Goeser T, Seipp S, Wahl R, Müller H M, Stremmel W, Theilmann L
Department of Internal Medicine, University of Heidelberg, Germany.
J Hepatol. 1997 Mar;26(3):498-502. doi: 10.1016/s0168-8278(97)80413-8.
BACKGROUND/AIMS: Recently, the hepatitis GB-C virus (GBV-C) has been identified as another virus potentially causing chronic hepatitis. Although high rates of coinfection are emerging in drug addicts with chronic hepatitis C virus infection, no detailed data on clinical presentation are available. Therefore, co-infection was sought in hepatitis C virus patients to determine the impact of GB-C virus on clinical presentation.
GBV-C was determined by nested reverse transcriptase-polymerase chain reaction in serum of 70 HIV negative intravenous drug abusers with chronic hepatitis C. Biochemical, histological and virological parameters were compared between patients with or without GBV-C coinfection.
Hepatitis C virus and GBV-C coinfection was found in 18 of 70 (25.7%) patients. Cases with coinfection were younger and had shorter duration of disease (31.4+/-6.2 vs. 35.3+/-7.3 (p=0.09) and 9.9+/-6.8 vs. 12.9+/-7.7 (p=0.17) years) than those without coinfection. Neither hepatitis C virus genotype distribution and HCV RNA levels nor serum liver function tests, titers of immunoglobulins or autoantibodies differed between the two groups. Histologically, chronic active hepatitis (16.7 vs. 46.4%, p=0.07), fibrosis (8.3% vs. 21.4%, p=0.3), and cirrhosis (0% vs. 8.2%, p=0.31) were less prevalent in coinfected patients. After interferon treatment, 5/6 coinfected and 11/19 patients with hepatitis C virus infection alone had cleared HCV RNA and 4/6 lost GBV-C RNA from serum. The two patients with GBV-C/HCV infection who persistently cleared hepatitis C virus but not GBV-C from serum had normal transaminases during follow-up despite persistence of GBV-C.
Coinfection of chronic hepatitis C patients with GBV-C does not lead to a significant change in clinical presentation, severity of liver disease, hepatitis C viremia, or response to interferon treatment.
背景/目的：最近，庚型肝炎病毒（GBV-C）已被确认为另一种可能导致慢性肝炎的病毒。尽管在慢性丙型肝炎病毒感染的吸毒者中合并感染率不断上升，但尚无关于临床表现的详细数据。因此，在丙型肝炎病毒患者中寻找合并感染情况，以确定GB-C病毒对临床表现的影响。
采用巢式逆转录聚合酶链反应检测70例HIV阴性的慢性丙型肝炎静脉吸毒者血清中的GBV-C。比较合并或未合并GBV-C感染患者的生化、组织学和病毒学参数。
70例患者中有18例（25.7%）存在丙型肝炎病毒和GBV-C合并感染。合并感染的患者比未合并感染的患者更年轻，病程更短（分别为31.4±6.2岁对35.3±7.3岁（p=0.09）和9.9±6.8年对12.9±7.7年（p=0.17））。两组之间丙型肝炎病毒基因型分布、HCV RNA水平、血清肝功能检查、免疫球蛋白或自身抗体滴度均无差异。组织学上，合并感染患者中慢性活动性肝炎（16.7%对46.4%，p=0.07）、纤维化（8.3%对21.4%，p=0.3）和肝硬化（0%对8.2%，p=0.31）的发生率较低。干扰素治疗后，6例合并感染患者中有5例、19例单纯丙型肝炎病毒感染患者中有11例清除了HCV RNA，6例中有4例血清中GBV-C RNA消失。2例GBV-C/HCV感染患者血清中持续清除丙型肝炎病毒但未清除GBV-C，尽管GBV-C持续存在，但随访期间转氨酶正常。
慢性丙型肝炎患者合并GBV-C感染不会导致临床表现、肝病严重程度、丙型肝炎病毒血症或对干扰素治疗反应的显著改变。
