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住院患者急性丙型肝炎诊断的困难

Difficulty of acute hepatitis C diagnosis in a hospitalised patient.

作者信息

Takamizawa Shigemasa, Yamada Toru, Kitamura Koichi, Hiraoka Eiji

机构信息

Department of Internal Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan.

Department of Nephrology, Endocrinology, and Diabetes, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan.

出版信息

BMJ Case Rep. 2018 Nov 28;11(1):e226907. doi: 10.1136/bcr-2018-226907.

Abstract

The hepatitis C virus (HCV) causes acute hepatitis C and is commonly detected via HCV antibody testing. However, delayed seroconversion of HCV antibodies and non-specific symptoms may hinder the diagnosis of this disease. A 71-year-old woman developed acute hepatitis while hospitalised for back pain. An HCV antibody test was negative, and she had no risk factors for hepatitis C. She was referred to our hospital for further evaluation. The HCV antibody test was repeated 16 days after the initial test; owing to a positive result, she was diagnosed with acute hepatitis C. Several months thereafter, the HCV spontaneously cleared. When diagnosing an HCV infection, the time at which the testing is performed needs to coincide with the time at which HCV antibody seroconversion occurs. Timely diagnosis of an HCV infection allows appropriate treatment during the acute phase which may prevent disease progression to the chronic phase.

摘要

丙型肝炎病毒(HCV)可导致急性丙型肝炎,通常通过HCV抗体检测来发现。然而,HCV抗体血清转化延迟和非特异性症状可能会妨碍对该疾病的诊断。一名71岁女性因背痛住院期间发生了急性肝炎。HCV抗体检测呈阴性,且她没有丙型肝炎的危险因素。她被转诊至我院作进一步评估。在初次检测16天后重复进行了HCV抗体检测;由于结果呈阳性,她被诊断为急性丙型肝炎。此后数月,HCV自发清除。在诊断HCV感染时,检测时间需要与HCV抗体血清转化发生时间相一致。及时诊断HCV感染可在急性期进行适当治疗,这可能会防止疾病进展至慢性期。

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Enhancing the detection and management of acute hepatitis C virus infection.加强急性丙型肝炎病毒感染的检测和管理。
Int J Drug Policy. 2015 Oct;26(10):899-910. doi: 10.1016/j.drugpo.2015.07.003. Epub 2015 Jul 16.
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Current knowledge and future perspectives on acute hepatitis C infection.急性丙型肝炎感染的现有知识和未来展望。
Clin Microbiol Infect. 2015 Aug;21(8):797.e9-797.e17. doi: 10.1016/j.cmi.2015.03.026. Epub 2015 Apr 16.
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World J Gastroenterol. 2014 Aug 28;20(32):11033-53. doi: 10.3748/wjg.v20.i32.11033.
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Epidemiology and natural history of HCV infection.丙型肝炎病毒感染的流行病学和自然史。
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Natural history of acute and chronic hepatitis C.丙型肝炎急性和慢性的自然史。
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