Prevalence of Hepatitis C Vims Antibody in Beta‐Thalassemic Polytransfused Children in a Long‐Term Follow‐Up
Prevalence of Hepatitis C Vims Antibody in Beta‐Thalassemic Polytransfused Children in a Long‐Term Follow‐Up
复制标题
长期随访中β-地中海贫血多次输血儿童丙型肝炎病毒抗体的患病率
DOI：
10.1111/j.1423-0410.1991.tb00916.x
复制
发表时间：
1991
期刊：
影响因子：
2.7
通讯作者：
A. Vierucci
中科院分区：
文献类型：
--
作者：
M. Resti;C. Azzari;M. Rossi;C. Vullo;L. Borgatti;A. Vierucci
患有重型地中海贫血的儿童常规接受输血治疗，因此他们是血液传播病毒感染的高风险人群[l]。在过去的几年中，B型肝炎病毒（HBV）发挥了重要作用，但常规献血者HBV筛查[2]和HBV疫苗接种[3]已大大减少了β-地中海贫血儿童中HBV相关肝病的发生。今天，非甲非乙型（NANB）肝炎占输血后肝炎的90%以上[4]。最近开发的用于检测针对丙型肝炎病毒（HCV）抗原的抗体的测定[5，6]表明，超过85%的NANB肝炎是由HCV引起的[7]。在佛罗伦萨和费拉拉的儿科进行了一项研究，以评估地中海贫血多输血儿童人群中抗-HCV抗体的流行率。用于检测抗HCV抗体的测定法（“Ortho HCV”，Ortho Diagnostics，拉里坦，新泽西州，美国）使用。在这一人群中进行了约13年的长期随访，评估了抗HCV抗体的流行率和持续性。HCV感染和输血单位数之间的相关性也被考虑在内。对35例重型β地中海贫血患者（男20例，女15例）进行了检查。他们接受定期输血治疗，用洗过的浓缩血细胞。患者从出生起随访12.6 ± 4.1年（中位数12年）。在第一次输血前从所有患者中抽取的样本进行抗HCV抗体检测，所有样本均为阴性。如表1所示，22名儿童（62.9%）在随访期间血清转化。该百分比与血友病患者中获得的百分比相似[8]。在血清转换时，他们接受了平均83.9 f 60.7血液单位（中位数68.5）; 13例患者（37.1%）保持阴性。血清转换时的平均年龄为5.5岁，中位数为5.5岁，众数为2至4岁。在男性和女性之间以及在脾切除（n = 8）和未脾切除（n = 27）的儿童之间没有发现差异。我们的研究结果表明，地中海贫血多输血儿童是HCV感染的高危人群。随访结束时，抗-HCV阳性组与阴性组在性别、年龄、输血次数等方面均无差异。
Children with @-thalassemia major are routinely treated with blood transfusions and consequently they are a population at high risk for blood-borne viral infections [l]. In past years an important role was played by hepatitis B virus (HBV), bur routine blood donor screening [2] for HBV and HBV vaccination [3] have substantially reduced HBV-related liver disease in @-thalassemic children. Today non-A, non-B (NANB) hepatitis is responsible for more than 90% of postransfusion hepatitis [4]. The recently developed assay for detection of antibodies against an antigen of hepatitis C virus (HCV) [5,6] demonstrates that more than 85% of NANB hepatitis are caused by HCV [7]. A study to evaluate the prevalence of anti-HCV antibodies in a population of @-thalassemic polytransfused children has been carried out in the Departments of Pediatrics of Florence and Ferrara. An assay for detection of antiHCV antibodies ('Ortho HCV', Ortho Diagnostics, Raritan, N.J., USA) has been used. A long-term follow-up of about 13 years prevalence and persistence of anti-HCV antibodies has been evaluated in this population. The correlation between HCV infection and the number of blood units transfused has also been considered. Thirty-five patients with p-thalassemia major (20 males and 15 females) were examined. They received periodic transfusion therapy with washed packed blood cells. The patients were followed since birth for 12.6 f 4.1 years (median 12 years). Samples drawn from all patients before the first transfusion were tested for anti-HCV antibodies and all were negative. As shown in table 1,22 children (62.9%) seroconverted during follow-up. This percentage is similar to that obtained in haemophilic patients [8]. At the time of seroconversion they had received a mean of 83.9 f 60.7 blood units (median 68.5); 13 patients (37.1%) remained negative. The mean age at the time of seroconversion is 5.5 years, the median is 5.5 years and the mode is between 2 and 4 years. No difference was found between males and females and between splenectomized (n = 8) and unsplenectomized (n = 27) children. Our results show that @-thalassemic polytransfused children are a high-risk population for HCV infection. At the end of follow-up no difference in sex, age and number of transfusions was found between those antiHCV positive and those anti-HCV negative.