Maier K P
Fachbereich Gastroenterologie, Medizinischen Klinik, Städtischen Krankenanstalten Esslingen, Akademisches Lehrkrankenhaus, Universität Tübingen.
Schweiz Rundsch Med Prax. 1994 Sep 6;83(36):1005-7.
Clinically, acute hepatitis C is an asymptomatic disease in up to 90% of cases. Transaminases fluctuate characteristically. Anti-HCV (RIBA-II) and HCV-RNA (PCR) are diagnostic early in the course of the disease. The risk of chronification is high, exceeding 50% of cases, irrespective of disease transmission (parenterally or sporadic). Alpha-interferon is applicated in pilot-studies to reduce the risk of chronification, with varying results. Chronic hepatitis C is an insidious disease. Again, most cases are asymptomatic. Bilirubin is normal. GPT-activity tends to fluctuate during the course. Anti-HCV and HCV-RNA can be detected in serum. About 20% of cases progress to cirrhosis (and HCC) after a long-lasting disease (20 to 30 years after infection). Alpha-Interferon therapy is successful in about 25% of patients.
临床上,高达90%的急性丙型肝炎病例是无症状的。转氨酶呈特征性波动。抗-HCV(重组免疫印迹法-II)和HCV-RNA(聚合酶链反应)在疾病早期即可诊断。无论疾病传播途径(经肠道外或散发性)如何,慢性化风险都很高,超过50%的病例会出现慢性化。在试点研究中应用α-干扰素以降低慢性化风险,结果各异。慢性丙型肝炎是一种隐匿性疾病。同样,大多数病例无症状。胆红素正常。谷丙转氨酶活性在病程中往往会波动。血清中可检测到抗-HCV和HCV-RNA。约20%的病例在长期患病(感染后20至30年)后会发展为肝硬化(和肝癌)。α-干扰素治疗在约25%的患者中取得成功。