Kernoff P B, Miller E J, Savidge G F, Machin S J, Dewar M S, Preston F E
Department of Haematology, Royal Free Hospital, London.
Br J Haematol. 1987 Oct;67(2):207-11. doi: 10.1111/j.1365-2141.1987.tb02328.x.
The risk of post-infusion non-A, non-B hepatitis (NANBH) in patients receiving a first exposure to unheated or conventionally 'dry heated' factor VIII concentrates approaches 100%, implying invariable contamination of these products. Amongst 18 patients who received a first treatment with a 'wet heated' commercial concentrate, five (28%) developed asymptomatic NANBH, suggesting a more efficient inactivation of NANB agent(s) by this process. 2/9 (22%) of the batches of concentrate used in the study were implicated in NANBH transmission. One of those two batches, responsible for NANBH in four patients, had been prepared from a plasma pool containing an unusually large proportion of donations with high alanine aminotransferase (ALT) levels. A resulting high level of viral contamination in this batch may have been sufficient to override the effects of the sterilization process. All patients remained anti-HIV seronegative at 17-28 months of follow-up.
首次接受未加热或传统“干热”处理的凝血因子 VIII 浓缩剂的患者，输注后发生非甲非乙型肝炎（NANBH）的风险接近 100%，这意味着这些产品存在恒定污染。在 18 例首次接受“湿热”商业浓缩剂治疗的患者中，5 例（28%）发生了无症状 NANBH，提示该处理过程能更有效地灭活 NANB 病原体。研究中使用的浓缩剂批次有 2/9（22%）与 NANBH 传播有关。这两批中的一批导致 4 例患者发生 NANBH，该批次是由一个血浆池制备的，该血浆池中丙氨酸转氨酶（ALT）水平高的献血比例异常大。该批次中由此产生的高病毒污染水平可能足以抵消灭菌过程的效果。在 17 - 28 个月的随访中，所有患者的抗 HIV 血清学检测仍为阴性。
