.43)×106]IU/ml(中位值2.54×104IU/ml)。36份进行基因分型的标本包括47.2%基因1型、5.6%基因2型、19.4%基因3型和27.8%基因6型。慢性感染组标本的年龄及抗-HCV水平(S/CO值)显著高于病毒自然清除和假阳性组(χ2=7.812,P<0.05;χ2=90.865,P<0.01)。结论深圳地区献血者HCV感染病毒自然清除率约为46.9%。HCV基因型中1型为主要,6型也占有较高比例。年龄小、女性献血者更易于自然清除病毒。病毒血症即慢性感染者HCV抗体水平显著升高,其在HCV自然康复过程中的作用还有待进一步研究。
Objective To determine the natural clearance and viremia of patients with hepatitis C virus (HCV) infection in blood donors in Shenzhen, China, that is, the ratio of spontaneous and chronic infections, and their demographic characteristics, to provide data for the study of hepatitis C prevention and control . Methods Two kinds of EIA method were used to detect anti-HCV positive serum samples from blood donors in Shenzhen. The viral load was determined by quantitative PCR and the nested PCR was used to confirm the nucleic acid. Then the samples were divided into 3 Three HCV infection states, namely, virus natural clearance (RNA- / Ab +), viremia (RNA + / Ab +) and false positives (RNA- / Ab-) were analyzed statistically in 3 infectious status blood donors in clinical information Gender, age), ALT, anti-HCV differences. HCV RNA positive specimens were genotyped by analysis of the 5’-NCR sequence. Results Of the 152 samples screened for anti-HCV positive, 45 were naturally cleared, 51 were viremia and 56 were false positive. The viral load ranged from [(12.6 ~ 2.43) × 106] IU / ml (median 2.54 × 104IU / ml) in 50 HCV-positive PCR positive samples. Twenty-six genotyped samples included 47.2% of genotype 1, 5.6% of genotype 2, 19.4% of genotype 3 and 27.8% of genotype 6. The age and anti-HCV level (S / CO value) in chronic infection group were significantly higher than those in natural clearance and false positive group (χ2 = 7.812, P <0.05; χ2 = 90.865, P <0.01). Conclusion The natural clearance rate of HCV infection in blood donors in Shenzhen is about 46.9%. Type 1 is the predominant HCV genotype, while Type 6 also has a higher proportion. Young, female blood donors are more likely to naturally clear the virus. The level of HCV antibody in patients with chronic viremia, ie chronic infection, is significantly elevated. The role of HCV antibody in the natural recovery of HCV remains to be further studied.