The natural course of hepatitis C virus infection 18 years after an epidemic outbreak of non-A, non-B hepatitis in a plasmapheresis centre
The natural course of hepatitis C virus infection 18 years after an epidemic outbreak of non-A, non-B hepatitis in a plasmapheresis centre
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DOI：
10.1136/gut.44.4.563
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发表时间：
1999-04-01
期刊：
影响因子：
24.5
通讯作者：
Vogel, W
中科院分区：
文献类型：
--
作者：
Datz, C;Cramp, M;Vogel, W
背景-丙型肝炎病毒（HCV）感染的自然史是可变的，确定病程的因素尚不清楚。目的-确定HCV感染的自然病程在一个良好的特点组的患者18年后，在一个血浆置换中心的非甲，非乙型肝炎流行爆发。方法-在1994年和1996年之间，20 30个受影响的个人进行了研究。使用第二代和第三代ELISA检测试剂盒确认HCV感染。通过聚合酶链反应（PCR）方法检测HCV RNA，并通过分析巢式PCR产生的保守5 '非翻译区的扩增子进行HCV基因分型。14例患者进行了32次肝活检。18例肝酶谱异常，17例HCVRNA阳性，均为1a型感染。该队列中有90%的患者在非甲非乙型肝炎急性发作后18年表现出慢性HCV感染的证据，其中50%患有进行性肝病，20%患有肝硬化。个体之间发生的疾病结果的相当大的变化，并没有发现与急性疾病的临床特征之间的相关性。结论-变异的HCV感染的后果感染相同的病毒的情况下，表明宿主因素是重要的，在确定疾病的结果。决定疾病自然史差异的因素仍有待阐明。
Background-The natural history of hepatitis C virus (HCV) infection is variable and factors determining the course of the illness are unclear.Aims-To determine the natural course of HCV infection in a well characterised group of patients 18 years after ana epidemic outbreak of non-a, non-B hepatitis at a plasmapheresis centre.Methods-Between 1994 and 1996, 20 of 30 affected individuals were studied. HCV infection was confirmed using second and third generation ELISA test kits. HCV RNA was detected by a polymerase chain reaction (PCR) method and HCV genotyping was performed by analysing amplicons from the conserved 5'-nontranslated region generated by nested PCR. Thirty two liver biopsies were carried out in 14 patients.Results-HCV antibodies were detected in all subjects. Eighteen patients had abnormal liver enzymes and 17 were HCV RNA positive, all of whom were infected with genotype 1a. Ninety per cent of this cohort showed evidence of chronic HCV infection with 50% having progressive liver disease and 20% cirrhosis 18 years after acute onset of non-A, non-B hepatitis. Considerable variation in disease outcome occurred between individuals and no correlation with clinical features of the acute illness was found.Conclusions-Variability in the consequences of HCV infection in cases infected with the same virus suggests that host factors are important in determining disease outcome. The factors which determine differences in the natural history of the disease still remain to be elucidated.