Montalto G, Soresi M, Tripi S, Carroccio A, Bascone F, Di Martino D, Bonfissuto G, Notarbartolo A
Cattedra di Medicina Interna, Università degli Studi di Palermo.
Ann Ital Med Int. 1995 Apr-Jun;10(2):89-92.
The discovery of virus C as an etiological agent of chronic liver disease (CLD) has modified previously-held concepts concerning the etiology of this disease. In a study of 581 consecutive patients with CLD, we confirmed that virus C was the sole agent responsible for it in 64.2% of all cases. Moreover, virus C was characteristically associated with virus B, alcohol consumption, and autoimmunity. When the various CLD were separated into subgroups, i.e., chronic persistent hepatitis (CPH), chronic active hepatitis (CAH), and liver cirrhosis (LC), virus C continued to be the main etiological agent, varying from 60.5% to 68.3%: this suggested constant evolution from milder to more severe forms of liver disease. Virus B alone was found less frequently, probably thanks to the virtual elimination of post-transfusion hepatitis B and the anti-B virus vaccination which is now widely administered. Frequency was 15.2% in the CPH group but lower in the LC and CAH groups (7.4% and 6.3% respectively), suggesting that evolution from the milder to the more severe forms of liver disease may not occur. Finally, we confirmed a statistically significant difference in mean age between hepatitis C virus positive men and women (p < 0.0001): in men, frequency was higher in the 20- to 50-year-old group; in women it was higher in the 50+year-old group.
丙型病毒作为慢性肝病（CLD）的病原体被发现，改变了以往关于该疾病病因的观念。在一项对581例连续性慢性肝病患者的研究中，我们证实，在所有病例中，64.2%的病例丙型病毒是唯一病因。此外，丙型病毒的特征是与乙型病毒、饮酒和自身免疫有关。当将各种慢性肝病分为亚组，即慢性持续性肝炎（CPH）、慢性活动性肝炎（CAH）和肝硬化（LC）时，丙型病毒仍然是主要病因，比例从60.5%至68.3%不等：这表明肝病形式从较轻向较重不断演变。单独发现乙型病毒的情况较少，这可能是由于输血后乙型肝炎实际上已消除，以及目前广泛接种乙肝疫苗。在CPH组中，其比例为15.2%，但在LC组和CAH组中较低（分别为7.4%和6.3%），这表明肝病可能不会从较轻形式向较重形式演变。最后，我们证实丙型肝炎病毒阳性的男性和女性平均年龄存在统计学显著差异（p<0.0001）：男性在20至50岁组中比例较高；女性在50岁以上组中比例较高。
