Quantitation of hepatitis C virus RNA in liver transplant recipients.
Quantitation of hepatitis C virus RNA in liver transplant recipients.
复制标题
肝移植受者中丙型肝炎病毒 RNA 的定量。
DOI：
10.1016/0016-5085(94)90759-5
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发表时间：
1994
期刊：
影响因子：
29.4
通讯作者：
Urdea,M
中科院分区：
文献类型：
--
作者：
Chazouilleres,O;Kim,M;Combs,C;Ferrell,L;Bacchetti,P;Roberts,J;Ascher,NL;Neuwald,P;Wilber,J;Urdea,M
背景/目的：丙型肝炎病毒感染在肝移植患者中是常见的，但免疫抑制对HCVRNA水平的影响及其与肝损伤的关系尚未被研究。方法：通过聚合酶链式反应扩增和分支DNA分析检测100例丙型肝炎病毒感染的肝移植患者血清中的HCVRNA。结果：移植后的平均水平是移植前的16倍(分别为7,935,000和496,000 Eq/mL；n=65；P<；0.0001)。移植前水平高的患者移植后平均水平高于移植前水平低的患者(分别为17,119,000和6,504,000 Eq/ml；P=0.064)。在复发和获得性感染的患者中，移植后的水平是相似的，并且与采样时间无关。50%的丙型肝炎病毒感染者肝活检标本正常，病毒血症程度与肝损害程度无明显关系。结论：肝移植术后丙型肝炎病毒RNA水平明显升高。在没有组织学肝炎的情况下，经常发现病毒血症，这表明“携带者状态”很常见。在一些(尽管病毒RNA水平很高)中没有同种移植物损伤，这表明在免疫抑制的患者中，丙型肝炎病毒感染可能是可以耐受的，而不会造成直接的肝脏损伤。
Background/Aims:Hepatitis C virus (HCV) infection is common in liver transplant recipients, yet the effects of immunosuppression on HCV RNA levels and the relationship of HCV RNA levels to hepatic damage have not been studied.Methods:To explore these issues, we measured HCV RNA in serum by polymerase chain reaction amplification and branched DNA assay from 100 HCV-infected patients undergoing liver transplantation.Results:Mean posttransplant levels were 16-fold higher than pretransplant values (7,935,000 and 496,000 Eq/mL, respectively; n = 65;P< 0.0001). Patients with high pretransplant levels had higher mean posttransplant levels than those with low pretransplant levels (17,119,000 and 6,504,000 Eq/ mL, respectively;P= 0.064). Posttransplant levels were similar in patients with recurrent and acquired infection and were independent of time of sampling. Fifty percent of patients with HCV infection had normal liver biopsy specimens, and there was no strong relationship between level of viremia and degree of hepatic damage.Conclusions:HCV RNA levels increase markedly following liver transplantation. The frequent finding of viremia in the absence of histological hepatitis suggests that a “carrier state” is common. Absence of allograft damage in some (despite high levels of viral RNA) suggests that in immunosuppressed patients, HCV infection may be tolerated without direct hepatic damage.