Ohnishi H, Sugihara J, Moriwaki H, Muto Y
First Department of Internal Medicine, Gifu University School of Medicine, Japan.
Gastroenterol Jpn. 1991 Jul;26 Suppl 3:212-5. doi: 10.1007/BF02779302.
Serial serum samples obtained from 27 patients with fulminant hepatic failure (FHF) in a variety of etiology were tested for anti-hepatitis C virus antibody (anti-HCV) with uses of two different assay systems. The incidence of anti-HCV in patients with FHF due to hepatitis B (Ortho test system; 7/11, 63.6%: Abbott test system; 9/11, 81.8%) was found to be significantly higher than that in acute HBV hepatitis (Ortho test system; 0/17, 0%) (P less than 0.001). In particular, all 3 post-transfusion HBV-FHF patients were positive for the antibody using both Ortho and Abbott test systems, and cut-off index in those patients was serially increased. On the other hand, cut-off index in anti-HCV positive patients with sporadic hepatitis A virus (HAV)- and HBV-FHF was high even prior to plasma exchange therapy, and gradually decreased. These results strongly suggest that in patients with post-transfusion HBV-FHF, HCV was superinfected over HBV and in the sporadic HAV- and HBV-FHF patients, HAV or HBV were co-infected over HCV carrier. In any events, co-infection and/or superinfection of HCV may play an important role in the development of this fatal disease.
从27例病因各异的暴发性肝衰竭（FHF）患者获取系列血清样本，使用两种不同检测系统检测抗丙型肝炎病毒抗体（抗-HCV）。发现乙型肝炎所致FHF患者中抗-HCV的发生率（Ortho检测系统；7/11，63.6%：雅培检测系统；9/11，81.8%）显著高于急性HBV肝炎患者（Ortho检测系统；0/17，0%）（P＜0.001）。特别是，所有3例输血后HBV-FHF患者使用Ortho和雅培检测系统时抗体均呈阳性，且这些患者的临界指数呈系列升高。另一方面，散发性甲型肝炎病毒（HAV）和HBV-FHF的抗-HCV阳性患者在血浆置换治疗前临界指数就很高，且逐渐下降。这些结果强烈提示，在输血后HBV-FHF患者中，HCV在HBV基础上发生了重叠感染，而在散发性HAV和HBV-FHF患者中，HAV或HBV在HCV携带者基础上发生了合并感染。无论如何，HCV的合并感染和/或重叠感染可能在这种致命疾病的发生中起重要作用。
