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目的调查丽水地区无偿献血者戊型肝炎病毒(HEV)感染率与特征。方法对丽水市中心血站2015年1月-4月8 963名无偿献血者的样品留样,用酶联免疫吸附法(ELISA)筛查血清HEV-Ig G与Ig M抗体的阳性率,对HEVIg M抗体阳性的标本进行RT-PCR检测,经测序后分析其基因型,分析HEV-Ig G与Ig M抗体阳性者在无偿献血人群中的分布特征。结果 8 963名献血者中,HEV-Ig G与Ig M抗体的阳性检出率分别是31.9%和0.86%。77例HEVIg M抗体阳性样本中,RT-PCR检测HEV RNA阳性4例,4例病毒血症中3例为基因IV型感染、1例为I型感染。HEV-Ig M抗体阳性样本中,有88.31%(68/77)合并HEV-Ig G抗体阳性。HEV-Ig G与Ig M抗体阳性率在谷丙转氨酶阳性人群中明显高于正常人群,差异有统计学意义(P<0.01)。HEV-Ig G抗体阳性率具有年龄积累效应。结论本地区献血人群存在一定比例的戊型肝炎病毒携带者,有必要对现有输血途径传播戊型肝炎的风险进行评估。
Objective To investigate the prevalence and characteristics of hepatitis E virus (HEV) in unpaid blood donors in Lishui area. Methods Samples of 8 963 unpaid blood donors in Lishui city center blood bank were collected from January 2015 to April 2015. Serum HEV-Ig G and Ig M antibody positive rates were screened by enzyme-linked immunosorbent assay (ELISA) HEVIg M antibody positive samples were detected by RT-PCR, sequenced and analyzed their genotypes, analysis HEV-Ig G and Ig M antibody positive distribution in the blood donors. Results Among 8 963 blood donors, the positive rates of HEV-Ig G and Ig M antibodies were 31.9% and 0.86%, respectively. Among 77 HEVIg M antibody positive samples, 4 were positive for HEV RNA by RT-PCR, 3 were genotype IV infection and 4 were genotype IV infection, and 1 was type I infection. Among HEV-Ig M positive samples, 88.31% (68/77) were positive with HEV-Ig G antibody. The positive rate of HEV-Ig G and Ig M antibody in alanine aminotransferase-positive population was significantly higher than that in normal population (P <0.01). The positive rate of HEV-Ig G antibody has an age-accumulating effect. Conclusion There is a certain proportion of hepatitis E virus carriers in blood donors in this area. It is necessary to evaluate the risk of hepatitis E spread through existing blood transfusion routes.