Miller D J, Kleber H, Bloomer J R
Yale J Biol Med. 1979 Jan-Feb;52(1):135-40.
One hundred and seventy-seven former heroin addicts, consisting of 85 who were newly admitted to a methadone maintenance program and 92 who had received methadone for a mean period of 30 months, were prospectively studied for up to 2 years in order to determine: (1) the effect of heroin withdrawal on the hepatic abnormalities, and (2) the incidence of HBsAg, anti-HBs, and anti-HCc as indices of the frequency of hepatitis B virus infection. Our study indicates that (1) hepatic abnormalities persist when heroin is discontinued and are not temporally related to drug and/or needle usage, and (2) that 71% of subjects had either HBsAg or anti-HBs; anti-HBc was tested for in 16 patients and was present in 100%, although 9 of the 16 were both HBsAg- and anti-HBs-negative. This study suggests that hepatitis B is largely responsible for the liver dysfunction. It is proposed that an abnormality in immune function, induced by heroin, is responsible for the high incidence of chronic hepatitis. Attention is drawn to the similarity between former drug addicts and hemophiliacs, since both develop chronic hepatitis in spite of anti-HBs in the serum.
177名曾经的海洛因成瘾者，其中85名是新加入美沙酮维持治疗项目的，92名接受美沙酮治疗平均达30个月，对他们进行了为期2年的前瞻性研究，以确定：（1）海洛因戒断对肝脏异常的影响，以及（2）作为乙型肝炎病毒感染频率指标的乙肝表面抗原（HBsAg）、乙肝表面抗体（抗-HBs）和乙肝核心抗体（抗-HBc）的发生率。我们的研究表明：（1）停用海洛因后肝脏异常仍然存在，且与药物和/或针头使用没有时间上的关联；（2）71%的受试者有HBsAg或抗-HBs；对16名患者检测了抗-HBc，100%呈阳性，尽管这16名患者中有9名HBsAg和抗-HBs均为阴性。这项研究表明，乙型肝炎在很大程度上导致了肝功能障碍。有人提出，海洛因诱导的免疫功能异常是慢性肝炎高发的原因。注意到曾经的吸毒者和血友病患者之间的相似性，因为尽管血清中有抗-HBs，他们都会患上慢性肝炎。
