内蒙古自治区蒙古族聚集区丁型肝炎流行现状分析

付春山; 冯笑梅; 迟秀梅; 訾君; 牛俊奇; 张专才

doi:10.3969/j.issn.1001-5256.2023.05.012

内蒙古自治区蒙古族聚集区丁型肝炎流行现状分析

DOI: 10.3969/j.issn.1001-5256.2023.05.012

付春山^1a,
冯笑梅^1b,
迟秀梅²,
訾君²,
牛俊奇³,
张专才^1a, , ,

1a.
内蒙古自治区国际蒙医医院消化一科，呼和浩特 010013
1b.
内蒙古自治区国际蒙医医院检验科，呼和浩特 010013
2.
吉林大学第一医院感染性疾病及病原生物学中心基因治疗实验室，长春 130061
3.
吉林大学第一医院感染性疾病及病原生物学中心肝病科，长春 130012

基金项目:

国家自然科学基金项目 (81970519);

吉林省自然科学基金 (YDZJ202201ZYTS016)

伦理学声明：本研究经由吉林大学第一医院伦理委员会批准，批号：19K056-001。所有患者均签署知情同意书。

利益冲突声明：本文不存在任何利益冲突。

作者贡献声明：付春山负责患者资料收集，撰写论文；冯笑梅负责标本收集及论文审阅；迟秀梅、訾君负责标本检测，资料分析，撰写论文；张专才、牛俊奇负责课题设计，论文审阅并最后定稿。

详细信息

通信作者:
张专才，hhht253zzc@163.com (ORCID: 0009-0000-8749-7205)

计量
- 文章访问数: 402
- HTML全文浏览量: 108
- PDF下载量: 67
- 被引次数: 0
出版历程
- 收稿日期: 2022-11-30
- 录用日期: 2023-01-11
- 出版日期: 2023-05-20

Epidemiological situation of hepatitis D in the gathering area of Mongolian population in Inner Mongolia Autonomous Region of China

1a.
First Department of Gastroenterology, Inner Mongolia International Mongolian Hospital, Hohhot 010013, China
1b.
Department of Clinical Laboratory, Inner Mongolia International Mongolian Hospital, Hohhot 010013, China
2.
Gene Therapy Laboratory, Center for Pathogen Biology and Infectious Diseases, The First Hospital of Jilin University, Changchun 130061, China
3.
Department of Hepatology, Center for Pathogen Biology and Infectious Diseases, The First Hospital of Jilin University, Changchun 130012, China

Research funding:

National Natural Science Foundation of China (81970519);

Natural Science Foundation of Jilin Province (YDZJ202201ZYTS016)

More Information

Corresponding author: ZHANG Zhuancai, hhht253zzc@163.com (ORCID: 0009-0000-8749-7205)

