Shuhart M C, Myerson D, Spurgeon C L, Bevan C A, Sayers M H, McDonald G B
Section of Gastroenterology/Hepatology, Fred Hutchinson Cancer Research Center, University of Washington, Seattle 98104, USA.
Bone Marrow Transplant. 1996 Apr;17(4):601-6.
In March 1992, 12 bone marrow transplant patients at the Fred Hutchinson Cancer Research Center received blood components from donors who were anti-HCV-nonreactive by first generation ELISA but whose serum later tested anti-HCV-reactive to a second generation ELISA. All these blood components were further tested for anti-HCV using a second-generation RIBA and for HCV RNA by polymerase chain reaction. Recipient sera were tested for HCV RNA prior to and following blood component infusion. Blood components from four donors were positive for HCV RNA. All recipients of HCV RNA-positive blood components became viremic on the first day tested post-infusion. In addition, two recipients of HCV RNA-negative blood components tested HCV RNA-positive both pre- and post-infusion. Viremia persisted up to the time of death or day 100 in five of the six patients who were HCV RNA-positive post-transplant. No HCV RNA-positive recipient developed symptomatic acute hepatitis, and only two had aminotransferase elevations consistent with chronic hepatitis. We conclude that HCV RNA-positivity in blood components accurately predicts transmission of virus. Infection with HCV did not adversely affect short-term patient outcome following bone marrow transplantation.
1992年3月，弗雷德·哈钦森癌症研究中心的12名骨髓移植患者接受了来自供体的血液成分，这些供体通过第一代酶联免疫吸附测定法检测抗丙型肝炎病毒呈阴性，但后来其血清经第二代酶联免疫吸附测定法检测抗丙型肝炎病毒呈阳性。所有这些血液成分均使用第二代重组免疫印迹法进一步检测抗丙型肝炎病毒，并通过聚合酶链反应检测丙型肝炎病毒核糖核酸。在输注血液成分之前和之后，对受者血清进行丙型肝炎病毒核糖核酸检测。来自四名供体的血液成分丙型肝炎病毒核糖核酸呈阳性。所有接受丙型肝炎病毒核糖核酸阳性血液成分的受者在输注后第一天检测时均出现病毒血症。此外，两名接受丙型肝炎病毒核糖核酸阴性血液成分的受者在输注前后检测丙型肝炎病毒核糖核酸均呈阳性。在移植后丙型肝炎病毒核糖核酸呈阳性的六名患者中，有五名患者的病毒血症一直持续到死亡或第100天。没有丙型肝炎病毒核糖核酸阳性的受者出现有症状的急性肝炎，只有两名患者的转氨酶升高与慢性肝炎一致。我们得出结论，血液成分中的丙型肝炎病毒核糖核酸阳性可准确预测病毒传播。丙型肝炎病毒感染对骨髓移植后的短期患者预后没有不利影响。
