Fujimoto N, Kyo M, Ichikawa Y, Fukunishi T, Nagano S
Department of Urology, Hyogo Prefectural Nishinomiya Hospital, Japan.
Transpl Int. 1994;7 Suppl 1:S346-9. doi: 10.1111/j.1432-2277.1994.tb01388.x.
To assess the prevalence of hepatitis C virus (HCV) infection in renal transplant recipients and its impact on posttransplant liver disease, the sera from 176 recipients who had been followed for 1-20 years (mean 8.3 years) were tested for HCV-specific antibody using enzyme immunoassay. HCV-specific antibody was detected in 53 patients (30.1%) including 2 patients also positive for hepatitis B surface antigen (HBsAg). Among 167 HBsAg-negative patients, the presence of HCV-specific antibody was associated with an increased incidence of chemically significant hepatitis (70.6% vs. 9.5% in anti-HCV-negative patients, P < 0.01). Hepatitis was more likely to be chronic in anti-HCV-positive patients than in anti-HCV-negative patients (P<0.05). Serious liver disease developed in 4 of 51 anti-HCV-positive, HBsAg-negative patients: liver failure causing death in 3 and hepatoma in 1. Liver biopsy specimens from anti-HCV-positive patients showed more aggressive histological lesions compared with those from anti-HCV-negative patients. We conclude that HCV infection is quite prevalent in our renal transplant recipients and plays a major role in posttransplant chronic liver disease.
为评估丙型肝炎病毒（HCV）感染在肾移植受者中的流行情况及其对移植后肝脏疾病的影响，我们采用酶免疫分析法对176例随访1至20年（平均8.3年）的受者血清进行了HCV特异性抗体检测。53例患者（30.1%）检测到HCV特异性抗体，其中2例患者同时乙肝表面抗原（HBsAg）阳性。在167例HBsAg阴性患者中，HCV特异性抗体的存在与具有临床意义的肝炎发病率增加相关（抗HCV阴性患者中为70.6%，抗HCV阳性患者中为9.5%，P<0.01）。抗HCV阳性患者的肝炎比抗HCV阴性患者更易发展为慢性肝炎（P<0.05）。51例抗HCV阳性、HBsAg阴性患者中有4例发生了严重肝脏疾病：3例因肝衰竭死亡，1例患肝癌。与抗HCV阴性患者相比，抗HCV阳性患者的肝活检标本显示出更具侵袭性的组织学病变。我们得出结论，HCV感染在我们的肾移植受者中相当普遍，并且在移植后慢性肝病中起主要作用。
