| Objective:To observe the epidemic status of HCV and clinical characteristics of hepatitis C and related diseases in monitored residents in a blood donation village from Hebei province.To infer possible risk factors through statistical analysis,and to provide basic data for reducing HCV spread among the crowd and for treatment and management of HCV infected people.Methods:538 monitored residents in a blood donation village from Hebei province were taken as the study objects.Questionnaires were conducted for 492 objects and blood samples were collected from people reached the informed consent,and aspectic condition was required to separate serums.492 samples were tested centrally and qualitatively by an enzyme-linked immunosorbent assay(ELISA)test specific for anti-HCV or HBV antigen-antibody system.By means of PCR 116 serums positive for anti-HCV were detected quantitatively for viral loads and amplification of nucleic acids of 26 sera were done to determine the genotypes.Clinical examination were performed for 78 cases positive for anti-HCV or HBsAg,mainly including blood analysis,liver function examination,hepatic fibrosis detection,and clinical diagnosis.Results:1 The positive rate of anti-HCV in the general population was 22.09%(108/489),which was higher in the illiteracies(44.21%)and people aged 46~70 years old(41.34%)(P<0.001).42.17% of blood donors were positive for anti-HCV,which was higher than the rate of 3.19% of populations without blood donation history(P<0.001).Born at home,farmers,and surgical history were hazard factors of HCV infection through univariate analysis;however,multivariate analysis did not show that.HBsAg and HBcAb did also not enlarge the chance of HCV infection.2 HCV RNA detection rate was 51.72%,and virual loads had no connection with gender,age,history of blood donation,surgical history,HBsAg or HBcAb status,and drinking,which were also not related to spontaneous clearance rate of HCV RNA.A history of blood donation would enlarge the risk of HBV/HCV dual infection.3 Among 26 samples genotyped in serum,1b sub-genotypes were detected from 14(53.85%)sera,and 2a sub-genotypes were checked from 12(46.15%)sera.Statistical difference was not found in the HCV RNA loads,ALT,AST,total bilirubin and platelet level between two different genotypes.4 Among the 78 cases with disease diagnosis,48 were chronic hepatitis,and 2 were compensated HCV-related cirrhosis,and 6 were suspected hepatitis C.70.83% of cases chronically infected HCV appeared at least a clinical manifestation,mainly including abdominal distension,fatigue,dizziness,headache,abdominalgia,hepatic face,liver palm,lower extremity edema,and cirrhotic patients showed out various kinds of clinical symptoms or signs.7 out of the definitely diagnosed or suspected patients with chronic hepatitis C suffered from type 2 diabetes.5 Patients with chronic hepatitis C and cirrhosis had a higher level of ALT,AST,and patients with liver cirrhosis also had a higher degree of liver stiffness values,total bilirubin and liver fibrosis stage.Multivariate analysis showed that total bilirubin and liver stiffness values in patients with HCV related diseases were higher than that of other patients,but drinking was not.Conclusions:1 The anti-HCV positive rate is high in the surveillance populations,and blood donation is the main reason for this phenomenon,meanwhile the risk of HBV/HCV dual infection increases.2 1b and 2a sub-genotypes are distributed in some HCV infected persons.3 Cases with chronic hepatitis C as well as cirrhosis act with many kinds of clinical manifestations,and some also show extra-hepatic damage simultaneously.4 Patients with chronic hepatitis C and cirrhosis present raised levels of transaminase and liver stiffness,whose treatment and management should be zealously reinforced. |
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