Gitnick G L
West J Med. 1978 Feb;128(2):117-26.
Viral hepatitis may be classified into three or more forms including type A hepatitis, type B hepatitis, and a group denoted as non-A non-B hepatitis which may represent viral hepatitis of one or more causes. The differentiation of these forms of hepatitis is primarily serologic. The development of antibody to hepatitis A virus can be detected by radioimmunoassay as well as by other test systems. The serologic diagnosis of type B hepatitis rests on the detection of hepatitis B surface antigen or on the development of antibody to hepatitis B core antigen or hepatitis B surface antigen. The serologic diagnosis of non-A non-B hepatitis is a diagnosis of exclusion for assay systems for this form of disease are not yet available.A prototype hepatitis B vaccine has been prepared and is currently undergoing clinical trials. Gamma globulin is now available that contains high titered antibody against hepatitis B virus. Normal immune globulin contains high titers directed against hepatitis A virus. Therefore, for documented exposure, effective prophylaxis is available for both of these forms of acute liver disease. The past decade has resulted in rapid advances in our understanding of the pathogenesis of acute hepatitis and its extrahepatic manifestations. However, it is clear that specific treatment for acute hepatitis and the accurate description of the etiologic agents of non-A non-B hepatitis require exploration.
病毒性肝炎可分为三种或更多类型,包括甲型肝炎、乙型肝炎,以及一组被称为非甲非乙型肝炎的类型,后者可能代表由一种或多种病因引起的病毒性肝炎。这些肝炎类型的区分主要依靠血清学检测。甲型肝炎病毒抗体的产生可以通过放射免疫测定以及其他检测系统来检测。乙型肝炎的血清学诊断基于乙型肝炎表面抗原的检测,或者基于乙型肝炎核心抗原或乙型肝炎表面抗原抗体的产生。非甲非乙型肝炎的血清学诊断是一种排除性诊断,因为针对这种疾病形式的检测系统尚未问世。一种乙型肝炎疫苗原型已经制备出来,目前正在进行临床试验。现在已有含有高滴度抗乙型肝炎病毒抗体的丙种球蛋白。正常免疫球蛋白含有高滴度的抗甲型肝炎病毒抗体。因此,对于有记录的接触,针对这两种急性肝病都有有效的预防措施。在过去十年里,我们对急性肝炎发病机制及其肝外表现的认识有了迅速进展。然而,显然急性肝炎的特异性治疗以及非甲非乙型肝炎病原体的确切描述仍有待探索。