van der Poel C L, Reesink H W, Lelie P N, Leentvaar-Kuypers A, Choo Q L, Kuo G, Houghton M
Red Cross Blood Bank Amsterdam, The Netherlands.
Lancet. 1989 Aug 5;2(8658):297-8. doi: 10.1016/s0140-6736(89)90486-8.
In a prospective study carried out in the Netherlands (1984-86) to establish the incidence of post-transfusion hepatitis non-A, non-B (PTH-NANB) in patients undergoing open heart surgery, 393 patients received 5315 blood product transfusions. PTH-NANB developed in 9 patients (index cases); stored serum samples from these patients and from 9 control patients, matched for age, sex, and number of blood product transfusions, as well as serum samples of all implicated blood products, were selected retrospectively. Sera were tested under code with a radioimmunoassay for the detection of antibodies to hepatitis C virus (anti-HCV). PTH-NANB patients received 151 blood product transfusions and control patients 140. 4 of 9 PTH-NANB patients (3/5 chronic, 1/4 acute resolved hepatitis) and 0/9 controls seroconverted. 7 of the transfusions given to PTH-NANB patients but none of those given to control patients were anti-HCV positive. In 7 of 9 serum sets from PTH-NANB index cases plus implicated donors, either a donor or the recipient was anti-HCV positive. Among the donors implicated in transmission of PTH-NANB there was a strong correlation between raised alanine aminotransferase levels and the presence of anti-HCV antibodies.
在荷兰开展的一项前瞻性研究(1984 - 1986年)中,为确定接受心脏直视手术患者的输血后非甲非乙型肝炎(PTH - NANB)发病率,393例患者接受了5315次血液制品输注。9例患者发生了PTH - NANB(索引病例);回顾性选取了这些患者以及9例对照患者(按年龄、性别和血液制品输注次数匹配)的储存血清样本,以及所有相关血液制品的血清样本。血清采用编码放射免疫分析法检测丙型肝炎病毒抗体(抗 - HCV)。PTH - NANB患者接受了151次血液制品输注,对照患者接受了140次。9例PTH - NANB患者中有4例(3/5为慢性肝炎,1/4为急性肝炎已缓解)血清学转换,而9例对照患者均未发生血清学转换。给予PTH - NANB患者的输注中有7次抗 - HCV呈阳性,而给予对照患者的输注均无抗 - HCV阳性。在9组来自PTH - NANB索引病例及相关供血者的血清中,有7组供血者或受血者抗 - HCV呈阳性。在与PTH - NANB传播相关的供血者中,丙氨酸转氨酶水平升高与抗 - HCV抗体的存在之间存在很强的相关性。