Allain J P, Dailey S H, Laurian Y, Vallari D S, Rafowicz A, Desai S M, Devare S G
Abbott Laboratories, Diagnostics Division, Abbott Park, Illinois 60064.
J Clin Invest. 1991 Nov;88(5):1672-9. doi: 10.1172/JCI115482.
Hepatitis C virus (HCV) is the major etiologic agent associated with non-A, non-B hepatitis. This study was designed to assess virologic and serologic markers in hemophiliacs exposed to non-heat-treated and/or virus-inactivated plasma derivatives. Serial bleeds from 48 hemophilic patients were analyzed for the presence of HCV viral RNA sequences as detected by polymerase chain reaction (PCR) and antibodies to structural (core) and nonstructural (C-100 and 33C) proteins by specific dot immunoblot assay. All patients exposed to non-heat-treated products, and four of six patients exposed only to virus inactivated products, had evidence of HCV infection. However, over the 5-yr study period, six exposed patients (13%) consistently lacked detectable anti-C-100 and seven (15%) lost this antibody. HCV viremia (PCR positive) was found in 91% of exposed patients, and was significantly more frequent in HIV seropositive hemophiliacs (P less than 0.05). Six patients had high antibody level to HCV and elevated ALT, but appeared to clear viremia. Four hemophiliacs were HCV seropositive but lacked detectable viremia. These data indicate that hemophiliacs remain persistently infected by HCV and that antibody to the core antigen of HCV is a reliable marker of this transfusion transmissible agent.
丙型肝炎病毒（HCV）是与非甲非乙型肝炎相关的主要病原体。本研究旨在评估暴露于未经热处理和/或病毒灭活血浆衍生物的血友病患者的病毒学和血清学标志物。通过聚合酶链反应（PCR）检测48例血友病患者的系列出血样本中HCV病毒RNA序列的存在情况，并通过特异性斑点免疫印迹法检测针对结构（核心）和非结构（C-100和33C）蛋白的抗体。所有暴露于未经热处理产品的患者，以及6例仅暴露于病毒灭活产品的患者中的4例，均有HCV感染的证据。然而，在5年的研究期间，6例暴露患者（13%）始终未检测到抗C-100抗体，7例（15%）失去了这种抗体。91%的暴露患者检测到HCV病毒血症（PCR阳性），在HIV血清阳性的血友病患者中更为常见（P<0.05）。6例患者HCV抗体水平高且ALT升高，但似乎清除了病毒血症。4例血友病患者HCV血清学阳性但未检测到病毒血症。这些数据表明，血友病患者持续受到HCV感染，并且抗HCV核心抗原抗体是这种经输血传播病原体的可靠标志物。
