Maruta A, Tanabe J, Hashimoto C, Kato K, Kanamori H, Fukawa H, Miyashita H, Fujisawa S, Fujita H, Matsuzaki M, Motomura S, Kodama F, Ookawa S, Mohri H, Ishigatsubo Y
Department of Hematology/Chemotherapy, Kanagawa Cancer Center, Yokohama, Japan.
Bone Marrow Transplant. 1999 Aug;24(4):359-63. doi: 10.1038/sj.bmt.1701905.
To clarify the role of hepatitis G virus (HGV) infection in liver dysfunction following allogeneic BMT, we examined cryopreserved serum samples from 33 patients who had a history of blood transfusions before BMT and whose serum samples had been stored periodically, before BMT, on day 100, and thereafter for the presence of HGV-RNA and hepatitis C virus (HCV)-RNA by reverse transcription polymerase chain reaction. Nineteen patients (58%) out of 33 were positive for HGV-RNA before BMT and 10 for HCV-RNA. All patients positive for HCV-RNA were also positive for HGV-RNA. Patients were divided into three groups according to their viral status before BMT; namely, the G+C+ group (n = 10), the G+C- group (n = 9) and the G-C- group (n = 14). Two patients in the G-C- group became positive for HGV-RNA after BMT. One patient in the G+C- group suffered an acute exacerbation of hepatitis, with GPT levels reaching over 1000 IU/l, 2 and 3 years after BMT, showing quite a different clinical course from those in the G+C- group. Excluding these three patients, GPT levels of the patients in the G+C+ group were significantly higher after day 100 and remained higher than those of patients in the G+C- and G-C- groups for at least 4 years. There were no significant differences in post-transplant GPT levels between the G+C- group and the G-C- group at any time point. Of the seven patients followed-up for 5 to 10 years, three patients became HGV-RNA-negative, while four remained positive. In the absence of HCV co-infection, the behavior of GPT values post transplant in patients with HGV infection did not differ from those without HGV infection. With respect to the patient who was G+C- and showed high values of GPT 2 and 3 years post transplant, we suspect that his liver dysfunction might have been caused by some unknown virus or etiology.
为阐明庚型肝炎病毒（HGV）感染在异基因骨髓移植（BMT）后肝功能障碍中的作用，我们检测了33例BMT前有输血史患者的冷冻血清样本，这些患者的血清样本在BMT前、第100天及之后定期保存，采用逆转录聚合酶链反应检测HGV-RNA和丙型肝炎病毒（HCV）-RNA的存在情况。33例患者中有19例（58%）在BMT前HGV-RNA呈阳性，10例HCV-RNA呈阳性。所有HCV-RNA阳性患者的HGV-RNA也呈阳性。根据患者BMT前的病毒状态将其分为三组，即G+C+组（n = 10）、G+C-组（n = 9）和G-C-组（n = 14）。G-C-组有2例患者在BMT后HGV-RNA转为阳性。1例G+C-组患者在BMT后2年和3年出现肝炎急性加重，谷丙转氨酶（GPT）水平超过1000 IU/l，其临床病程与G+C-组患者有很大不同。排除这3例患者后，G+C+组患者在第100天后GPT水平显著升高，并至少4年高于G+C-组和G-C-组患者。G+C-组和G-C-组在任何时间点的移植后GPT水平均无显著差异。在随访5至10年的7例患者中，3例患者HGV-RNA转为阴性，4例仍为阳性。在无HCV合并感染的情况下，HGV感染患者移植后GPT值的变化与未感染HGV的患者无异。对于移植后2年和3年GPT值较高的G+C-组患者，我们怀疑其肝功能障碍可能由某种未知病毒或病因引起。
