Sampietro M, Tavazzi D, Cerino M, Zatelli S, Lunghi G, Orlandi A, Fargion S, Fiorelli G, Cappellini M D
Dipartimento di Medicina Interna, Università di Milano, Milan, Italy.
Haematologica. 2001 Jan;86(1):39-43.
Patients with thalassemia-major are at risk of blood-borne viral infections. TT virus (TTV), a single stranded, circular DNA virus, has recently been found to be associated with acute and chronic hepatitis. The aims of this study were to assess the prevalence of TTV infection in adult patients with transfusion-dependent thalassemia, and to evaluate the clinical significance of TTV.
We studied 68 adult patients with thalassemia major, 97% of whom were hepatitis C virus (HCV) antibody positive. TTV DNA was amplified from serum by heminested polymerase chain reaction (PCR). Direct sequencing of PCR products was used to establish TTV genotypes.
TTV DNA was detected in 47 patients (69.1%). Sequence analysis of PCR products identified TTV genotype 1b as the most common viral genotype in this group. Patients co-infected by HCV and TTV had a significantly higher histologic grade score than patients with isolated HCV infection (5.1+/-2.7 vs. 2.8+/-1.7, p=0.02) while the stage score was not significantly different.
TTV is highly prevalent among Italian multiply transfused patients. In these patients TTV viremia appears to affect the necro-inflammatory activity of hepatitis C, though no evidence of an effect on the evolution of fibrosis was found.
重型地中海贫血患者有血源性病毒感染的风险。TT病毒(TTV)是一种单链环状DNA病毒,最近被发现与急慢性肝炎有关。本研究的目的是评估输血依赖型地中海贫血成年患者中TTV感染的患病率,并评估TTV的临床意义。
我们研究了68例成年重型地中海贫血患者,其中97%丙型肝炎病毒(HCV)抗体呈阳性。通过半巢式聚合酶链反应(PCR)从血清中扩增TTV DNA。PCR产物的直接测序用于确定TTV基因型。
47例患者(69.1%)检测到TTV DNA。PCR产物的序列分析确定TTV基因型1b是该组中最常见的病毒基因型。HCV和TTV合并感染的患者组织学分级评分显著高于单纯HCV感染的患者(5.1±2.7对2.8±1.7,p = 0.02),而分期评分无显著差异。
TTV在意大利多次输血患者中高度流行。在这些患者中,TTV病毒血症似乎影响丙型肝炎的坏死性炎症活动,尽管未发现对纤维化进展有影响的证据。