Locasciulli A, Testa M, Pontisso P, Bacigalupo A, Ljungman P, Frickhofen N, Alberti A
Clinica Pediatrica Università di Milano, Divisione di Ematologia Pediatrica, Ospedale S Gerardo Monza (MI), Italy.
Bone Marrow Transplant. 1997 Feb;19(3):237-40. doi: 10.1038/sj.bmt.1700650.
Hepatitis C virus (HCV) genotypes were investigated in 57 HCV-infected patients undergoing allogeneic BMT at four European BMT units where death resulting from liver failure (LF) in HCV-infected patients varied from < 1% to > 80%. The aim of the study was to determine whether differing HCV genotypes could account for the different severity of post-transplant liver disease (LD). Sera from patients with pre (n = 22) or post-BMT (n = 35) HCV infection were collected from Italy (Genova, Monza), Sweden (Huddinge) and Germany (Ulm). Patients were grouped as follows: LF: 19/57; acute hepatitis (AH): 10/57 or chronic hepatitis (CH): 22/57; no liver disease (LD): 6/57. HCV genotypes were identified by hybridisation of the 5'UTR amplified products with type-specific oligonucleotides probes according to Simmonds (Hepatology 1994; 19: 1321-1324). Genotype HCV 1 was identified in 34 patients (60%), HCV 2 in 15 (26%), HCV 3 in three (5%), mixed infection in three (5%) and undefined in two (3.5%). In the LF group HCV 1 was identified in 10/19 and other genotypes in 9/19. Median timing of LF was earlier in patients infected with HCV 1 compared to other genotypes (45 and 68 days, respectively), largely due to the cause of LF; death from veno-occlusive disease (VOD) and hepatitis occurred at 30 and 68 days post-BMT, respectively. Genotype 1 was also identified in cases with no LD. These data indicate that there was no evident correlation between HCV genotype and type or severity of post-transplant liver disease.
在四个欧洲骨髓移植单位，对57例接受异基因骨髓移植的丙型肝炎病毒（HCV）感染患者进行了HCV基因型研究，这些单位中HCV感染患者因肝衰竭（LF）导致的死亡率从<1%到>80%不等。该研究的目的是确定不同的HCV基因型是否可以解释移植后肝病（LD）的不同严重程度。从意大利（热那亚、蒙扎）、瑞典（胡丁厄）和德国（乌尔姆）收集了移植前（n = 22）或移植后（n = 35）HCV感染患者的血清。患者分组如下：肝衰竭（LF）：19/57；急性肝炎（AH）：10/57或慢性肝炎（CH）：22/57；无肝病（LD）：6/57。根据西蒙兹的方法（《肝脏病学》1994年；19：1321 - 1324），通过将5'非翻译区（5'UTR）扩增产物与型特异性寡核苷酸探针杂交来鉴定HCV基因型。在34例患者（60%）中鉴定出HCV 1型，15例（26%）为HCV 2型，3例（5%）为HCV 3型，3例（5%）为混合感染，2例（3.5%）未明确。在LF组中，19例中有10例鉴定为HCV 1型，9例为其他基因型。与其他基因型相比，感染HCV 1型的患者LF的中位时间更早（分别为45天和68天），这主要是由于LF的病因；因静脉闭塞性疾病（VOD）死亡和肝炎分别发生在移植后30天和68天。在无LD的病例中也鉴定出了1型。这些数据表明，HCV基因型与移植后肝病的类型或严重程度之间没有明显的相关性。
