[庚型肝炎病毒合并感染对慢性丙型肝炎的意义——文献综述]

[Significance of coinfection with hepatitis G virus for chronic hepatitis C--a review of the literature].

作者信息

Rambusch E G, Wedemeyer H, Tillmann H L, Heringlake S, Manns M P

机构信息

Medizinische Hochschule Hannover, Zentrum Innere Medizin und Dermatologie.

出版信息

Z Gastroenterol. 1998 Jan;36(1):41-53.

PMID:9531689

Abstract

BACKGROUND

The clinical significance of the recently discovered hepatitis C virus (HGV/GB virus C (GBV-C) is not conclusively clarified. The aim of this analysis was to evaluate the frequency of HGV/GBV-C coinfection at existing hepatitis C infection, the significance for the course of the liver disease, and its response to antiviral therapy.

METHODS

The literature available by medline and the PubMed Retrieval System as well as abstracts of recent German, European, and American conferences on liver diseases (GASL, EASL, ASSLU) concerning HCV/GBV-C-coinfection were analyzed.

RESULTS

We identified 66 references with 5,388 patients suffering from HCV-infection. 941 (17.5%) were coinfected with GBV-C. Excluding some groups at risk (intravenous drug abusers, dialysis patients, patients after liver transplantation), the rate of coinfection varied significantly in respect to geography: 20.5% in European vs. 10.9% in Japan (p < 0.0001). Additionally, coinfection occurred in 38% of intravenous drug users. The studies showed that coinfection was related to the frequency of blood transfusions. Furthermore, the parenteral transmission route of GBV-C was generally confirmed. Overall GBV-C does not seem to have any negative influence on the course of HCV-related chronic liver disease or the development of chronicity of acute hepatitis C infection, nor does it have any influence on histology, transaminase-levels or response of HCV to antiviral therapy; GBV-C was shown to be sensitive to interferon-alpha with a relapse rate up to 53% comparable to HCV. There is no correlation between response of HCV and GBV-C to interferon.

CONCLUSION

This analysis of the published data concerning coinfection of HCV and HGV/GBV-C revealed no influence of GBV-C on the course of HCV-related liver disease (clinical, biochemical, histological). GBV-C does not modify the response rate of HCV to interferon-alpha, but GBV-C is sensitive to interferon with high relapse rates.

摘要

背景

最近发现的丙型肝炎病毒（HGV/GB病毒C（GBV-C））的临床意义尚未得到最终明确。本分析的目的是评估在现有的丙型肝炎感染中HGV/GBV-C合并感染的频率、对肝病病程的意义及其对抗病毒治疗的反应。

方法

分析了通过医学在线（Medline）和PubMed检索系统获取的文献，以及近期德国、欧洲和美国肝病会议（GASL、EASL、ASSLU）上有关HCV/GBV-C合并感染的摘要。

结果

我们确定了66篇参考文献，涉及5388例丙型肝炎病毒感染患者。其中941例（17.5%）合并感染GBV-C。排除一些高危人群（静脉吸毒者、透析患者、肝移植术后患者）后，合并感染率在地域上差异显著：欧洲为20.5%，日本为10.9%（p<0.0001）。此外，38%的静脉吸毒者合并感染。研究表明，合并感染与输血频率有关。此外，GBV-C的肠道外传播途径总体上得到了证实。总体而言，GBV-C似乎对丙型肝炎相关慢性肝病的病程或急性丙型肝炎感染的慢性化发展没有任何负面影响，对组织学、转氨酶水平或丙型肝炎对抗病毒治疗的反应也没有任何影响；GBV-C被证明对α干扰素敏感，复发率高达53%，与丙型肝炎病毒相当。丙型肝炎病毒和GBV-C对干扰素的反应之间没有相关性。