Wick M R, Moore S, Taswell H F
Transfusion. 1985 Mar-Apr;25(2):93-101. doi: 10.1046/j.1537-2995.1985.25285169225.x.
Posttransfusion hepatitis of the non-A, non-B variety continues to be a significant problem in current hemotherapy. This disorder is many times more common than transfusion-associated disease caused by hepatitis B virus, cytomegalovirus, and Epstein-Barr virus, and also seems to be viral in origin. Several potential etiological agents have been implicated, but none has been identified with certainty, despite concerted efforts at doing so. Clinical disease is usually attended by few symptoms and signs, but evolution to chronic liver disease is distressingly common; over 50 percent of all cases of non-A, non-B posttransfusion hepatitis manifest this transition. Efforts at prevention of non-A, non-B hepatitis associated with blood transfusion have thus far been hampered by the lack of reliable laboratory markers for carriers of this disease, and controversy exists over the implementation of screening tests on blood donors, using such nonspecific indicators of possible viral carriage as serum alanine aminotransferase levels. It is probable, however, that simple measures such as more restrained blood usage, encouraged by greater educational efforts within the medical community, could be beneficial in minimizing the number of new cases of non-A, non-B posttransfusion hepatitis seen each year in the United States.
非甲非乙型输血后肝炎仍是当前血液治疗中的一个重大问题。这种疾病比由乙型肝炎病毒、巨细胞病毒和爱泼斯坦-巴尔病毒引起的输血相关疾病要常见许多倍,而且似乎也是由病毒引起的。已经有几种潜在的病原体被牵连其中,但尽管人们齐心协力进行排查,却仍未确定任何一种病原体。临床疾病通常症状和体征较少,但发展为慢性肝病的情况却极为常见;所有非甲非乙型输血后肝炎病例中,超过50%会出现这种转变。迄今为止,由于缺乏针对这种疾病携带者的可靠实验室标志物,预防与输血相关的非甲非乙型肝炎的努力受到了阻碍,而且对于使用血清丙氨酸转氨酶水平等可能病毒携带的非特异性指标对献血者进行筛查测试的实施存在争议。然而,通过医学界加大教育力度鼓励采取诸如更谨慎用血等简单措施,可能有助于减少美国每年出现的非甲非乙型输血后肝炎新病例数量。