血液透析患者中的TTV病毒感染

TT virus infection in hemodialysis patients.

作者信息

Utsunomiya S, Yoshioka K, Wakita T, Seno H, Takagi K, Ishigami M, Yano M, Watanabe K, Kobayashi M, Watanabe K, Kishimoto H, Kakumu S

机构信息

Third Department of Internal Medicine, Nagoya University School of Medicine, Japan.

出版信息

Am J Gastroenterol. 1999 Dec;94(12):3567-70. doi: 10.1111/j.1572-0241.1999.01647.x.

DOI:10.1111/j.1572-0241.1999.01647.x

PMID:10606320

Abstract

OBJECTIVE

Recently, TT virus (TTV), associated with posttransfusion hepatitis, was discovered. Prevalence of TTV infection in maintenance hemodialysis (HD) units and its pathogenicity to liver was investigated.

METHODS

A total of 115 patients on HD were assessed for presence of serum TTV. DNA was purified from sera, and nested polymerase chain reaction was done for the detection of TTV DNA.

RESULTS

TTV was detected in 59 patients on HD (51.3%), as compared with healthy blood donors (15 of 91 [16.5%], p < 0.0001). Serum HCV RNA and HBs antigen were positive in 16 and three patients, respectively. The prevalence rate of TTV was already 58.3% in the patients on HD for only 1 yr, and did not change according to the duration of HD until 15 yr on HD. TTV was positive in 51.2% (43 of 84) of the patients with history of blood transfusion, and in 51.6% (16 of 31) of those without it. In HCV-negative patients, alanine aminotransferase (ALT) levels of TTV-positive patients were similar to those of TTV-negative patients. Contrarily, in HCV-positive patients, ALT levels were more frequently > or =15 IU/L in TTV-positive patients (14 of 18) than in TTV-negative patients (five of 15) (p < 0.05).

CONCLUSIONS

TTV infection is remarkably prevalent in patients on HD and in healthy blood donors. It is suggested that TTV generally does not cause liver disease by itself, but there remains the possibility that TTV may aggravate liver disease caused by HCV.

摘要

目的

最近，发现了与输血后肝炎相关的TT病毒（TTV）。研究了维持性血液透析（HD）单位中TTV感染的患病率及其对肝脏的致病性。

方法

对115例接受HD治疗的患者进行血清TTV检测。从血清中纯化DNA，并进行巢式聚合酶链反应以检测TTV DNA。

结果

在59例接受HD治疗的患者中检测到TTV（51.3%），而健康献血者中为91例中的15例（16.5%，p<0.0001）。血清HCV RNA和HBs抗原分别在16例和3例患者中呈阳性。HD治疗仅1年的患者中TTV患病率已达58.3%，且在HD治疗15年之前，TTV患病率并未随HD治疗时间的延长而改变。有输血史的患者中51.2%（84例中的43例）TTV呈阳性，无输血史的患者中51.6%（31例中的16例）TTV呈阳性。在HCV阴性患者中，TTV阳性患者的丙氨酸氨基转移酶（ALT）水平与TTV阴性患者相似。相反，在HCV阳性患者中，TTV阳性患者（18例中的14例）ALT水平≥15 IU/L的频率高于TTV阴性患者（15例中的5例）（p<0.05）。