Rodriguez-Iñigo E, Tomás J F, Gómez-García de Soria V, Bartolomé J, Pinilla I, Amaro M J, Carreño V, Fernández-Rañada J M
Department of Hematology, Hospital Universitario La Princesa, Madrid, Spain.
Blood. 1997 Aug 1;90(3):1326-31.
Acute and chronic liver dysfunction is common after allogeneic bone marrow transplantation (BMT). Although toxicity, graft versus-host disease (GVHD), and viral infections are the major causes, etiologic diagnosis is difficult and often remains unknown. We conducted a prospective study to establish the role of the infection with both the hepatitis C virus (HCV) and the recently discovered hepatitis G virus (HGV) in liver dysfunction after BMT. From January 1994 to December 1995, 59 patients who had undergone an allogeneic BMT at our institution were enrolled in the study. HGV-RNA was identified in serum by nested polymerase chain reaction (PCR), and HCV was studied by the presence of second generation enzyme-linked immunosorbent assay (ELISA)-antibodies and HCV-RNA by nested PCR. HGV-RNA was detected in 25 patients (42%) (before BMT in 18 and after BMT in 7). HCV-RNA was present in 12 patients (20%) (before BMT in 11 and after BMT in one). The presence of HCV-RNA and HGV-RNA was clearly associated with a previous history of blood transfusions. No significant association was found between viral infection and acute liver toxicity. Some degree of liver dysfunction was present 6 months after BMT in 25 of 40 evaluable patients (62%). Long-term liver dysfunction was more common among patients infected with HCV alone (3 of 4) or with both HCV and HGV (3 of 3) than in those infected with either HGV alone (eight of 13) or with no virus infection (10 of 20). We found a high prevalence of HGV infection in our BMT population. However, no role for HGV in liver disease could be established in this study, and the relationship between HGV infection and liver dysfunction requires further clarification.
急性和慢性肝功能障碍在异基因骨髓移植（BMT）后很常见。尽管毒性、移植物抗宿主病（GVHD）和病毒感染是主要原因，但病因诊断困难，往往仍不明确。我们进行了一项前瞻性研究，以确定丙型肝炎病毒（HCV）和最近发现的庚型肝炎病毒（HGV）感染在BMT后肝功能障碍中的作用。1994年1月至1995年12月，我们机构59例接受异基因BMT的患者被纳入研究。通过巢式聚合酶链反应（PCR）在血清中鉴定HGV-RNA，通过第二代酶联免疫吸附测定（ELISA）抗体的存在以及巢式PCR检测HCV-RNA来研究HCV。25例患者（42%）检测到HGV-RNA（18例在BMT前，7例在BMT后）。12例患者（20%）存在HCV-RNA（11例在BMT前，1例在BMT后）。HCV-RNA和HGV-RNA的存在与既往输血史明显相关。未发现病毒感染与急性肝毒性之间存在显著关联。40例可评估患者中有25例（62%）在BMT后6个月出现一定程度的肝功能障碍。单独感染HCV（4例中的3例）或同时感染HCV和HGV（3例中的3例）的患者比单独感染HGV（13例中的8例）或无病毒感染（20例中的10例）的患者更易出现长期肝功能障碍。我们发现我们的BMT人群中HGV感染率很高。然而，本研究未能确定HGV在肝病中的作用，HGV感染与肝功能障碍之间的关系需要进一步阐明。
