Gessoni G, Manoni F
Transfusional Service, Chioggia Community Hospital, Italy.
Eur J Med. 1992 Sep;1(5):288-94.
The aim of our study was to evaluate the aetiopathogenetic role of hepatitis C virus (HCV) in the genesis of chronic liver disease and hepatocellular carcinoma and the relationship between presence of circulating antibodies against non-structural HCV antigens and disease activity.
Using a new enzyme-immunoassay capable of detecting, either separately or together, circulating antibodies to structural and non-structural hepatitis C virus antigens, we tested 208 chronic hepatitis B surface antigen (HBsAg) carriers and 144 patients suffering from chronic liver disease.
Among the chronic HBsAg carriers with normal transaminase activity, there were 4% who proved to be anti-HVC positive, compared with 14.5% among those with high serum transaminase. Among subjects with chronic liver disease, 20% of patients with chronic persistent hepatitis, 54% with chronic active hepatitis, 35% with liver cirrhosis and 47% with hepatocellular carcinoma proved to be anti-HCV positive. With regard to the aetiology of liver disease, 13% and 25% of chronic HBV infected patients, with or without anti-delta virus superinfection respectively, had anti-hepatitis C virus antibody. This prevalence was 22% among alcoholic liver disease and 89% among patients with cryptogenic liver diseases. The percentage of subjects with circulating antibodies against non-structural HCV proteins was higher among HBsAg chronic carriers with raised alanine aminotransferase and among patients with chronic active hepatitis and hepatocellular carcinoma.
Many subjects with chronic liver disease have circulating anti-HCV antibodies. Anti-HCV positive subjects, especially those with antibodies to non-structural antigens, are more frequently found among patients with aggressive liver diseases. Among HBsAg chronic carriers the prevalence of anti-HCV was lower in "healthy carriers" and HBeAg positive rather than in HBeAg negative subjects with high alanine aminotransferase. We therefore suggest that there may be a relation between HCV replication, activeness of the liver disease and presence of antibodies to non-structural viral antigens.
我们研究的目的是评估丙型肝炎病毒（HCV）在慢性肝病和肝细胞癌发生中的病因学作用，以及循环抗HCV非结构抗原抗体的存在与疾病活动之间的关系。
使用一种新型酶免疫测定法，该方法能够单独或同时检测针对丙型肝炎病毒结构和非结构抗原的循环抗体，我们对208例慢性乙型肝炎表面抗原（HBsAg）携带者和144例慢性肝病患者进行了检测。
在转氨酶活性正常的慢性HBsAg携带者中，4%被证明抗-HCV阳性，而在血清转氨酶高的携带者中这一比例为14.5%。在慢性肝病患者中，20%的慢性持续性肝炎患者、54%的慢性活动性肝炎患者、35%的肝硬化患者和47%的肝细胞癌患者被证明抗-HCV阳性。关于肝病的病因，分别有13%和25%的慢性HBV感染患者，无论有无丁型肝炎病毒重叠感染，都有抗丙型肝炎病毒抗体。在酒精性肝病患者中这一患病率为22%，在隐源性肝病患者中为89%。在丙氨酸转氨酶升高的HBsAg慢性携带者以及慢性活动性肝炎和肝细胞癌患者中，针对HCV非结构蛋白的循环抗体的受试者百分比更高。
许多慢性肝病患者有循环抗-HCV抗体。抗-HCV阳性受试者，尤其是那些有非结构抗原抗体的受试者，在侵袭性肝病患者中更常见。在HBsAg慢性携带者中，抗-HCV的患病率在“健康携带者”和HBeAg阳性者中较低，而在丙氨酸转氨酶高的HBeAg阴性受试者中较高。因此，我们认为HCV复制、肝病活动度与非结构病毒抗原抗体的存在之间可能存在关联。
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