Findor J A, Silva M, Medina M, Bruch Igartúa E, Sordá J, Findor A J, Schiff E
División de Gastroenterología, Hospital de Clínicas, UBA, Argentina.
Acta Gastroenterol Latinoam. 1991;21(4):221-5.
In order to evaluate the prevalence of antibodies IgG against the virus of hepatitis C (anti HCV) in different forms of chronic liver disease negative for virus B markers of alcoholism, we studied 148 patients (pts) divided into several groups. Group I: Composed of 35 pts. with chronic active hepatitis (CAH) with definite evidence of parenteral exposure to blood. Group II: included 39 pts. with CAH without immune markers or evidence of possible parenteral transmission. Group III: Included 37 pts. with the diagnosis of CAH of autoimmune type with positivity of antinuclear, anti smooth muscle or both antibodies with range of positivity of 1:80 or higher. Group IV: was composed of 31 pts. with the diagnosis of primary biliary cirrhosis (PBC). Finally group V included 6 pts. with an overlap syndrome between CAH and PBC. The prevalence of anti HCV in the different groups was as follows: [table: see text] Two of the pts. positive for anti HCV in group III and 1 in group IV revealed parenteral exposure to blood or blood product.
The determinations of anti HCV in order to characterize the posttransfusional NANB chronic hepatitis is of value. Positivity of anti HCV is high in cryptogenic chronic hepatitis and rare in PBC. In CAH of autoimmune type and in the overlap syndrome the prevalence was higher than expected. The question if we are dealing with false positivity or an uncertain diagnosis of autoimmunity is raised.
为了评估在酒精性肝病B病毒标志物阴性的不同形式慢性肝病中丙型肝炎病毒抗体IgG(抗HCV)的流行情况,我们研究了148例患者,将其分为几组。第一组:由35例有明确非肠道接触血液证据的慢性活动性肝炎(CAH)患者组成。第二组:包括39例无免疫标志物或无可能非肠道传播证据的CAH患者。第三组:包括37例诊断为自身免疫型CAH的患者,其抗核抗体、抗平滑肌抗体或两者均呈阳性,阳性范围为1:80或更高。第四组:由31例诊断为原发性胆汁性肝硬化(PBC)的患者组成。最后,第五组包括6例CAH和PBC重叠综合征患者。不同组中抗HCV的流行情况如下:[表格:见正文]第三组中2例抗HCV阳性患者和第四组中1例抗HCV阳性患者有非肠道接触血液或血液制品的情况。
检测抗HCV以明确输血后非甲非乙型慢性肝炎具有重要价值。抗HCV在隐源性慢性肝炎中阳性率高,在PBC中少见。在自身免疫型CAH和重叠综合征中,其流行率高于预期。由此引发了我们面对的是假阳性还是自身免疫性诊断不明确的问题。