Cesaro S, Petris M G, Rossetti F, Cusinato R, Pipan C, Guido M, Masiero L, Botta G A, Meloni G A, Zanesco L
Department of Pediatrics, Università di Padova, Italy.
Blood. 1997 Aug 1;90(3):1315-20.
Sera of 658 patients who had completed treatment for pediatric malignancy were analyzed by a second-generation enzyme-linked immunosorbent assay and recombinant immunoblot assay test to assess the prevalence of hepatitis C virus (HCV)-seropositivity. All HCV-seropositive patients underwent detailed clinical, laboratory, virologic, and histologic study to analyze the course of HCV infection. One hundred seventeen of the 658 patients (17.8%) were positive for HCV infection markers. Among the 117 anti-HCV+ patients, 41 (35%) were also positive for markers of hepatitis B virus infection with or without delta virus infection markers, 91 (77.8%) had previously received blood product transfusions, and 25 (21.4%) showed a normal alanine aminotransferase (ALT) level during the last 5-year follow-up (11 of them never had abnormal ALT levels). The remaining 92 patients showed ALT levels higher than the upper limit of normal range. Eighty-one of 117 (70%) anti-HCV+ patients were HCV-RNA+, with genotype 1b being present in most patients (54%). In univariate analysis, no risk factor for chronic liver disease was statistically significant. In this study, the prevalence of HCV infection was high in patients who were treated for a childhood malignancy. In about 20% of anti-HCV+ patients, routes other than blood transfusions are to be considered in the epidemiology of HCV infection. After a 14-year median follow-up, chronic liver disease of anti-HCV+ positive patients did not show progression to liver failure.
采用第二代酶联免疫吸附试验和重组免疫印迹试验对658例完成小儿恶性肿瘤治疗的患者血清进行分析，以评估丙型肝炎病毒（HCV）血清阳性的流行情况。所有HCV血清阳性患者均接受了详细的临床、实验室、病毒学和组织学研究，以分析HCV感染的病程。658例患者中有117例（17.8%）HCV感染标志物呈阳性。在117例抗HCV阳性患者中，41例（35%）同时伴有或不伴有丁型病毒感染标志物的乙型肝炎病毒感染标志物阳性，91例（77.8%）既往接受过血液制品输血，25例（21.4%）在过去5年的随访中丙氨酸氨基转移酶（ALT）水平正常（其中11例ALT水平从未异常）。其余92例患者ALT水平高于正常范围上限。117例抗HCV阳性患者中有81例（70%）HCV-RNA阳性，大多数患者（54%）为1b型基因型。单因素分析显示，没有慢性肝病的危险因素具有统计学意义。在本研究中，接受儿童恶性肿瘤治疗的患者中HCV感染的流行率很高。在约20%的抗HCV阳性患者中，HCV感染的流行病学应考虑输血以外的其他途径。经过14年的中位随访，抗HCV阳性患者的慢性肝病未进展为肝衰竭。
