Belli L S, Silini E, Alberti A, Bellati G, Vai C, Minola E, Rondinara G, de Carlis L, Asti M, Forti D, Ideo G
Divisione di Medicina Generale-Epatologia CRESPI, Ospedale Niguarda Ca' Granda, Milan, Italy.
Liver Transpl Surg. 1996 May;2(3):200-5. doi: 10.1002/lt.500020305.
Several genotypes of hepatitis C virus (HCV) have been recently identified by phylogenetic analysis, but their clinical relevance in the liver transplant setting is unknown. We evaluated the incidence and course of recurrent hepatitis C after transplantation in 50 patients who underwent transplantation for HCV-related liver disease. Liver biopsy specimens were obtained when clinically indicated and at yearly intervals; hepatitis was histologically graded and staged according to standard criteria. HCV-RNA was detected by nested reverse-transcription polymerase chain reaction (RT-PCR). HCV genotyping was performed by primer specific PCR. Follow-up was 6 to 62 months. HCV genotype distribution after transplantation of our 50 patients was as follows: 31 type 1b, 13 type 2a, 3 type 1a, 1 type 3a, 1 type 1b/2a, and 1, undetermined. Actuarial rates of recurrent hepatitis and of severe fibrosis or cirrhosis 5 years after transplantation were 56% and 20%, respectively, in patients infected by type 1b and 33% (P = .18) and 8% (P = .16) in those infected by 2a. In conclusion, this study provides evidence that in patients infected by HCV type 1b there is a trend for a more aggressive recurrent liver disease.
最近通过系统发育分析鉴定出了几种丙型肝炎病毒（HCV）基因型，但它们在肝移植环境中的临床相关性尚不清楚。我们评估了50例因HCV相关肝病接受移植的患者移植后丙型肝炎复发的发生率和病程。在临床指征明确时及每年获取肝活检标本；根据标准标准对肝炎进行组织学分级和分期。通过巢式逆转录聚合酶链反应（RT-PCR）检测HCV-RNA。通过引物特异性PCR进行HCV基因分型。随访时间为6至62个月。我们50例患者移植后的HCV基因型分布如下：31例1b型，13例2a型，3例1a型，1例3a型，1例1b/2a型，1例未确定。1b型感染患者移植后5年复发性肝炎和严重纤维化或肝硬化的精算发生率分别为56%和20%，2a型感染患者分别为33%（P = 0.18）和8%（P = 0.16）。总之，本研究提供了证据表明，在1b型HCV感染患者中，复发性肝病有更具侵袭性的趋势。
