Inokuchi K, Nakata K, Hamasaki K, Daikoku M, Nakao K, Kato Y, Yatsuhashi H, Koga M, Yano M, Nagataki S
First Department of Internal Medicine, Nagasaki University School of Medicine, Japan.
J Hepatol. 1996 Mar;24(3):258-64. doi: 10.1016/s0168-8278(96)80002-x.
BACKGROUND/METHODS: The cause of fulminant hepatitis is still not fully understood. We studied 23 patients with fulminant hepatitis, using polymerase chain reaction to detect hepatitis virus genomes. Tests for HBsAg and IgM anti-HAV and IgM anti-HBc were performed in all patients. Serum samples were stored at -70 degrees C for later analysis of anti-HCV and hepatitis virus genomes such as hepatitis B virus, hepatitis C virus and hepatitis D virus.
Of 23 patients, 17 (74%) had HBV-DNA and two (9%) had HCV-RNA. No patient was positive for both viruses or positive for HDV-RNA. Serological tests indicated that two patients, negative for HBV-DNA and HCV-RNA, were positive for IgM anti-HAV. In contrast, 8 of 17 (47%) HBV-DNA positive patients were negative for both IgM anti-HBc and HBsAg in conjunction with low levels of viremia. Four patients were positive for anti-HCV, but only one was positive for HCV-RNA. One patient, positive for HCV-RNA, was negative for anti-HCV.
Our results indicate that analysis of hepatitis virus genomes using polymerase chain reaction allows accurate identification of the virus causing fulminant hepatitis.
背景/方法：暴发性肝炎的病因仍未完全明确。我们对23例暴发性肝炎患者进行了研究，采用聚合酶链反应检测肝炎病毒基因组。对所有患者进行了乙肝表面抗原、甲型肝炎病毒IgM抗体和乙型肝炎核心抗体IgM检测。血清样本保存在-70℃，以备后续检测丙型肝炎病毒抗体及乙肝病毒、丙肝病毒和丁型肝炎病毒等肝炎病毒基因组。
23例患者中，17例（74%）乙肝病毒DNA阳性，2例（9%）丙肝病毒RNA阳性。没有患者两种病毒均为阳性或丁型肝炎病毒RNA阳性。血清学检测显示，2例乙肝病毒DNA和丙肝病毒RNA均为阴性的患者甲型肝炎病毒IgM抗体阳性。相反，17例乙肝病毒DNA阳性患者中有8例（47%）乙型肝炎核心抗体IgM和乙肝表面抗原均为阴性，且病毒血症水平较低。4例患者丙型肝炎病毒抗体阳性，但只有1例丙肝病毒RNA阳性。1例丙肝病毒RNA阳性患者丙型肝炎病毒抗体阴性。
我们的结果表明，采用聚合酶链反应分析肝炎病毒基因组能够准确鉴定引起暴发性肝炎的病毒。
