Masuko K, Mitsui T, Iwano K, Yamazaki C, Okuda K, Meguro T, Murayama N, Inoue T, Tsuda F, Okamoto H, Miyakawa Y, Mayumi M
Masuko Hospital, Aichi-Ken, Japan.
N Engl J Med. 1996 Jun 6;334(23):1485-90. doi: 10.1056/NEJM199606063342301.
A recently discovered non-A-E hepatitis virus has been designated hepatitis GB virus C (HGBV-C), but little is known about its mode of transmission and its clinical manifestations. We studied 519 patients on maintenance hemodialysis to determine whether they were infected with HGBV-C.
HGBV-C RNA was identified in serum by a reverse-transcription-polymerase-chain-reaction assay with nested primers deduced from a non-structural region. A nucleotide sequence of 100 bp in the nonstructural region was determined on HGBV-C clones.
HGBV-C RNA was detected on 3.1 percent of the patients on hemodialysis (16 of 519), as compared with 0.9 percent of healthy blood donors (4 of 448, P<0.03). None of the 16 patients had evidence of active liver disease, although 7 were also infected with hepatitis C virus. Eight patients with HGBV-C infection were followed for 7 to 16 years. In two patients the virus was present at the start of hemodialysis. One had a history of transfusion, and HGBV-C persisted over a period of 16 years; the other became free of HGBV-C after 10 years. In five patients, HGBV-C RNA was first detected 3 to 20 weeks after blood transfusion and persisted for up to 13 years. One patient with no history of transfusion was infected with an HGBV-C variant with the same sequence as in two of the patients with post-transfusion HGBV-C infections.
Patients on maintenance hemodialysis are at increased risk for HGBV-C infection. This virus produces persistent infections, which may be transmitted by transfusions but may also be transmitted by other means.
最近发现的一种非甲 - 戊型肝炎病毒被命名为庚型肝炎病毒C（HGBV - C），但其传播方式和临床表现尚不清楚。我们对519例维持性血液透析患者进行了研究，以确定他们是否感染了HGBV - C。
采用逆转录 - 聚合酶链反应法，利用从非结构区域推导的巢式引物在血清中鉴定HGBV - C RNA。对HGBV - C克隆的非结构区域100 bp的核苷酸序列进行了测定。
血液透析患者中3.1%（519例中的16例）检测到HGBV - C RNA，而健康献血者中这一比例为0.9%（448例中的4例，P<0.03）。16例患者均无活动性肝病证据，尽管其中7例也感染了丙型肝炎病毒。对8例HGBV - C感染患者进行了7至16年的随访。2例患者在血液透析开始时就已感染该病毒。1例有输血史，HGBV - C持续存在16年；另1例在10年后病毒转阴。5例患者在输血后3至20周首次检测到HGBV - C RNA，并持续长达13年。1例无输血史的患者感染了一种HGBV - C变异株，其序列与2例输血后感染HGBV - C的患者相同。
维持性血液透析患者感染HGBV - C的风险增加。这种病毒可导致持续性感染，可能通过输血传播，但也可能通过其他途径传播。
