Hibbs J R, Issaragrisil S, Young N S
Clinical Hematology Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland.
Am J Trop Med Hyg. 1992 May;46(5):564-70. doi: 10.4269/ajtmh.1992.46.564.
Aplastic anemia is a rare, life-threatening disease of unknown etiology, with unusually high prevalence in Thailand. It is sometimes associated with non-A, non-B hepatitis (NANBH). The hepatitis C virus (HCV), one of the causes of NANBH, is similar to flaviviridiae, a family of viruses many of whose members cause acute bone marrow suppression. To test the hypothesis that HCV viremia is associated with aplastic anemia among patients in Thailand, we compared 53 untransfused hospitalized aplastic anemia patients and 39 untransfused controls hospitalized for other conditions. We used the polymerase chain reaction to identify HCV viremia in three (5.7%) untransfused patients and two (5.1%) untransfused controls (P = 1.0, by Fisher's two-tailed exact test). Although our data do not exclude the possibility that a small subset of aplastic anemia cases are precipitated by HCV, we conclude that HCV viremia is not generally associated with aplastic anemia in Thailand. Our results also imply that the prevalence of HCV viremia may be unexpectedly high among untransfused persons in Thailand, a hypothesis that should be tested in other populations.
再生障碍性贫血是一种病因不明的罕见的危及生命的疾病，在泰国发病率异常高。它有时与非甲非乙型肝炎（NANBH）相关。丙型肝炎病毒（HCV）是NANBH的病因之一，与黄病毒科相似，该病毒科的许多成员会导致急性骨髓抑制。为了验证HCV病毒血症与泰国患者再生障碍性贫血相关的假设，我们比较了53例未输血的住院再生障碍性贫血患者和39例因其他疾病住院的未输血对照。我们使用聚合酶链反应在3例（5.7%）未输血患者和2例（5.1%）未输血对照中鉴定出HCV病毒血症（通过Fisher双侧精确检验，P = 1.0）。尽管我们的数据不排除一小部分再生障碍性贫血病例由HCV引发的可能性，但我们得出结论，在泰国HCV病毒血症通常与再生障碍性贫血无关。我们的结果还表明，泰国未输血人群中HCV病毒血症的患病率可能出乎意料地高，这一假设应在其他人群中进行检验。