摘要

摘要: 目的探讨内蒙古自治区蒙古族聚集区丁型肝炎病毒(HDV)感染情况以及分子流行病学特点。方法纳入2019年4月—2020年10月在国际蒙医医院就诊的乙型肝炎表面抗原(HBsAg)阳性的患者230例，根据患者情况分为乙型肝炎合并肝硬化组(n=18)和乙型肝炎组(n=212);并以HBsAg定量值250 IU/mL为界限将患者分为HBsAg＜250 IU/mL组(n=104)和HBsAg≥250 IU/mL组(n=126)。采用ELISA方法进行HDV抗体的检测，抗体阳性者进一步利用实时定量PCR方法进行HDV RNA检测。并对HDV RNA阳性标本进行分型检测。计数资料两组间比较采用χ²检验。结果 HDV抗体检测阳性率为16.09%，抗体阳性患者中HDV RNA阳性率为91.89%。乙型肝炎合并肝硬化患者共18例，HDV抗体检测阳性率为44.44%，抗体阳性患者HDV RNA阳性率为100%。HBsAg＜250 IU/mL的患者共104例，其中只有3例(2.88%)HDV抗体阳性。而HBsAg≥250 IU/mL的患者共126例，HDV抗体阳性率为26.98%。所有能测出分型的标本的基因分型均为1型。结论内蒙古自治区蒙古族聚集区HDV感染率较高，尤其是HBsAg≥250 IU/mL及肝硬化患者。需加强HBsAg阳性患者的丁型肝炎检测，及早诊断和治疗，防止肝炎进一步发展。
- 丁型肝炎 /
- δ肝炎病毒 /
- 乙型肝炎 /
- 流行病学研究
Abstract: Objective To investigate the status and molecular epidemiology of hepatitis D virus (HDV) infection in the gathering area of Mongolian population in Inner Mongolia Autonomous Region of China. Methods A total of 230 patients with positive hepatitis B surface antigen (HBsAg) who attended Inner Mongolia International Mongolian Hospital from April 2019 to October 2020 were enrolled, and according to related information, they were divided into hepatitis B+liver cirrhosis group(n=18) and hepatitis B group(n=212). According to HBsAg quantification with a cut-off value of 250 IU/mL, the patients were divided into HBsAg < 250 IU/mL group(n=104) and HBsAg ≥250 IU/mL group(n=126). ELISA was used to detect HDV antibody, and quantitative real-time PCR was used to measure HDV RNA in patients with positive HDV antibody. Genotyping was performed for HDV RNA-positive samples. The chi-square test was used for comparison of categorical data between two groups. Results The positive rate of HDV antibody was 16.09%, and among the patients with positive HDV antibody, the positive rate of HDV RNA was 91.89%. Among the 18 patients with hepatitis B and liver cirrhosis, the positive rate of HDV antibody was 44.44%, and among the patients with positive HDV antibody, the positive rate of HDV RNA was 100%. There were 104 patients with HBsAg < 250 IU/mL, among whom only 3 patients (2.88%) were positive for hepatitis D antibody, and there were 126 patients with HBsAg ≥250 IU/mL, with a positive rate of HDV antibody of 26.98%. Genotype 1 was observed in all the samples that could be genotyped. Conclusion There is a relatively high infection rate of HDV in Inner Mongolia Autonomous Region, especially in patients with HBsAg ≥250 IU/mL or those with liver cirrhosis. It is necessary to strengthen the detection of hepatitis D in HBsAg-positive patients and perform early diagnosis and treatment to prevent the further progression of hepatitis.
- Hepatitis D /
- Hepatitis Delta Virus /
- Hepatitis B /
- Epidemiologic Studies

HTML全文

图 1 HDV分型系统树

Figure 1. HDV typing phylogenetic tree

下载: 全尺寸图片幻灯片

表 1 患者基本信息

Table 1. List of basic patient information

项目	数值
年龄(岁)	46.5±14.2
乙型肝炎合并肝硬化	7.83%(18/230)
HDV-IgG(+)	44.44%(8/18)
HDV-RNA(+)	100%(8/8)
乙型肝炎	92.17%(212/230)
HDV-IgG(+)	13.68%(29/212)
HDV RNA(+)	89.66%(26/29)
HBsAg＜250 IU/mL	45.22%(104/230)
HDV-IgG(+)	2.88%(3/104)
HDV RNA(+)	33.33%(1/3)
HBsAg≥250 IU/mL	54.78%(126/230)
HDV-IgG(+)	26.98%(34/126)
HDV RNA(+)	97.06%(33/34)
总HDV-IgM(+)	13.91%(32/230)
总HDV-IgG(+)	16.09%(37/230)
总HDV RNA(+)	91.89%(34/37)
基因分型
Ⅰ型	79.41%(27/34)
未分型	20.59%(7/34)

下载: 导出CSV

参考文献(15)

