Vargas V, Krawczynski K, Castells L, Martinez N, Esteban J, Allende H, Esteban R, Guardia J
Liver Unit, Hospital General Universitari Vall d'Hebron, Barcelona, Spain.
Liver Transpl Surg. 1998 Jul;4(4):320-7. doi: 10.1002/lt.500040407.
The value of immunohistochemical methods to identify hepatitis C virus antigen (HCVAg) in liver tissue has not been established. We have evaluated the significance of HCVAg expression in livers of patients with transplants and recurrent hepatitis C virus (HCV) infection.
Forty-two liver biopsy specimens from 32 liver-transplant recipients with recurrent HCV infection were tested for HCVAg using fluorescein isothiocyanate-labeled polyclonal, polyreactive human immunoglobulin. Histologic assessment of liver and quantitation of HCV RNA in sera were carried out in specimens obtained simultaneously with biopsies.
HCVAg was found in 33% of the liver specimens obtained during the first month after transplantation and in all liver specimens obtained between 1 and 18 months after transplantation. Amounts of the antigen were significantly greater in specimens obtained more than 1 month after transplantation. A statistically significant increase of the average HCV RNA level in serum was observed in samples tested after the first month after the transplantation, and some decrease in the HCV RNA level was found in those obtained between 6 and 18 months after transplantation. Larger amounts of HCVAg were observed in specimens corresponding to episodes of acute or chronic hepatitis than in those associated with minimal parenchymal evidence of rejection.
OBSERVATIONS of HCVAg expression in liver biopsy specimens indicated that the presence of viral antigens in hepatocytes is a constant finding in specimens obtained 1 month or longer after transplantation. Although large amounts of HCVAg correlated with acute or chronic hepatitis, the nature of this association with the development of pathologic changes remains to be established.
免疫组化方法在肝组织中鉴定丙型肝炎病毒抗原（HCVAg）的价值尚未确定。我们评估了HCVAg在移植患者肝脏以及复发性丙型肝炎病毒（HCV）感染中的表达意义。
对32例复发性HCV感染的肝移植受者的42份肝活检标本，使用异硫氰酸荧光素标记的多克隆、多反应性人免疫球蛋白检测HCVAg。在与活检同时获取的标本中进行肝脏组织学评估以及血清中HCV RNA定量分析。
移植后第一个月获取的肝脏标本中，33%检测到HCVAg，而在移植后1至18个月获取的所有肝脏标本中均检测到HCVAg。移植后1个月以上获取的标本中抗原量显著更高。移植后第一个月后检测的样本中，血清平均HCV RNA水平有统计学显著升高，而在移植后6至18个月获取的样本中发现HCV RNA水平有所下降。与急性或慢性肝炎发作对应的标本中观察到的HCVAg量，多于与实质排斥证据最少相关的标本。
肝活检标本中HCVAg表达的观察结果表明，移植后1个月或更长时间获取的标本中，肝细胞内病毒抗原的存在是一个持续发现。虽然大量HCVAg与急性或慢性肝炎相关，但这种与病理变化发展的关联性质仍有待确定。
