C型肝炎病毒盛行率與肝功能異常捐血人之潛隱性C型肝炎病毒感染研究

HCV prevalence and Investigation of Occult HCV Infection in Blood Donors with Abnormal Liver Function

陳錦隆(Chin-Lung Chen)

指導教授 ： 楊沂淵

臺北醫學大學/醫學科技學院/醫學檢驗暨生物技術學系所/碩士(2014年)

https://doi.org/10.6831/TMU.2014.00020

摘要

C型肝炎病毒為黃熱病毒科（Flaviviridae）之單股正性RNA病毒，由Qui-Lim Choo和George Kuo等學者於1989年以分子生物技術，在非A非B型肝炎之病患血清中鑑別出病毒體，而人類為其主要宿主。依據台灣疾病管制署公布資訊，估計台灣人口約有2%罹患C型肝炎，且南台灣之某些地區的地方性流行率很高。近年來，台灣地區受到C型肝炎病毒感染之人口數及比例正逐年上升；Castillo等學者於2004年發表一項名為潛隱性C型肝炎感染的慢性肝炎，該類型感染的特性是血清中偵測不到HCV RNA卻伴隨有肝功能檢測異常，但約70%罹患潛隱性C型肝炎感染的病人在周邊血液單核球細胞中發現有C型肝炎病毒核酸存在，但尚不了解病毒是否會在這些細胞中進行複製。因而設計此研究，針對肝功能檢測異常捐血人進行篩檢是否有潛隱性C型肝炎病毒感染（Occult Hepatitis C infection；OCI）存在，並統計2004至2013年捐血人C型肝炎感染盛行率。目前台北捐血中心之血液檢測，均以血清/血漿作為檢體來源；在本實驗設計中，將使用不同於捐血中心目前使用之血液檢體，改以周邊血液單核球細胞（Peripheral blood mononuclear cells；PBMCs）取代血清作為實驗檢體進行C型肝炎病毒核酸檢測。由於C型肝炎病毒主要感染肝臟細胞，因此罹患C型肝炎時，丙胺酸轉胺酶（ALT）數值會呈現不穩定的狀態或在臨床診斷臨界值呈現轉變；因此，對於丙胺酸轉胺酶指數異常之捐血人，探討其臨床意義，除生理性異常外，是否有病理性原因存在，實有其必要。為了避免潛隱性C型肝炎病毒感染對血品造成危害，確保血液品質以提升輸血安全，故以此作為本論文之研究主題。

關鍵字

C型肝炎病毒盛行率 ； 潛隱性C型肝炎病毒感染

並列摘要

Hepatitis C Virus (HCV) is an enveloped, single-stranded positive RNA virus that belonging to the Flaviviridae family; the human are main host. In 1989, Qui-Lim Choo and George Kuo et al., used a molecular cloning approach to identify the virion from the non-A, non-B hepatitis patient's serum. According to published by CDC of Taiwan, it is estimated that 2% of the general Taiwan population are infected with HCV, and highest regional prevalence were reported in some area in southern Taiwan. Recently, the proportion of Taiwan's population infected HCV are increased; Since 2004, a new form of chronic HCV infection named occult hepatitis C virus (OCI) was described by Castillo et al.. This infection is characterized by absence HCV RNA in serum, but with abnormality in liver function tests; however, about 70% of patients with OCI also have occurrence HCV-RNA in peripheral blood mononuclear cells (PBMCs) but it is not known if HCV is replicating in these cells. For this reason, the aim of this study design was to investigated the potential existence of occult hepatitis C virus infection (OCI) in blood donors with abnormal ALT levels and performed statistical analysis the prevalence of donors with HCV infection in the period between 2004 and 2013. Currently, all specimen using serum / plasma during laboratory experiment in Taipei Blood Center; in this study, we used a new specimen replaced serum by peripheral blood mononuclear cells (Peripheral blood mononuclear cells; PBMCs) which different from Taipei Blood Center's specimen had detected the HCV RNA. Because HCV mainly invasive liver cells, the alanine aminotransferase (ALT) index will reveal an unstable pattern or high variability levels of clinical borderlines when human infected with HCV; therefore, it is a essential to issue that clinical significance of blood donors with abnormal ALT Index, whether physiologic or pathologic reasons. In order to avoid OCI cause hazard to the transfusion, enhanced safety and ensured quality of blood products; therefore, we offer this project as research topic of this thesis.

並列關鍵字

HCV prevalence ； Occult HCV Infection

參考文獻

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