[1]	RIZZETTO M, CANESE MG, ARICÒ S, et al. Immunofluorescence detection of new antigen-antibody system (delta/anti-delta) associated to hepatitis B virus in liver and in serum of HBsAg carriers[J]. Gut, 1977, 18(12): 997-1003. DOI: 10.1136/gut.18.12.997.
[2]	ZHANG Z, URBAN S. New insights into HDV persistence: The role of interferon response and implications for upcoming novel therapies[J]. J Hepatol, 2021, 74(3): 686-699. DOI: 10.1016/j.jhep.2020.11.032.
[3]	STOCKDALE AJ, KREUELS B, HENRION MYR, et al. The global prevalence of hepatitis D virus infection: Systematic review and meta-analysis[J]. J Hepatol, 2020, 73(3): 523-532. DOI: 10.1016/j.jhep.2020.04.008.
[4]	SHEN DT, GOYAL H, XU HG. Differences in delta virus hepatitis diagnosis methods and its effect on the hepatitis D prevalence[J]. Gut, 2020, 69(10): 1893. DOI: 10.1136/gutjnl-2019-320159.
[5]	BUTI M, STEPANOVA M, PALOM A, et al. Chronic hepatitis D associated with worse patient-reported outcomes than chronic hepatitis B[J]. JHEP Rep, 2021, 3(3): 100280. DOI: 10.1016/j.jhepr.2021.100280.
[6]	URBAN S, NEUMANN-HAEFELIN C, LAMPERTICO P. Hepatitis D virus in 2021: Virology, immunology and new treatment approaches for a difficult-to-treat disease[J]. Gut, 2021, 70(9): 1782-1794. DOI: 10.1136/gutjnl-2020-323888.
[7]	MENTHA N, CLÉMENT S, NEGRO F, et al. A review on hepatitis D: From virology to new therapies[J]. J Adv Res, 2019, 17: 3-15. DOI: 10.1016/j.jare.2019.03.009.
[8]	KOH C, HELLER T, GLENN JS. Pathogenesis of and new therapies for hepatitis D[J]. Gastroenterology, 2019, 156(2): 461-476. e1. DOI: 10.1053/j.gastro.2018.09.058.
[9]	ARAGONA M, MACAGNO S, CAREDDA F, et al. Serological response to the hepatitis delta virus in hepatitis D[J]. Lancet, 1987, 1(8531): 478-480. DOI: 10.1016/s0140-6736(87)92090-3.
[10]	NOUREDDIN M, GISH R. Hepatitis delta: Epidemiology, diagnosis and management 36 years after discovery[J]. Curr Gastroenterol Rep, 2014, 16(1): 365. DOI: 10.1007/s11894-013-0365-x.
[11]	CHEN HY, SHEN DT, JI DZ, et al. Prevalence and burden of hepatitis D virus infection in the global population: A systematic review and meta-analysis[J]. Gut, 2019, 68(3): 512-521. DOI: 10.1136/gutjnl-2018-316601.
[12]	ROGGENBACH I, CHI XM, LEMPP FA, et al. HDV seroprevalence in HBsAg-positive patients in China occurs in hotspots and is not associated with HCV mono-infection[J]. Viruses, 2021, 13(9): 1799. DOI: 10.3390/v13091799.
[13]	CHEN XH, OIDOVSAMBUU O, LIU P, et al. A novel quantitative microarray antibody capture assay identifies an extremely high hepatitis delta virus prevalence among hepatitis B virus-infected mongolians[J]. Hepatology, 2017, 66(6): 1739-1749. DOI: 10.1002/hep.28957.
[14]	WU SS, ZHANG Y, TANG YY, et al. Molecular epidemiology and clinical characteristics of hepatitis delta virus (HDV) infected patients with elevated transaminases in Shanghai, China[J]. BMC Infect Dis, 2020, 20(1): 565. DOI: 10.1186/s12879-020-05275-1.
[15]	CHEMIN I, PUJOL FH, SCHOLTÈS C, et al. Preliminary evidence for hepatitis delta virus exposure in patients who are apparently not infected with hepatitis B virus[J]. Hepatology, 2021, 73(2): 861-864. DOI: 10.1002/hep.31453.