Second infection with a different hepatitis C virus genotype in a intravenous drug user during interferon therapy
Second infection with a different hepatitis C virus genotype in a intravenous drug user during interferon therapy
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DOI：
10.1136/gut.52.6.900
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发表时间：
2003-06-01
期刊：
影响因子：
24.5
通讯作者：
Marcellin, P
中科院分区：
文献类型：
--
作者：
Asselah, T;Vidaud, D;Marcellin, P
静脉吸毒者 (IVDU) 中丙型肝炎病毒抗体（抗 HCV）的流行率一直非常高。黑猩猩交叉攻击研究提供的证据表明可能会发生不同 HCV 毒株的再感染。在人类中，多次输血的血友病患者和最近的 IVDU 中均报告了不同 HCV 毒株的再感染，但在干扰素 (IFN) 治疗期间尚未报告病例。我们报告了一名 22 岁女性因 HCV 基因型 3a 慢性感染而接受 IFN α 治疗的情况。六个月时，逆转录聚合酶链式反应无法检测到 HCV RNA。 1997 年 10 月，仍在接受干扰素治疗的她在静脉注射药物后患上了急性肝炎，并通过基因分型和测序方法鉴定出 HCV 基因型 1a 感染。 IFN治疗一直持续到1998年8月，1999年1月HCV-RNA检测不到。我们的病例表明，以前的丙型肝炎病毒感染可能阻止了慢性病的发展。另一种解释是，干扰素虽然不能预防急性丙型肝炎，但可以预防慢性丙型肝炎。 IVDU 中多重感染的风险凸显了预防策略的必要性。
The prevalence of antibodies against hepatitis C virus (anti-HCV) among intravenous drug users (IVDU) has consistently been very high. Cross challenge studies in chimpanzees provide evidence that reinfection with different HCV strains may occur. In humans, reinfection with different HCV strains has been reported in multitransfused haemophiliacs and recently in IVDU but no case has been reported while on interferon (IFN) therapy. We report on a 22 year old woman who was treated with IFN alpha for HCV genotype 3a chronic infection. At six months, HCV RNA was undetectable by reverse transcription-polymerase chain reaction. In October 1997, while still on IFN, she developed an acute hepatitis after an intravenous drug injection and HCV genotype 1a infection was identified using genotyping and sequencing methods. IFN therapy was continued until August 1998, and in January 1999 HCV-RNA was not detectable. Our case indicates that the previous HCV infection might have prevented development of chronicity. An alternative explanation is that IFN, while not preventing acute hepatitis C, may prevent chronicity. The risk of multiple infection in IVDU underlines the need for preventive strategies.