Long-term outcome of chronic hepatitis C virus infection in primary hypogammaglobulinaemia
Long-term outcome of chronic hepatitis C virus infection in primary hypogammaglobulinaemia
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DOI：
10.1093/qjmed/92.8.433
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发表时间：
1999-08-01
影响因子：
13.3
通讯作者：
Froland, SS
中科院分区：
文献类型：
--
作者：
Bjoro, K;Skaug, K;Froland, SS
原发性低丙种球蛋白血症患者HCV感染的临床病程似乎比免疫功能正常的患者更严重。我们研究了20名已知有13-15年HCV感染史的挪威低丙种球蛋白血症患者的慢性HCV感染的长期病程。在观察期间（1984-1999年），20例患者中有12例发生肝硬化，其余8例也有慢性肝病，大多数病例经肝活检证实。20名患者中有11人死亡。2例因HCV肝硬化肝移植后死亡。5人死于终末期肝功能衰竭，没有接受肝移植。两名患者死于其他原因，但与晚期肝病的结果，而两名死亡与HCV感染无关。在普通变异型免疫缺陷（CVI）患者中，六分之五的人死亡。两名患者在干扰素单药治疗3年后清除了丙型肝炎病毒，而三名患者对干扰素和利巴韦林联合治疗取得了持续应答。病毒载量似乎对疾病进展没有重大影响。我们的研究结果强调了低丙种球蛋白血症患者丙型肝炎病毒感染的严重性。CVI患者的预后最差。
The clinical course of HCV infection in patients with primary hypogammaglobulinaemia appears to be more severe than in immunocompetent patients. We studied the long-term course of chronic HCV infection in 20 Norwegian hypogammaglobulinaemia patients with a 13-15 year known history of HCV infection. Twelve of 20 patients developed cirrhosis during the observation period (1984-1999), and the remaining eight also had chronic liver disease verified by liver biopsy in the majority of the cases. Eleven of the 20 patients are dead. Two died following liver transplantation for HCV cirrhosis. Five died due to terminal liver failure without receiving a liver allograft. Two patients died from other causes, but with advanced liver disease contributing to the outcome, while two deaths were unrelated to the HCV infection. Among patients with common variable immunodeficiency (CVI), five out of six are dead. Two patients cleared the hepatitis C virus 3 years following interferon monotherapy, while three patients achieved a sustained response to combination therapy with interferon and ribavirin. Viral load did not seem to have a major impact on disease progression. Our results emphasize the severity of hepatitis C virus infection in patients with hypogammaglobulinaemia. Patients with CVI appear to have the poorest prognosis.