北京大学人民医院2015年-2018年HCV感染筛查情况分析

孔祥沙; 杨瑞锋; 张海莹; 季颖; 朱凌; 刘艳; 魏来

doi:10.3969/j.issn.1001-5256.2019.08.012

北京大学人民医院2015年-2018年HCV感染筛查情况分析

DOI: 10.3969/j.issn.1001-5256.2019.08.012

北京大学人民医院北京大学肝病研究所丙型肝炎和肝病免疫治疗北京市重点实验室
清华大学附属清华长庚医院肝胆胰中心

基金项目:

北京大学人民医院研究与发展基金(RDY2017-24)；抗感染新药研发国家重点实验室开放课题(SKLAID201802)；北京市卫生与健康科技成果与适宜技术推广项目(2018-TG-19)；

详细信息

中图分类号: R512.63;R181.3
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出版历程
- 收稿日期: 2019-03-27
- 出版日期: 2019-08-20

Screening for hepatitis C virus infection in Peking University People's Hospital in 2015-2018

Beijing Key Laboratory for Hepatitis C and Immunotherapy for Liver Diseases, Peking University Hepatology Institute, People's Hospital, Peking University

Research funding:

摘要

摘要: 目的分析一家综合性三甲医院HCV感染筛查漏检的情况。方法回顾分析2015年-2018年就诊于北京大学人民医院同期进行抗-HCV和HCV RNA检测的3659例患者信息。抗-HCV采用雅培Architect I2000和强生Vitros 3600检测,HCV RNA采用罗氏Cobas AmpliPrep/Cobas Taqman 96全自动病毒定量系统检测。收集HCV RNA阳性而抗-HCV阴性的患者标本,Sanger测序法检测HCV基因型,并对患者HCV感染状况及其临床状况追踪随访。抗-HCV检测结果用样本吸光度值与阳性判定值（cut-off）的比值（S/CO）表示。利用GraphPad Prism 5. 0作抗-HCV S/CO比值分布图。结果 3659例患者中6例（0. 16%）患者至少1种试剂检测抗-HCV为阴性,而HCV RNA为阳性,均值为（6. 40±1. 86） log10IU/ml。6例患者中5例（83%）为急性白血病患者,另1例为呼吸系统疾病患者。6例患者中1例预后良好,3例预后不良,2例死亡。结论 HCV感染使用抗体作为首选筛查方法,仍有0. 16%感染者会被漏检,...
- 肝炎病毒属 /
- 丙型肝炎抗体 /
- 病毒载量
Abstract: Objective To investigate missed detection in the screening for hepatitis C virus (HCV) infection in a general hospital in 2015-2018. Methods A retrospective analysis was performed for the data of 3659 patients who attended People's Hospital, Peking University, from 2015 to 2018 and underwent the detection of anti-HCV and HCV RNA. Architect I2000 by Abbott and Vitros 3600 by Johnson and Johnson were used to measure anti-HCV, and the Roche Cobas AmpliPrep/Cobas Taqman 96 automatic virus quantification system was used to measure HCV RNA. The specimens were collected from the patients with positive HCV RNA and negative anti-HCV, and Sanger sequencing was used to determine HCV genotype. The patients were followed up to observe the status of HCV infection and clinical conditions. The signal-to-cut-off (S/CO) ratio was used to express the results of anti-HCV detection. GraphPad Prism 5. 0 was used to plot the distribution map of the S/CO ratio of anti-HCV. Results Of all 3659 patients, 6 (0. 16%) had negative anti-HCV based on at least one reagent and positive HCV RNA, with a mean level of (6. 40 ± 1. 86) log10 IU/ml. Among these 6 patients, 5 (83%) had acute leukemia and 1 had respiratory disease; among these patients, 1 had good prognosis, 3 had poor prognosis, and 2 died. Conclusion When antibody is used as the primary screening method for HCV infection, the rate of missed detection reaches 0. 16%, and most of these patients have poor prognosis. HCV RNA detection should be performed for patients with immunodeficiency to avoid missed detection.
- hepacivirus /
- hepatitis C antibodies /
- viral load

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参考文献(12)

[1] Chinese Society of Hepatology and Chinese Society of Infectious Disease, Chinese Medical Association. The guideline of prevention and treatment for hepatitis C:A 2015 update[J]. J Clin Hepatol, 2015, 31 (12) :1961-1979. (in Chinese) 中华医学会肝病学分会, 中华医学会感染病学分会.丙型肝炎防治指南 (2015年更新版) [J].临床肝胆病杂志, 2015, 31 (12) :1961-1979.

[2] WEI L, LIM SG, XIE Q, et al. Sofosbuvir-velpatasvir for treatment of chronic hepatitis C virus infection in Asia:A singlearm, open-label, phase 3 trial[J]. Lancet Gastroen Hepatol, 2019, 4 (2) :127-134.

[3] YANG RF, WEI L. Detection of hepatitis C virus infection[J].J Clin Hepatol, 2011, 27 (1) :1-7. (in Chinese) 杨瑞锋, 魏来.丙型肝炎病毒感染的检测[J].临床肝胆病杂志, 2011, 27 (1) :1-7.

[4] Centers for Disease Control and Prevention. Testing for HCV infection:An update of guidance for clinicians and laboratorians[J]. MMWR, 2013, 62 (18) :362-365.

[5] YANG R, GUAN W, WANG Q, et al. Performance evaluation and comparison of the newly developed Elecsys anti-HCV II assay with other widely used assays[J]. Clin Chim Acta, 2013, 426:95-101.

[6] RAO H, WEI L, LOPEZ-TALAVERA JC, et al. Distribution and clinical correlates of viral and host genotypes in Chinese patients with chronic hepatitis C virus infection[J]. J Gastroenterol Hepatol, 2014, 29 (3) :545-553.

[7] CHEN YS, LI L, CUI FQ, et al. A sero-epidemiological study on hepatitis in China[J]. Chin J Epidemiol, 2011, 32 (9) :888-891. (in Chinese) 陈园生, 李黎, 崔富强, 等.中国丙型肝炎血清流行病学研究[J].中华流行病学杂志, 2011, 32 (9) :888-891.

[8] European Association for the Study of the Liver. EASL recommendations on treatment of hepatitis C 2018[J]. J Hepatol, 2018, 69 (2) :461-511.

[9] SHEN LP, BI SL. Recent advances in molecular epidemiological methods for analyzing hepatitis C virus transmission[J].Chin J Microbiol Immunol, 2016, 36 (10) :779-782. (in Chinese) 沈立萍, 毕胜利.丙型肝炎病毒传播分子流行病学诊断技术研究进展[J].中华微生物和免疫学杂志, 2016, 36 (10) :779-782.

[10] POZZETTO B, MEMMI M, GARRAUD O, et al. Health careassociated hepatitis C virus infection[J]. World J Gastroenterol, 2014, 20 (46) :17265-17278.

[11] KYVERNITAKIS A, MAHALE P, POPAT UR, et al. Hepatitis C virus infection in patients undergoing hematopoietic cell transplantation in the era of direct-acting antiviral agents[J]. Biol Blood Marrow Transplant, 2016, 22 (4) :717-722.

[12] MEDICI MC, CHEZZI C, de CONTO F, et al. Evolving strategy for HCV testing in an Italian tertiary care hospital[J]. J Clin Virol, 2016, 77:92-98.

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