CAJ | 학술논문

目的系统分析1997-2012年上海市戊型肝炎(戊肝)的流行特征、血清学和基因分型特点.方法利用国家法定传染病报告数据；采用ELISA检测社区健康人群戊肝病毒(HEV)-IgG抗体,计算标化阳性率；使用巢式RT-PCR、基因测序和GenBank数据构建上海市HEV基因数据库.结果 16年间上海市戊肝以散发为主,发病率呈季节性和周期性,总体略呈下降趋势.男性发病率显著高于女性,患者以30 ～ 65岁年中老年人为主.2001-2012年4次社区健康人群抗体水平监测,共采集血清标本3979份,人群HEV-IgG抗体标化阳性率分别为22.32％、18.56％、10.22％和34.43％,抗体阳性率与监测对象的年龄组别和地区分布呈显著关联.对2004-2008年上海市新发现的73株HEV同源性和进化树分析显示,HEV以基因Ⅳ型为主,包含4个已知基因亚型(4a、4d、4h和4i)；人病毒株序列与猪基因Ⅳ型病毒株序列(GU188851、DQ450072和EF570133)的核苷酸同源性分别为83.09％～ 97.96％、85.87％～97.26％和83.80％～ 95.10％；不同区县来源的HEV分离株中,同源性＞99％的序列有59对.结论戊肝仍是上海市需长期重点防治的急性传染病之一.其人畜共患命题还有待进一步探索.
목적 계통분석1997-2012년상해시무형간염(무간)적류행특정、혈청학화기인분형특점.방법 이용국가법정전염병보고수거；채용ELISA검측사구건강인군무간병독(HEV)-IgG항체,계산표화양성솔；사용소식RT-PCR、기인측서화GenBank수거구건상해시HEV기인수거고.결과 16년간상해시무간이산발위주,발병솔정계절성화주기성,총체략정하강추세.남성발병솔현저고우녀성,환자이30 ～ 65세년중노년인위주.2001-2012년4차사구건강인군항체수평감측,공채집혈청표본3979빈,인군HEV-IgG항체표화양성솔분별위22.32％、18.56％、10.22％화34.43％,항체양성솔여감측대상적년령조별화지구분포정현저관련.대2004-2008년상해시신발현적73주HEV동원성화진화수분석현시,HEV이기인Ⅳ형위주,포함4개이지기인아형(4a、4d、4h화4i)；인병독주서렬여저기인Ⅳ형병독주서렬(GU188851、DQ450072화EF570133)적핵감산동원성분별위83.09％～ 97.96％、85.87％～97.26％화83.80％～ 95.10％；불동구현래원적HEV분리주중,동원성＞99％적서렬유59대.결론 무간잉시상해시수장기중점방치적급성전염병지일.기인축공환명제환유대진일보탐색.
Objective The aim of this study was to systemically analyze the epidemiologic,serological and genetic characteristics of hepatitis E virus (HEV) in Shanghai from 1997 to 2012.Methods We analyzed the data related to the epidemics of hepatitis E from China Information System for Disease Control and Prevention.We implemented serological surveillance program,based on community healthy population with enzyme-linked immunosorbent assay method and estimated the standardized sero-prevalence.We also obtained nucleotide sequences of hepatitis E patients using the nested RT-PCT assays,together with propotype sequences in the GenBank to construct a HEV genetic database in Shanghai.Results In this paper,we found that the distribution of hepatitis E patients was sporadic in the past 16 years in Shanghai.The morbidity kept declining,but with seasonal and periodical fluctuation.Morbidity in males was significantly higher than in females,with the hard hit population between 30 and 65 year-olds.In total,3979 sera samples were collected through the serological surveillance programs in 2001,2004,2007 and 2012.The standardized sero-prevalence rates of the said years were 22.32％,18.56％,10.22％ and 34.43％ which all showing strong relationship with age groups and the regions where the populations were being monitored.73 nucleotide sequences of hepatitis E patients from hospitals were identified,during 2004 and 2008.Results from phylogenetic analysis revealed that all HEV isolates belonged to genotype Ⅳ and including 4 known subtypes 4a,4d,4h and 4i which sharing 83.09％-97.96％,85.87％-97.26％ and 83.80％-95.10％ nucleotide sequence identities with the swine HEV genotype Ⅳ of GU188851,DQ450072 and EF570133.Meanwhile,59 HEV isolates from different districts shared 99％ nucleotide sequence identities with each other.Conclusion Hepatitis E would still be a challenge for long time and the zoonotic questions that related to hepatitis E,need to be explored and explained in the future.