当前丙型肝炎病毒在中国的流行主要是被污染的输血

StephenW

The Current Hepatitis C Virus Prevalence in China May Have Resulted Mainly from an Officially Encouraged Plasma Campaign in the 1990s: a Coalescence Inference with Genetic Sequences

    Ling Lua,b,
    Wangxia Tonga,
    Lin Gua,
    Chunhua Lib,
    Teng Luc,
    Kok Keng Teed and
    Guihua Chena

+ Author Affiliations

    Laboratory for Hepatology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, Chinaa
    Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, Kansas, USAb
    University of Southern California, Los Angeles, California, USAc
    Centre of Excellence for Research in AIDS (CERiA), Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysiad

ABSTRACT

In this study, we investigated hepatitis C virus (HCV) molecular epidemiology and evolutionary dynamics. Both E1 and NS5B sequences were characterized in 379 of 433 patients in southern China and classified into five major subtypes: 1b in 256 patients, 6a in 67 patients, 2a in 29 patients, 3a in 14 patients, and 3b in 13 patients. Using the E1 sequences obtained, along with those from other studies using samples from China, we inferred the HCV epidemic history by means of coalescence strategies. Five Bayesian skyline plots (BSPs) were estimated for the five subtypes. They concurrently highlighted the rapid growth in the HCV-infected population size from 1993 to 2000, followed by an abrupt slowing. Although flanked on both sides by variable population sizes, the plots showed distinct patterns of rapid HCV growth. Coincidently, 1993 to 2000 was a period when contaminated blood transfusions were common in China due to a procedural error in an officially encouraged plasma campaign. The abrupt slowing in 1998 to 2000 corresponded to the central government outlawing paid blood donations in 1998. Using a parametric model, the HCV population growth rates were estimated during 1993 to 2000. It was revealed that the 6a rate was the highest, followed by those of 1b, 2a, 3b, and 3a. Because these rates differed significantly (P < 1e−9) from each other, they may help explain why 6a is increasingly prevalent in southern China and 1b is predominant nationwide. These rates are approximately 10-fold higher than those reported elsewhere. These findings suggested that during the plasma campaign, certain barriers to efficient viral transmission were removed, allowing wide HCV dissemination.

StephenW

当前丙型肝炎病毒在中国的流行，主要从官方鼓励等离子运动在20世纪90年代：聚结推理可能导致基因序列

    凌Lua中， B，
    望厦汤加，
    民国卦，
    春华解放，
    腾吕克，
    角颈开球和
    桂花切纳

+作者所属机构

    孙中山大学，广州，广东，吃奶，第三附属医院肝病实验室
    病理学和实验室医学，堪萨斯医学中心大学，堪萨斯城，堪萨斯州， USAB
    南加州大学，洛杉矶，加州， USAC
    研究在艾滋病（氧化铈） ，马来亚大学医学系，医学系，吉隆坡， Malaysiad中卓越中心

摘要

在这项研究中，我们调查了丙型肝炎病毒（HCV）分子流行病学和进化动态。在中国南部的433例中的379 E1和NS5B序列进行了表征，并分为五个主要的亚型：在256例患者中， 1B 6A 67例29例，2A ，3A ， 14例， 13例和3b 。使用E1序列，以及那些从其他研究使用的样本来自中国，我们通过合并策略推断HCV流行史。五贝叶斯天际线图（板级支持包） ，估计五个亚型。他们同时强调了丙型肝炎病毒感染的人口规模的快速增长， 1993至2000年，然后突然放缓。虽然两侧双方变量的人口规模，地块HCV快速增长表现出不同的模式。巧合的是，1993年至2000年期间，当污染输血共同在中国由于一个程序错误在官方鼓励血浆活动。 1998年至2000年的突然放缓符合中央政府于1998年立法禁止有偿献血。使用一个参数模型，丙型肝炎病毒的人口增长率估计在1993至2000年期间。据透露， 6A率是最高的，其次是那些1B，2A ，3B和3a 。由于这些价格差异显着（ P < 1E -9）对方，他们可能有助于解释为什么在中国南部6a是越来越普遍和1b是全国占主导地位。这些费率约10倍，高于其他机构的报道。这些结果表明，在等离子体运动，某些高效的病毒传播的障碍被拆除，允许宽HCV传播。