Occult hepatitis C virus infection in patients in whom the etiology of persistently abnormal results of liver-function tests is unknown
Occult hepatitis C virus infection in patients in whom the etiology of persistently abnormal results of liver-function tests is unknown
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DOI：
10.1086/380202
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发表时间：
2004-01-01
影响因子：
6.4
通讯作者：
Carreño, V
中科院分区：
文献类型：
--
作者：
Castillo, I;Pardo, M;Carreño, V
背景在排除所有已知的肝病原因后，有些患者的肝功能检查长期异常结果的病因不明（ALF-EU）。我们分析了100例抗-HCV抗体和血清HCV RNA阴性的ALF-EU患者肝活检标本中丙型肝炎病毒（HCV）RNA的存在。采用逆转录聚合酶链反应（RT-PCR）和原位杂交技术检测肝和外周血单个核细胞（PBMCs）中的HCV RNA状态。在来自100名抗HCV抗体和血清HCV RNA阴性的患者中的57名的肝活检标本中检测到HCV RNA（即，有隐匿性HCV感染者）。在57例隐匿性HCV感染者中，48例（84.2%）肝内HCV RNA呈负极性。核苷酸序列分析证实了HCV RNA检测的特异性，患者感染了HCV 1b基因型。在这57例肝内HCV RNA患者中，40例（70%）在其PBMC中有病毒RNA。在肝组织学方面，隐匿性HCV感染的患者比无肝内HCV RNA的患者更容易出现坏死性炎症活动（P= 0.017）和纤维化（P = 0.022）。ALF-EU患者在缺乏抗HCV抗体和血清HCV RNA的情况下可能存在肝内HCV RNA。
Background. There are patients in whom the etiology of long-standing abnormal results of liver-function tests is unknown (ALF-EU) after exclusion of all known causes of liver diseases. We analyzed the presence of hepatitis C virus (HCV) RNA in liver-biopsy specimens from 100 patients who were negative for anti-HCV antibodies and for serum HCV RNA and who had ALF-EU.Methods. HCV RNA status was tested by reverse-transcription polymerase chain reaction (RT-PCR) and by in situ hybridization, in liver and peripheral-blood mononuclear cells (PBMCs).Results. HCV RNA was detected in liver-biopsy specimens from 57 of 100 patients negative for anti-HCV antibodies and for serum HCV RNA (i.e., who had occult HCV infection). HCV RNA of negative polarity was found in the liver of 48 (84.2%) of these 57 patients with occult HCV infection. Nucleotide-sequence analysis confirmed the specificity of detection of HCV RNA and that patients were infected with the HCV 1b genotype. Of these 57 patients with intrahepatic HCV RNA, 40 (70%) had viral RNA in their PBMCs. With regard to liver histology, patients with occult HCV infection were more likely to have necroinflammatory activity (P=.017) and fibrosis (P = .022) than were patients without intrahepatic HCV RNA.Conclusion. Patients with ALF-EU may have intrahepatic HCV RNA in the absence of anti-HCV antibodies and of serum HCV RNA.