Naito M, Hayashi N, Hagiwara H, Hiramatsu N, Kasahara A, Fusamoto H, Kamada T
First Department of Medicine, Osaka University School of Medicine, Japan.
Hepatology. 1994 Apr;19(4):871-5.
We studied hepatitis C virus carriers with normal liver function to evaluate the histological features of their livers and the replicative levels of hepatitis C virus. Liver biopsies were performed in 22 hepatitis C virus carriers with persistently normal ALT levels. Hepatitis C virus RNA in serum was quantified with a competitive assay that combined reverse transcription and the polymerase chain reaction, which is based on co-amplification of the target RNA with known amounts of synthetic mutated RNA. Three patients had normal livers on histological study, whereas the other 19 had chronic persistent hepatitis, with lymphoid infiltrates or aggregates in portal tracts commonly observed but intralobular inflammatory changes absent or minimal. The titer of hepatitis C virus RNA (logarithmic transformed copy number per milliliter of serum) varied from 4.0 to 8.0 (mean +/- S.D.: 6.3 +/- 1.1); it was significantly lower in the three patients with normal livers (4.3 +/- 0.2) than in those with chronic persistent hepatitis with mild (6.4 +/- 0.8, n = 11) or moderate (7.1 +/- 0.5, n = 8) portal inflammation. The titer of hepatitis C virus RNA was correlated with the total score (r = 0.68) and the score for portal inflammation (r = 0.68) in the histological activity index. These results indicated that there seem to be "healthy carriers" of hepatitis C virus with extremely low levels of viral replication. However, in most hepatitis C virus carriers with persistently normal ALT levels, there are inflammatory changes in the portal tracts, with severity depending on the replicative levels of hepatitis C virus.
我们研究了肝功能正常的丙型肝炎病毒携带者，以评估其肝脏的组织学特征和丙型肝炎病毒的复制水平。对22例丙氨酸氨基转移酶（ALT）水平持续正常的丙型肝炎病毒携带者进行了肝脏活检。采用一种结合逆转录和聚合酶链反应的竞争性检测方法对血清中的丙型肝炎病毒RNA进行定量，该方法基于目标RNA与已知量的合成突变RNA的共扩增。组织学研究显示，3例患者肝脏正常，而其他19例患有慢性持续性肝炎，常见门静脉区有淋巴细胞浸润或聚集，但小叶内炎症改变不存在或轻微。丙型肝炎病毒RNA滴度（每毫升血清的对数转换拷贝数）在4.0至8.0之间变化（平均值±标准差：6.3±1.1）；3例肝脏正常的患者（4.3±0.2）的病毒滴度显著低于轻度门静脉炎症（6.4±0.8，n = 11）或中度门静脉炎症（7.1±0.5，n = 8）的慢性持续性肝炎患者。丙型肝炎病毒RNA滴度与组织学活动指数中的总分（r = 0.68）和门静脉炎症评分（r = 0.68）相关。这些结果表明，似乎存在病毒复制水平极低的丙型肝炎病毒“健康携带者”。然而，在大多数ALT水平持续正常的丙型肝炎病毒携带者中，门静脉区存在炎症改变，其严重程度取决于丙型肝炎病毒的复制水平。
