Pawlotsky J M, Bouvier M, Fromont P, Deforges L, Duval J, Dhumeaux D, Bierling P
Department of Bacteriology and Virology, Hôpital Henri Mondor, Créteil, France.
J Hepatol. 1995 Dec;23(6):635-9. doi: 10.1016/0168-8278(95)80027-1.
BACKGROUND/AIMS: Chronic hepatitis C virus infections are often associated with extra-hepatic immunological manifestations, including various autoimmune disorders. The aims of this study were: (i) to determine the prevalence of hepatitis C virus markers in patients with autoimmune thrombocytopenic purpura, and (ii) to determine whether a relationship could exist between autoimmune thrombocytopenic purpura and hepatitis C virus infections.
One hundred and thirty-nine patients with autoimmune thrombocytopenic purpura (45 men, 94 women, mean age 42 years, range 16-90) were studied.
Anti-HCV antibodies were sought in their first and last available cryopreserved sera. In case of seropositivity, all their available cryopreserved sera were tested for anti-HCV antibodies and for HCV-RNA. Anti-HCV antibodies were detected in 14 of the 139 patients (10%). Four patients had transient anti-HCV seropositivity due to passive transfer of anti-HCV antibodies secondary to the infusion of intravenous immunoglobulin concentrates. Three patients seroconverted during follow up, due to intravenous drug use in one case, transfusion of non-HCV-screened blood units in one case, and infusion of intravenous immunoglobulins in one case. Seven patients had chronic hepatitis C discovered at the same time as autoimmune thrombocytopenic purpura. In two of them, hepatitis C virus transmission was the consequence of autoimmune thrombocytopenic purpura treatment but, in five cases, hepatitis C virus infection predated autoimmune thrombocytopenic purpura, so that the role of hepatitis C virus in autoimmune thrombocytopenic purpura could be suggested.
Whereas hepatitis C virus does not appear to be the main etiological agent of autoimmune thrombocytopenic purpura can be envisaged. On the other hand, treatment of autoimmune thrombocytopenic purpura or autoimmune thrombocytopenic purpura-related symptoms by blood product infusion can be complicated by hepatitis C virus transmission.
背景/目的：慢性丙型肝炎病毒感染常伴有肝外免疫表现，包括各种自身免疫性疾病。本研究的目的是：（i）确定自身免疫性血小板减少性紫癜患者中丙型肝炎病毒标志物的患病率，以及（ii）确定自身免疫性血小板减少性紫癜与丙型肝炎病毒感染之间是否可能存在关联。
对139例自身免疫性血小板减少性紫癜患者（45例男性，94例女性，平均年龄42岁，范围16 - 90岁）进行了研究。
在他们首次和最后可获得的冷冻保存血清中检测抗丙型肝炎病毒抗体。如果血清学呈阳性，则对其所有可获得的冷冻保存血清进行抗丙型肝炎病毒抗体和丙型肝炎病毒RNA检测。139例患者中有14例（10%）检测到抗丙型肝炎病毒抗体。4例患者因输注静脉注射免疫球蛋白浓缩物导致抗丙型肝炎病毒抗体被动转移而出现短暂的抗丙型肝炎病毒血清学阳性。3例患者在随访期间发生血清转化，其中1例是由于静脉吸毒，1例是由于输注未筛查丙型肝炎病毒的血液制品，1例是由于输注静脉注射免疫球蛋白。7例患者在诊断自身免疫性血小板减少性紫癜的同时被发现患有慢性丙型肝炎。其中2例中，丙型肝炎病毒传播是自身免疫性血小板减少性紫癜治疗的结果，但在5例中，丙型肝炎病毒感染早于自身免疫性血小板减少性紫癜，因此可以推测丙型肝炎病毒在自身免疫性血小板减少性紫癜中的作用。
虽然丙型肝炎病毒似乎不是自身免疫性血小板减少性紫癜的主要病因，但可以设想其存在一定作用。另一方面，通过输注血液制品治疗自身免疫性血小板减少性紫癜或与自身免疫性血小板减少性紫癜相关的症状可能会因丙型肝炎病毒传播而变得复杂。
