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儿童肝移植前后的GB病毒C(GBV-C/HGV)及E2抗体

GB virus C (GBV-C/HGV) and E2 antibodies in children preliver and postliver transplant.

作者信息

Elkayam O, Hassoba H M, Ferrell L D, Garcia-Kennedy R, Gish R G, Wright T L, Laffler T, Traylor D, Hunt G, Rosenthal P

机构信息

Department of Pediatrics, University of California, San Francisco, 94143, USA.

出版信息

Pediatr Res. 1999 Jun;45(6):795-8. doi: 10.1203/00006450-199906000-00002.

Abstract

The association of GB virus type C (GBV-C) virus and clinical disease is uncertain. The role of GBV-C and (Envelope) E2 antibody in children with liver transplants has not been determined. This study's aim is to examine the prevalence of GBV-C in children with liver transplants, to assess the relationship of GBV-C to posttransplant hepatitis, and to determine the role of E2 antibodies. Sera from 34 children, preliver and postliver transplant, between 1989-1996 were tested for GBV-C (Ribonucleic acid) RNA by the automated Abbott LCx PCR assay. Anti-E2 antibodies were detected by an Abbott immunoassay. Recent posttransplant liver biopsies were examined for hepatitis. The results of the study determined that pretransplant, four children (12%) were GBV-C RNA positive. Posttransplant, 14 (42%) children were GBV-C RNA positive. The GBV-C RNA positive conversion rate was 33% (CI 17.2-55.7%). Patients received blood products from a mean of 68 +/- 34 donors, which correlated with GBV-C acquisition. There was no difference in the incidence (32%versus 36%; p = 0.726) or severity (grade 2.00 versus 0.68; p = 0.126) of posttransplant hepatitis in the liver biopsies of GBV-C RNA negative and/or positive children, respectively. Pretransplant, nine of 32 children were anti-E2 positive. Posttransplant, eight of 32 children were anti-E2 positive, including five children who were anti-E2 positive pretransplant. Of nine children who were anti-E2 positive and GBV-C RNA negative pretransplant, three became GBV-C RNA positive posttransplant. The results of this study conclude that the prevalence of GBV-C infection in children postliver transplantation is high and that blood product transfusions correlate with GBV-C acquisition. Also, no correlation was found between GBV-C RNA and the incidence or severity of posttransplant hepatitis. Finally, E2 antibody presence before transplantation failed to provide complete protection from GBV-C acquisition.

摘要

丙型GB病毒(GBV-C)与临床疾病之间的关联尚不确定。GBV-C及(包膜)E2抗体在儿童肝移植受者中的作用尚未明确。本研究旨在检测儿童肝移植受者中GBV-C的感染率,评估GBV-C与移植后肝炎的关系,并确定E2抗体的作用。采用雅培LCx自动化PCR检测法对1989年至1996年间34例儿童肝移植受者肝移植前后的血清进行GBV-C(核糖核酸)RNA检测。采用雅培免疫分析法检测抗E2抗体。对近期移植后的肝脏活检组织进行肝炎检查。研究结果显示,移植前,4例儿童(12%)GBV-C RNA呈阳性。移植后,14例儿童(42%)GBV-C RNA呈阳性。GBV-C RNA阳性转化率为33%(可信区间17.2 - 55.7%)。患者平均接受了68±34名供者的血液制品,这与GBV-C感染相关。GBV-C RNA阴性和/或阳性儿童肝活检中移植后肝炎的发生率(分别为32%对36%;p = 0.726)或严重程度(2.00级对0.68级;p = 0.126)无差异。移植前,32例儿童中有9例抗E2呈阳性。移植后,32例儿童中有8例抗E2呈阳性,其中包括5例移植前抗E2呈阳性的儿童。移植前9例抗E2呈阳性且GBV-C RNA阴性的儿童中,3例移植后GBV-C RNA转为阳性。本研究结果表明,儿童肝移植后GBV-C感染率较高,血液制品输注与GBV-C感染相关。此外,未发现GBV-C RNA与移植后肝炎的发生率或严重程度之间存在相关性。最后,移植前存在E2抗体并不能完全预防GBV-C感染。

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