Angelico M, Tisone G, Rapicetta M, Pisani F, Gandin C, Chionne P, Dettori S, Iaria G, Danese V, Orlando G, Casciani C U
Dept. of Surgery, University of Rome Tor Vergata, Italy.
Ital J Gastroenterol Hepatol. 1997 Oct;29(5):448-55.
BACKGROUND/AIMS: The risk for hepatitis C virus infection in kidney transplant recipients has been reduced by the introduction of accurate diagnostic tests. Little is known, however, of the current risk factors and the molecular genetics of hepatitis C virus infection in Italy.
We studied 101 Italian kidney allograft recipients, transplanted between 1975 and 1995, in Italy or abroad. Sera were assayed for biochemistry, presence of HBsAg, anti-hepatitis C virus antibodies, hepatitis C virus-RNA (by reverse transcription nested PCR) and hepatitis C virus genotyping.
HBsAg was found in 4 sera and anti-Hepatitis C Virus antibodies in 33 (33%). The duration of pre-transplant dialysis was longer in anti-hepatitis C virus positive than in anti-hepatitis C virus negative patients (5.9 +/- 4.3 vs 2.8 +/- 1.9 years, p = 0.0004). Anti-hepatitis C virus seropositivity was more frequent among patients grafted before than after 1990 (50% vs 27%, p = 0.04) and varied depending on the country of transplantation (25% in Italy; 56% in other European countries; and 40% in non-European developing countries). Twenty-seven sera were hepatitis C virus-RNA positive, including 5 without anti-hepatitis C virus antibodies. Hepatitis C virus genotype 1b was found in 13 (48%) patients, the remainder being infected with genotypes 1a (6 cases), 2a, 2c, 3a and 4. Genotype 1b was largely predominant among patients grafted in Europe but never found in those transplanted in developing countries. All but one patient without a sustained antibody response were infected by non-1b genotypes. Hepatitis C virus-RNA seropositivity was associated (p = 0.03) with a higher dose of prednisone (p = 0.03) and a lower dose of cyclosporine (p = 0.05) used as immunosuppressants.
Current risk factors for hepatitis C virus infection in Italian kidney graft recipients include the duration of haemodialysis, transplantation in developing countries and the level of post-transplant immunosuppression. The pattern of hepatitis C virus genotypes is changing from predominantly 1b to non-1b genotypes and the latter infection often occurs without a sustained antibody response. Few patients develop clinical liver disease.
背景/目的：准确诊断检测方法的引入降低了肾移植受者感染丙型肝炎病毒的风险。然而，目前对于意大利丙型肝炎病毒感染的危险因素和分子遗传学知之甚少。
我们研究了1975年至1995年间在意大利或国外接受移植的101例意大利肾移植受者。检测血清中的生化指标、乙肝表面抗原（HBsAg）、抗丙型肝炎病毒抗体、丙型肝炎病毒RNA（通过逆转录巢式PCR）以及丙型肝炎病毒基因分型。
4份血清中检测到HBsAg，33份（33%）血清中检测到抗丙型肝炎病毒抗体。抗丙型肝炎病毒阳性患者移植前透析时间长于抗丙型肝炎病毒阴性患者（5.9±4.3年对2.8±1.9年，p = 0.0004）。1990年前移植的患者抗丙型肝炎病毒血清阳性率高于1990年后移植的患者（50%对27%，p = 0.04），且根据移植国家不同而有所变化（意大利为25%；其他欧洲国家为5
