Hepatitis D viremia following orthotopic liver transplantation involves a typical HDV virion with a hepatitis B surface antigen envelope.
Hepatitis D viremia following orthotopic liver transplantation involves a typical HDV virion with a hepatitis B surface antigen envelope.
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原位肝移植后的丁型肝炎病毒血症涉及带有乙型肝炎表面抗原包膜的典型丁型肝炎病毒粒子。
DOI：
10.1002/hep.510270636
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发表时间：
1998
期刊：
影响因子：
--
通讯作者：
Gerin,JL
中科院分区：
文献类型：
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作者：
Smedile,A;Casey,JL;Cote,PJ;Durazzo,M;Lavezzo,B;Purcell,RH;Rizzetto,M;Gerin,JL
由于D型肝炎而接受原位肝移植（OLT）的患者经常在移植后表现出似乎是自主的或“分离的”丁型肝炎病毒（HDV）感染，在移植物或血清中没有乙型肝炎病毒（HBV）的证据。这些观察结果导致了HBV可能并不总是HDV感染所必需的假设，或者HDV可能作为潜伏感染存在，直到被HBV拯救。或者，明显的自主HDV感染可以解释为移植后少量肝细胞与两种病毒共同感染，HBV表达水平非常低，支持低水平的HDV传播。我们的结果与后一种假设是一致的。基于敏感聚合酶链反应（PCR）的乙肝病毒血症和HDV病毒血症分析表明，HDV病毒血症并非独立于HBV病毒血症。其他分析，包括PCR扩增、CsCl梯度的浮力密度分析和单克隆乙型肝炎表面抗原抗体（anti-HBs）的免疫沉淀，表明移植后的HDV颗粒是典型的：它包含全长HDV RNA和乙型肝炎表面抗原（HBsAg）包膜，与急性和慢性阶段的HDV重复感染或合并感染没有什么不同。此外，在黑猩猩中对第一种假设进行的实验测试并不支持HDV可以作为一种孤立的潜伏感染持续数周，随后可以被HBV拯救的观点。因此，数据表明，潜伏的HDV感染不是OLT接受者的一个因素。我们得出结论，移植后的HDV病毒粒子是典型的，OLT后的HDV病毒血症需要HBV感染的辅助功能。
Patients receiving orthotopic liver transplantation (OLT) because of type D hepatitis frequently exhibit what appears to be an autonomous, or “isolated,” hepatitis D virus (HDV) infection following the transplantation, with no evidence of hepatitis B virus (HBV) in the graft or in the serum. These observations have led to the hypothesis that HBV might not always be required for HDV infection, or that HDV could exist as a latent infection until rescued by HBV. Alternatively, an apparently autonomous HDV infection could be explained by coinfection of a small number of hepatocytes with both viruses following transplantation, with a very low level of HBV expression that supports low-level HDV propagation. Our results are consistent with the latter hypothesis. Sensitive polymerase chain reaction (PCR)-based analysis of HBV and HDV viremia in transplantation patients with HDV infection previously characterized as isolated showed that HDV viremia was not independent of HBV viremia. Additional analyses, including PCR amplification, buoyant density analysis in a CsCl gradient, and immunoprecipitation with monoclonal hepatitis B surface antigen antibodies (anti-HBs), indicated that the posttransplant HDV particle is typical: it contains full-length HDV RNA and an envelope of hepatitis B surface antigen (HBsAg) and is not different from that found during the acute and chronic stages of HDV superinfection or coinfection. Moreover, an experimental test of the first hypothesis in chimpanzees did not support the idea that HDV can persist for several weeks as an isolated, latent infection that can be rescued subsequently by HBV. The data indicate, therefore, that latent HDV infection is not a factor in OLT recipients. We conclude that the HDV virion in the posttransplantation setting is typical, and that HDV viremia following OLT requires the helper function of HBV infection.