Bianchi F B
Recenti Prog Med. 1993 Nov;84(11):774-8.
Since the discovery of HCV in 1989 and the availability of reliable tests to detect HCV infection, we are aware that a number of chronic hepatitis cases, previously considered as autoimmune, are closely related to HCV. This applies particularly to adults with autoimmune hepatitis type 2 (LKM1 positive): in the Mediterranean area the vast majority of such cases are indeed anti-HCV/HCV RNA positive. Different is the case of pediatric type 2 autoimmune hepatitis patients, whose disease is HCV-free and remains still "primary". In autoimmune hepatitis type 1 (anti-nuclear and anti-action antibody positive) HCV infection seems to be confined to patient with mild-moderate disease activity, while most of the severe cases are consistently HCV-free. Autoantibody testing is relevant in detecting autoimmune hepatitis within the cryptogenic subgroup and prior to interferon treatment of HCV-related chronic hepatitis.
自1989年发现丙型肝炎病毒(HCV)以及有可靠检测方法来检测HCV感染以来,我们已经意识到,许多以前被认为是自身免疫性的慢性肝炎病例与HCV密切相关。这尤其适用于2型自身免疫性肝炎(LKM1阳性)的成年人:在地中海地区,绝大多数此类病例实际上抗-HCV/HCV RNA呈阳性。小儿2型自身免疫性肝炎患者的情况则不同,他们的疾病无HCV感染,仍属“原发性”。在1型自身免疫性肝炎(抗核抗体和抗平滑肌抗体阳性)中,HCV感染似乎仅限于疾病活动程度为轻度至中度的患者,而大多数重症病例始终无HCV感染。自身抗体检测对于在隐源性亚组中检测自身免疫性肝炎以及在对HCV相关慢性肝炎进行干扰素治疗之前具有重要意义。