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北京大学人民医院2015年-2018年HCV感染筛查情况分析
Screening for hepatitis C virus infection in Peking University People’s Hospital in 2015-2018
文章发布日期:2019年07月05日  来源:  作者:孔祥沙,杨瑞锋,张海莹,等  点击次数:471次  下载次数:96次

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【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)log10 IU/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,且漏检患者多数预后不良,对免疫功能不全的患者,应检测HCV RNA以避免漏检。
【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.
【关键字】:肝炎病毒属; 丙型肝炎抗体; 病毒载量
【Key words】:hepacivirus; hepatitis C antibodies; viral load
【引证本文】:KONG XS, YANG RF, ZHANG HY, et al. Screening for hepatitis C virus infection in Peking University People’s Hospital in 2015-2018[J]. J Clin Hepatol, 2019, 35(8): 1710-1713. (in Chinese)
孔祥沙, 杨瑞锋, 张海莹, 等. 北京大学人民医院2015年-2018年HCV感染筛查情况分析[J]. 临床肝胆病杂志, 2019, 35(8): 1710-1713.

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