Mas A, Buti M, Esteban R, Sánchez-Tapias J M, Costa J, Jardí R, Bruguera M, Guardia J, Rodés J
Liver Unit, Hospital Clínic, Universitat de Barcelona, Spain.
Hepatology. 1990 Jun;11(6):1062-5. doi: 10.1002/hep.1840110624.
Hepatitis B virus DNA and hepatitis D virus RNA, the most sensitive markers of hepatitis B and hepatitis D virus replication, were sought by molecular hybridization with radioactive probes in serial serum samples from 29 consecutive patients with HBsAg-positive fulminant hepatitis. Nineteen patients had evidence of hepatitis D virus infection, as assessed by the presence in serum of delta antigen, anti-delta antibodies, or both. Hepatitis B virus DNA was found in only two patients: one was a chronic HBsAg carrier with hepatitis D virus superinfection and the other had fulminant hepatitis caused by hepatitis B and hepatitis D coinfection. Hepatitis D virus RNA was detected in three patients: two with hepatitis B and hepatitis D coinfection and also in the HBsAg carrier with positive hepatitis B virus DNA and hepatitis D virus superinfection. None of 10 patients with hepatitis B virus infection alone had detectable viral nucleic acids in serum. Overall, viral nucleic acids were detected in the sera of 4 of the 29 patients (14%). Hepatitis D virus antigenemia did not indicate hepatitis D virus replication because hepatitis D virus RNA was not detected in 9 of 12 patients with hepatitis D virus antigen in their sera. The low frequency of viral replication found in fulminant hepatitis B or D may explain the low recurrence rate of viral hepatitis in patients with fulminant hepatitis who have received liver transplantations.
采用放射性探针分子杂交法，在29例连续的HBsAg阳性暴发性肝炎患者的系列血清样本中，检测乙型肝炎病毒DNA和丁型肝炎病毒RNA，这两种病毒分别是乙肝病毒和丁肝病毒复制最敏感的标志物。通过血清中是否存在δ抗原、抗δ抗体或两者来评估，19例患者有丁型肝炎病毒感染的证据。仅在2例患者中发现乙肝病毒DNA：1例是慢性HBsAg携带者合并丁型肝炎病毒重叠感染，另1例是由乙肝和丁肝病毒合并感染引起的暴发性肝炎。在3例患者中检测到丁型肝炎病毒RNA：2例为乙肝和丁肝病毒合并感染，另1例是乙肝病毒DNA阳性且丁型肝炎病毒重叠感染的HBsAg携带者。仅感染乙肝病毒的10例患者血清中均未检测到病毒核酸。总体而言，29例患者中有4例（14%）血清中检测到病毒核酸。丁型肝炎病毒血症并不表明丁型肝炎病毒复制，因为在血清中存在丁型肝炎病毒抗原的12例患者中，有9例未检测到丁型肝炎病毒RNA。在暴发性乙肝或丁肝中发现的病毒复制低频率，可能解释了接受肝移植的暴发性肝炎患者中病毒性肝炎复发率低的原因。
