Halfon P, Levy M, San Marco M, Gerolami V, Khiri H, Bourliere M, Feryn J M, Gastaut J L, Pouget J, Cartouzou G
Laboratoire de Biochimie et Biologie Moléculaire, CHR la Conception, Marseille, France.
J Viral Hepat. 1996 Nov;3(6):329-32. doi: 10.1111/j.1365-2893.1996.tb00106.x.
Chronic hepatitis C virus (HCV) infections are often associated with extrahepatic immunological manifestations, including various autoimmune disorders. The aims of this study were to determine the prevalence of HCV markers in patients with myasthenia gravis (MG) and to determine any relationship with HCV infection. Eighty-three patients with MG. 40 men aged 20-93 years and 43 women aged 13-87 years (mean age 54 years) were studied. The MG patients were positive for antibody to acetylcholine receptor in addition, their sera was analysed for antibody to HCV (HCVAb) and HCV RNA, HCVAb was detected in two of the 83 patients (2.4%). Four patients were repeatedly HCV RNA positive. They were infected by HCV genotype 1 (one patient), HCV genotype 2a (two patients) and an undetermined HCV genotype in one patient. They received plasmapheresis or intravenous immunoglobulin treatment. Among the four patients, one was infected after the onset of MG without receiving a blood transfusion or using intravenous drugs. The other three had chronic hepatitis C which was discovered at the same time as MG and only one patient had been exposed to blood products. The prevalence of HCV markers in patients with MG (4.8%) was higher than that reported for the general French population, about 1%. This prevalence is similar to that occurring in patients exposed to plasmapheresis or intravenous immunoglobulin. In conclusion, HCV appears to play little, if any, role in causing MG. The higher prevalence of infection among MG patients may be related to transmission in the course of therapy.
慢性丙型肝炎病毒（HCV）感染常伴有肝外免疫表现，包括各种自身免疫性疾病。本研究的目的是确定重症肌无力（MG）患者中HCV标志物的流行率，并确定其与HCV感染的关系。研究了83例MG患者，其中40例男性，年龄20 - 93岁，43例女性，年龄13 - 87岁（平均年龄54岁）。MG患者乙酰胆碱受体抗体呈阳性，此外，对他们的血清进行了抗HCV（HCVAb）和HCV RNA检测，83例患者中有2例（2.4%）检测到HCVAb。4例患者HCV RNA反复阳性。他们分别感染了HCV 1型（1例患者）、HCV 2a型（2例患者），1例患者感染的HCV基因型未确定。他们接受了血浆置换或静脉注射免疫球蛋白治疗。在这4例患者中，1例在MG发病后感染，未接受输血或使用静脉药物。另外3例患有慢性丙型肝炎，与MG同时发现，只有1例患者接触过血液制品。MG患者中HCV标志物的流行率（4.8%）高于法国普通人群报道的约1%。这一流行率与接受血浆置换或静脉注射免疫球蛋白治疗的患者相似。总之，HCV在导致MG方面似乎几乎没有作用。MG患者中较高的感染率可能与治疗过程中的传播有关。
