河北赵县某“献血村”人群HCV血清及分子流行病学调查

发布时间：2018-05-15 07:46

本文选题：有偿献血员 + 抗-HCV阳性率　；参考：《河北医科大学》2009年硕士论文

【摘要】： 目的:了解河北赵县“献血村”村民HCV的感染情况及HCV基因型分布情况,通过统计分析推断该村村民出现抗-HCV阳性的危险因素,为减少HCV传播和对HCV感染者进行治理管理提供基础资料,并探讨HCV基因分型的方法。方法:以河北省赵县某“献血村”全村520位村民为研究对象,进行了一次横断面调查。对该村所有村民进行了问卷调查,并对所有村民采集血液样本,无菌分离血清。以酶联免疫法(ELISA)法对所有520份血清进行抗-HCV抗体检测;以RT-PCR法对其中可利用的483份血清分别扩增HCV之5'UTR、C/E1、NS5B基因片段,双脱氧链终止法测序;用Mega4.0软件进行HCV系统进化分析,构建系统进化树,判定基因亚型。结果:所有研究对象总的抗-HCV血清阳性率为28.46%(148/520)。无献血史村民的抗-HCV抗体阳性率为16.55%,有献血史的研究对象中抗-HCV血清阳性率为42.80%(101/236),有献血史与无献血史村民之间的抗-HCV阳性率存在显著性差异(P0.0001)。只献全血的献血员中抗-HCV抗体的阳性率为15.38%,只献血浆的献血员中抗-HCV抗体的阳性率则高达80.00%,既有献全血又有献浆史的献血员中抗-HCV抗体的阳性率也高达69.30%。出卖血浆是有偿献血员出现抗-HCV血清阳性的一个相关因素(P=0.0037),但是卖全血却不是其相关因素(P=0.7736),有手术史也是村民出现抗-HCV阳性的一个相关因素(P=0.0270)。献全血年数/次数与抗-HCV阳性率之间及献浆次数与抗-HCV阳性率之间存在剂量—反应关系。但经多因素logistic分析发现只有混合献血、献浆史与村民出现抗-HCV阳性之间存在相关性。HCV-RNA核酸定性检测结果为阳性的人数是79人,其中的71份样本成功地进行基因分型,1b亚型的样本数为37例,占52.11%;2a亚型的样本数为34例,占47.89%。结论:上个世纪八十年代末至九十年代初期间非法的单采浆过程中的不卫生的操作存在交叉污染,是导致有偿献血员出现抗-HCV抗体危险因素;高HCV感染率人群可能更易通过其他的经皮传播途径向普通人群传播丙型肝炎;该村居民感染的HCV基因型只有1b、2a两种亚型;利用HCV之C/E1区域进行系统进化分析可作为HCV基因分型的研究方法。由于单采浆时的交叉污染是这两种亚型的HCV都有同等的机会进行传播,因此这两种基因亚型所占的比例趋于平衡。
[Abstract]:Objective: to investigate the infection of HCV and the distribution of HCV genotypes in the villagers of "blood donation village" in Zhaoxian County, Hebei Province, and to infer the risk factors of anti-HCV positive in the villagers by statistical analysis. To reduce the transmission of HCV and the management of HCV infection to provide basic information, and to explore the method of HCV genotyping. Methods: a cross-sectional investigation was carried out among 520 villagers in a "blood donation village" in Zhaoxian County, Hebei Province. A questionnaire survey was conducted among all the villagers in the village, and blood samples were collected and aseptic serum was isolated from all the villagers. All 520 sera were tested for anti-HCV antibody by Elisa, and 5 of HCV C / E1 NS5B gene fragments were amplified by RT-PCR method and sequenced by dideoxy chain termination method. HCV phylogenetic analysis was performed with Mega4.0 software. A phylogenetic tree was constructed to identify gene subtypes. Results: the total positive rate of anti-HCV in all subjects was 28. 46%-520%. The positive rate of anti-HCV antibody in villagers without blood donation history was 16.555.The positive rate of anti-HCV serum in the study subjects with history of blood donation was 42.801 / 2360.The positive rate of anti-HCV was significantly different between the villagers with and without blood donation history (P 0.0001). The positive rate of anti-HCV antibody was 15.38 in the whole blood donors and 80.000 in the blood donors who only donated plasma. The positive rate of anti-HCV antibody was 69.30 in the blood donors who had both the whole blood donation and the plasma donation history. Selling plasma is a relative factor of anti-HCV seropositive in paid blood donors (P0. 0037), but selling whole blood is not related factor P0. 7736. A history of operation is also a related factor of anti-HCV positive in villagers (P0. 0270). There was a dose-response relationship between the number / times of whole blood donation and the positive rate of anti-HCV and the number of times of plasma donation and the positive rate of anti-HCV. However, according to multivariate logistic analysis, only mixed blood donation was found. The number of people who showed positive results by qualitative detection of HCV-RNA nucleic acid was 79, and the correlation between the history of plasma donation and the presence of anti-HCV positive in villagers was 79. Of these 71 samples were successfully genotyped in 37 cases, accounting for 52.11a subtype in 34 cases (47.89%). Conclusion: the unhygienic operation of illegal mono pulping during the late 1980s to the early 1990s is a risk factor for the emergence of anti-HCV antibodies in paid blood donors. The population with high HCV infection rate may be more likely to transmit hepatitis C to the general population through other transcutaneous transmission routes, and only 1bm2a subtype of HCV genotype was infected in this village population. Phylogenetic analysis based on the C/E1 region of HCV can be used as a genotyping method for HCV. Because the cross-contamination of the two subtypes has the same chance of transmission, the proportion of the two subtypes tends to be balanced.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2009
【分类号】：R193;R181.3

【引证文献】