Murphy P, Nowak T, Lemon S M, Hilfenhaus J
Department of Medicine, University of North Carolina at Chapel Hill 27599-7030.
J Med Virol. 1993 Sep;41(1):61-4. doi: 10.1002/jmv.1890410113.
Hepatitis A virus infections have been reported recently among hemophilic patients in Italy and Germany, leading to speculation that infectious hepatitis A virus (HAV) might have been present in some factor VIII concentrates. In both cases, the implicated factor concentrates had been treated by a solvent/detergent method, which inactivates enveloped viruses but which would not be expected to inactivate HAV, a nonenveloped picornavirus. To determine whether HAV would be inactivated during pasteurization of factor VIII concentrate, an alternative method employed for virus inactivation, we determined the extent to which the infectivity of cell culture-adapted HAV, suspended either in cell culture medium or in a proprietary stabilizing buffer, was reduced by heat treatment at 60 degrees C for 10 hr. The titer of infectious HAV declined rapidly at 60 degrees C, but the stabilizer considerably delayed HAV inactivation. In cell culture medium, HAV was inactivated by > 3.6 log10 within 30 min, but 3.6 log10 inactivation of HAV was reached only after 6 hr in the presence of the stabilizer. Residual infectious HAV was present after even 10 hr of heat treatment in the stabilizer, indicating that < 5.2 log10 infectious HAV particles are inactivated under these conditions. In the presence of the stabilizer, HAV was significantly more stable than poliovirus type 1, which has been used to validate virus inactivation by pasteurization. We conclude that pasteurized factor VIII concentrate should pose little if any risk for transmission of HAV if pooled plasma used for its manufacture contained low levels of the virus.
最近在意大利和德国的血友病患者中报告了甲型肝炎病毒感染病例,这引发了人们的猜测,即某些凝血因子VIII浓缩物中可能存在传染性甲型肝炎病毒(HAV)。在这两起病例中,涉及的凝血因子浓缩物均采用了溶剂/去污剂方法进行处理,该方法可使包膜病毒失活,但预计不会使无包膜的微小核糖核酸病毒HAV失活。为了确定在用于病毒灭活的另一种方法——凝血因子VIII浓缩物巴氏消毒过程中HAV是否会失活,我们测定了悬浮于细胞培养基或专用稳定缓冲液中的细胞培养适应型HAV在60℃热处理10小时后感染力降低的程度。传染性HAV的滴度在60℃时迅速下降,但稳定剂显著延迟了HAV的失活。在细胞培养基中,HAV在30分钟内失活>3.6 log10,但在有稳定剂存在的情况下,6小时后才达到HAV 3.6 log10的失活程度。即使在稳定剂中热处理10小时后仍存在残留的传染性HAV,这表明在这些条件下<5.2 log10的传染性HAV颗粒被灭活。在有稳定剂存在的情况下,HAV比用于验证巴氏消毒灭活病毒的1型脊髓灰质炎病毒明显更稳定。我们得出结论,如果用于制造凝血因子VIII浓缩物的混合血浆中病毒含量较低,那么巴氏消毒的凝血因子VIII浓缩物传播HAV的风险应该很小,甚至没有风险。