乙肝和丙肝病毒感染在非甲--戊肝炎中的角色

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VIRAL HEPATITIS-Retrospective Analysis of Non-A-E Hepatitis: Possible Role of Hepatitis B and C Virus Infection
病毒肝炎-非甲-戊肝炎的追溯分析: 乙肝和丙肝病毒感染在其中的可能角色

Z. He (1, 2), H. Zhuang (2), X. Wang (2), S.Song (1), Q.Dong (1), J. Yan (1), G. C. Buehring (3), G. Luo (4)

(1)Research Center of Virology, Beijing Ditan Hospital, Beijing, China
(2) Department of Microbiology, Peking University Health Science Center, Beijing, China
(3) School of Public Health, University of California, Berkeley, California
(4) Department of Microbiology, Immunology and Molecular Genetics, University of Kentucky College of Medicine, Lexington, Kentucky

In an effort to determine the cause of non-A-E hepatitis, a retrospective study was undertaken on a group of patients with hepatitis but without serological infection markers of hepatitis viruses A-E.
为了弄清楚非甲--戊型肝炎的起因, 科学家对一组不显示病毒肝炎血清指标病人进行了一项追溯研究.

A total of 60 patients admitted to Beijing Ditan Hospital during the period of September 1997 and September 1999 were chosen for this study.
为了研究, 北京地坛医院从1997年9月到1999年9月间录取了60名病人.

These patients were diagnosed as either acute or chronic hepatitis, but no serological markers of hepatitis viruses A-E were detected.
这些病人都是确诊患有急性或慢性肝炎, 但是血清试验指标都测验不到甲--戊型肝炎病毒.

Since TT virus (TTV), human parvovirus B19 (B19), SEN virus (SENV), and GB virus C/HGV were reported to be associated with hepatitis, attempts were made to detect the presence of these viruses in the sera of patients with non-A-E hepatitis by a nested polymerase chain reaction (nPCR) method.
因为TT肝炎病毒(输血传播病毒肝炎), 人细小病毒B19, SEN 肝炎病毒(输血有关的新病毒), GB病毒C／庚型肝炎病毒(GBV—C／HGV)可以造成肝炎, 在测不到甲--戊肝肝炎情况下, 重点在用nPCR测验方法监测是否有这些病毒出现先.

Also, more sensitive nPCR and RT-nPCR methods were used to determine HBV DNA and HCV RNA in these patients.
同时, 运用更精确的nPCR 和 RT-nPCR 方法在病人中检测乙肝病毒DNA和丙肝病毒RNA.

Results derived from these analyses demonstrate that HBV DNA was detected in most of these patients (47/60, 78.3%), suggesting that HBV infection played a major role in occult non-A-E hepatitis and detection of HBV DNA by more sensitive PCR methods such as nPCR should be considered for diagnosis of HBV infection.
测验结果证明乙肝病毒DNA在大部分病人血中发现(47/60人, 78.3%), 这提示乙肝病毒感染在隐喻型非甲--戊肝炎中起着非常重要的角色, 从而建议更精确的nPCR(nested polymerase chain reaction)方法应该应用到乙肝的检验.

In addition, HCV RNA was detected in three (5%) of these patients. However, GBV-C (HGV) RNA was not detected, and TTV, B19, and SENV appear not to be associated with non-A-E hepatitis, as the prevalence rates of these viruses in patients with non-A-E hepatitis were similar to those in patients with viral hepatitis A-E. The results from this study indicate that co-infection of TTV or B19 with HBV did not increase the severity of the disease. (J. Med. Virol., 69, 59-65, 2003).
此外, 在大约三人(5%)中测验到丙肝病毒RNA. G肝没有发现, TTV B19, 和 SENV 似乎也与非甲--戊型肝炎无关, 因为这些病毒在这些非甲--戊肝炎中的发病%和甲--戊型肝炎感染者相似. 研究结果指出TTV, B19 共染 HBV 并不会造成肝病恶化.

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文章最重要的地方在, 如果有肝炎症状, 或确诊患有急性/慢性肝炎, 但是甲--戊型病毒肝炎血清化验指标不显示, 而且其它几种病毒排外, 很有可能感染有隐喻型肝炎, 特别是乙肝. 应该进行更精密的HBV DNA 测验, 不能大意, 或只顾接种疫苗. 医生在给病人检查, 接种是都不能忽略这个悄悄增多的感染现象, 特别是在中国. (411011103)