Tassopoulos Nicolaos C, Papatheodoridis George V, Delladetsima Ioanna, Hatzakis Angelos
National Retrovirus Reference Center, Department of Hygiene and Epidemiology, Athens University Medical School, Athens, Greece.
J Gastroenterol Hepatol. 2008 Aug;23(8 Pt 1):1208-15. doi: 10.1111/j.1440-1746.2008.05454.x. Epub 2008 Jun 28.
The aim of the present study was to describe the clinicopathological characteristics and the natural history of acute non-(A-E) hepatitis and to assess the possible role of hepatitis G virus (HGV), TT virus (TTV) and mainly SEN virus (SENV).
A cohort of 55 patients with sporadic acute non-(A-E) hepatitis with a mean follow up of 31 (6-55) months was studied.
The clinical presentation was fulminant in one (1.8%), protracted with impaired regeneration in seven (12.7%) and benign in the remaining 47 (85.5%) cases. Progression to chronic hepatitis was observed in 15 (27.3%) patients; it was more frequent in clinically severe than in non-severe cases (five of eight patients or 62.5% vs 10 of 47 patients or 21.3%, P = 0.028). Six of 10 biopsied chronic non-(A-E) cases developed cirrhosis within 10-33 months. Serum HGV-RNA was detected in 16 of 55 (29.1%) patients, TTV in 20 of 38 (52.6%) patients and SENV-D/H DNA in 20 of 55 (36.4%) cases. HGV-RNA was detected more frequently in clinically severe than in non-severe cases (five of eight or 62.5% vs 11 of 47 or 23.4%, P = 0.038). There was no other association between the presence of HGV, TTV, or SENV infection and patient characteristics or severity and outcome of disease.
HGV, TTV, and SENV do not seem to be responsible for the majority of sporadic acute non-(A-E) hepatitis cases. Our cohort further supports the existence of new, unknown hepatitis agent(s) with uncertain mode of transmission. The non-(A-E) agent(s) can also cause chronic hepatitis, which often has an aggressive course with rapid development of cirrhosis.
本研究旨在描述急性非（A - E）型肝炎的临床病理特征及自然病程，并评估庚型肝炎病毒（HGV）、TT病毒（TTV）以及主要是SEN病毒（SENV）的可能作用。
对55例散发性急性非（A - E）型肝炎患者进行队列研究，平均随访31（6 - 55）个月。
临床表现为暴发性的1例（1.8%），迁延不愈且再生受损的7例（12.7%），其余47例（85.5%）为良性。15例（27.3%）患者进展为慢性肝炎；临床症状严重的患者比症状不严重的患者更常见（8例患者中的5例，即62.5%，对比47例患者中的10例，即21.3%，P = 0.028）。10例经活检的慢性非（A - E）型肝炎病例中有6例在10 - 33个月内发展为肝硬化。55例患者中有16例（29.1%）检测到血清HGV - RNA，38例患者中有20例（52.6%）检测到TTV，55例病例中有20例（36.4%）检测到SENV - D/H DNA。临床症状严重的患者比症状不严重的患者更频繁地检测到HGV - RNA（8例中的5例，即62.5%，对比47例中的11例，即23.4%，P = 0.038）。HGV、TTV或SENV感染的存在与患者特征、疾病严重程度及转归之间无其他关联。
HGV、TTV和SENV似乎并非大多数散发性急性非（A - E）型肝炎病例的病因。我们的队列进一步支持存在传播方式不确定的新型未知肝炎病原体。非（A - E）型病原体也可导致慢性肝炎，其病程通常进展迅速，常伴有肝硬化的快速发展。
