目的:了解江苏省农村地区戊型肝炎病毒(HEV)感染的特征及相关影响因素。方法:在江苏省部分农村地区,以整群抽样的方式进行戊型肝炎感染的血清学横断面调查以及1年的随访性研究,并对分离到的毒株进行基因分型,同时调查感染的相关影响因素。结果:横断面调查的4 139例自然人群中,抗-HEV-IgG阳性率为52.0%,男性阳性率显著高于女性,各年龄组阳性率随年龄升高而增加。经1年的随访,抗-HEV-IgG年阳转率为11.6 %,20岁以上年龄组的阳转率显著高于20岁以下年龄组;抗-HEV-IgG年阴转率为5.8%,0~9岁以下年龄组的阴转率显著高于10岁以上年龄组。从亚临床感染者分离到的5份HEV毒株中,基因Ⅰ型3株、基因Ⅵ型2株。相关影响因素分析显示,男性、年龄增加和接触生猪是感染的危险因素。结论:江苏省农村地区的HEV感染程度较高,亚临床感染的HEV基因分型为Ⅰ型和Ⅳ型;除性别、年龄外,接触生猪是感染的重要影响因素。
Objective:To investigate the epidemiological characteristics of hepatitis E virus(HEV) infection in rural area of Jiangsu provine and explore correlated effect factors. Methods:A cross-section and a follow-up seroepidemiologic study of HEV infection were conducted. Anti-HEV IgG and IgM were tested by commercial ELISA kits,and the RT-PCR method was applied to obtain the sequence of HEV from subclinical infection cases. Meanwhile correlated effect factors were studied. Results:The cross-sectional seroepidemiologic study showed that the anti-HEV IgG prevalence were 52% in the general population. The seropositivity rates of anti-HEV-IgG was highter in male than in female(P < 0.001),and the antibodies increased with age. Based on results from the follow-up study,the positive and negative seroconversion rate were 11.6% and 5.8% respectively. Overall,the positive seroconversion rate was higher in people more than 20 years old than in those less than 20 years,but the negative seroconversion rate of 0~9 year age group was higher than that of the older age groups. Both genotypeⅠ and genotype Ⅳ HEV were isolated from subclinical infection. Man,advancing age and breeding swine were risk factors in the infections of HEV. Conclusion:The prevalence of hepatitis E virus infection in this district was higher than any other districts reported in China. Genotype Ⅰ and genotype Ⅳ HEV were isolated from subclinical infection. Besides gender and age,breeding swine were effect factors in the infections of HEV.
张雪峰,张〓军,刘社兰,田〓华,许〓可,孟繁岳,夏宁邵,朱凤才.江苏省农村地区自然人群戊型肝炎感染状况的研究[J].南京医科大学学报(自然科学版),2008,28(3):360-363