Kisiel Elzbieta, Kryczka Wiesław
Wydział Nauk o Zdrowiu, Akademia Swietokrzyska im. J. Kochanowskiego w Kielcach.
Przegl Lek. 2007;64(7-8):521-4.
Infection with hepatitis C virus (HCV) may be associated with a wide spectrum of immunological abnormalities. HCV tends to induce nonspecific autoimmune reactions, as demonstrated by the high prevalence of various autoantibodies, including antiphospholipid antibodies (aPL). The aPL antibodies (lupus anticoagulant and anticardiolipin antibodies) are a heterogeneous family of immunoglobulins reactive with complexes of phospholipids and plasma proteins (cofactors). The most important of these protein cofactors are beta2-glycoprotein (beta2-GPI) and prothrombin. The antiphospholipid syndrome (APS) is an autoimmune disorder characterized by arterial or venous thrombosis, recurrent fetal losses in association with the presence of antiphospholipid (aPL) antibodies. Increased prevalence of aPL antibodies in several bacterial, parasitic, and viral infections have been reported. Most of the published data agree that anticardiolipin antibodies are frequently found in patients with chronic HCV infection, but they do not appear to be of clinical importance. Some studies, however, have found an increased incidence of thrombotic disorders in patients with chronic hepatitis C virus (HCV) who manifest aPL positivity. More prospective, long-term studies are required in order to address whether HCV is involved or not in the etiopathogenesis of APS.
丙型肝炎病毒(HCV)感染可能与多种免疫异常有关。HCV倾向于诱导非特异性自身免疫反应,各种自身抗体(包括抗磷脂抗体,aPL)的高流行率证明了这一点。aPL抗体(狼疮抗凝物和抗心磷脂抗体)是一类异质性免疫球蛋白,可与磷脂和血浆蛋白(辅助因子)的复合物发生反应。这些蛋白质辅助因子中最重要的是β2-糖蛋白(β2-GPI)和凝血酶原。抗磷脂综合征(APS)是一种自身免疫性疾病,其特征为动脉或静脉血栓形成、与抗磷脂(aPL)抗体的存在相关的反复流产。已有报道称,在几种细菌、寄生虫和病毒感染中aPL抗体的流行率增加。大多数已发表的数据一致认为,抗心磷脂抗体在慢性HCV感染患者中经常出现,但它们似乎没有临床重要性。然而,一些研究发现,表现出aPL阳性的慢性丙型肝炎病毒(HCV)患者血栓形成性疾病的发生率增加。为了确定HCV是否参与APS的发病机制,需要进行更多前瞻性的长期研究。