EPIDEMIOLOGY AND PATHOGENESIS OF HEPATITIS B AND C VIRUS

丙型肝炎病毒(丙型肝炎病毒)是美国慢性肝病的重要原因，也是确保血液供应安全的持续监管挑战。宫崎骏队列研究是一项对日本地区973人进行的持续研究，该地区的丙型肝炎病毒和人类T淋巴细胞嗜T细胞病毒I型(HTLV-I)都高度流行。1985-1995年间，该人群中有14名丙型肝炎病毒抗体(抗-丙型肝炎病毒)血清转换者(以前血清阴性者每1000人年有3.6名血清转换者)。在10个血清转换者中检测到了丙型肝炎病毒RNA，其中8个在一年以上仍可检测到。在一些患者中，丙型肝炎病毒和乙肝病毒都可能导致肝细胞癌(肝细胞癌)的发展，通常与p53肿瘤抑制基因的突变有关。直接测序检测突变提供了比免疫组织化学(IH)染色更多的信息，但所需的设备和所需的时间使其在大规模研究或发展中国家的研究中不太实用。在一项对28个肝癌的研究中，19个(68%)有50%到95%的细胞被染色。直接测序发现17例(61%)P53外显子5-8发生突变，与直接测序法相比，IH具有较高的敏感性和特异性，可用于检测肝细胞癌患者中突变的P53。

Hepatitis C virus (HCV) is an important cause of chronic liver disease in the United States and a continuing regulatory challenge for ensuring the safety of the blood supply. The Miyazaki Cohort Study is an ongoing study of 973 people in an area of Japan where both HCV and the human T lymphotropic virus type I (HTLV-I) are highly prevalent. Between 1985-1995, there were 14 seroconverters to antibody to HCV (anti-HCV) in this population (3.6 seroconverters per 1,000 person-years in previously seronegative persons). HCV-RNA was detectable in 10 of the seroconverters, and it remained detectable for greater than one year in eight of them. Both HCV and the hepatitis B virus may lead to the development of hepatocellular carcinoma HCC) in some patients, often in association with mutations in the p53 tumor suppressor gene. Detection of mutations by direct sequencing provides more information than immunohistochemical (IH) staining, but the equipment needed and the time required make it less practical for use in large-scale studies or in studies in developing countries. In a study of 28 HCCs, 19 (68%) had 50 to 95% of cells stained. Mutations in p53 exons 5-8 were found by direct sequencing in 17 (61%), indicating a high level of sensitivity and specificity of IH compared to direct sequencing to detect mutant p53 in HBV-infected patients with HCC.