Quantification of viral DNA and liver enzymes in plasma improves early diagnosis and management of herpes simplex virus hepatitis.
Quantification of viral DNA and liver enzymes in plasma improves early diagnosis and management of herpes simplex virus hepatitis.
复制标题
血浆中病毒 DNA 和肝酶的定量可改善单纯疱疹病毒肝炎的早期诊断和治疗。
DOI：
10.1111/j.1365-2893.2010.01352.x
复制
发表时间：
2011
影响因子：
2.5
通讯作者：
vanDoornum,GJ
中科院分区：
文献类型：
--
作者：
Beersma,MFC;Verjans,GMGM;Metselaar,HJ;Osterhaus,ADME;Berrington,WR;vanDoornum,GJ
单纯疱疹病毒（HSV）肝炎是一种罕见且可能危及生命的疾病。 HSV 肝炎的诊断因其临床表现不明显而受到阻碍，因此需要验证性实验室数据来识别受影响肝脏中的 HSV。然而，肝活检在凝血障碍的情况下通常是禁忌的，容易出现采样错误，并且在轻度 HSV 肝炎病例中敏感性较低。对侵入性较小的诊断工具的需求尚未得到满足。在 5 名 HSV 肝炎患者和 20 名患有 HSV-DNA 血症（无肝炎）的疾病对照中确定了 HSV DNA 载量和肝酶水平动力学的诊断和治疗价值。住院时，HSV 肝炎患者的 HSV DNA 载量中位数（±四分位数范围）（6.0 × 106±1.2 × 109）高于疾病对照（171 ± 2845）。病毒 DNA 载量与肝脏转氨酶水平和疾病严重程度相关。抗病毒治疗导致HSV肝炎患者HSV DNA载量迅速下降并改善肝功能。该数据主张对疑似HSV肝炎患者以及接受抗病毒治疗的患者血浆中HSV DNA载量和肝酶水平进行及时、连续的定量。
Herpes simplex virus (HSV) hepatitis is a rare and potential life‐threatening disease. The diagnosis of HSV hepatitis is hampered by its indifferent clinical presentation, which necessitates confirmatory laboratory data to identify HSV in the affected liver. However, liver biopsies are often contraindicated in the context of coagulopathy, are prone to sampling errors and have low sensitivity in mild HSV hepatitis cases. There is an unmet need for less invasive diagnostic tools. The diagnostic and therapeutic value of HSV DNA load and liver enzyme level kinetics was determined in five patients with HSV hepatitis and twenty disease controls with HSV‐DNAemia without hepatitis. At time of hospitalization, patients with HSV hepatitis had a higher median (± interquartile range) HSV DNA load (6.0 × 106±1.2 × 109) compared to disease controls (171 ± 2845). Viral DNA load correlated with liver transaminase levels and disease severity. Antiviral treatment led to rapid decline of HSV DNA load and improvement of liver function of patients with HSV hepatitis. The data advocate the prompt and consecutive quantification of the HSV DNA load and liver enzyme levels in plasma of patients suspected of HSV hepatitis as well as those under antiviral treatment.