Simmonds P, Davidson F, Lycett C, Prescott L E, MacDonald D M, Ellender J, Yap P L, Ludlam C A, Haydon G H, Gillon J, Jarvis L M
Department of Medical Microbiology, University of Edinburgh, UK.
Lancet. 1998 Jul 18;352(9123):191-5. doi: 10.1016/s0140-6736(98)03056-6.
A newly discovered DNA virus, transfusion-transmitted virus (TTV), has been implicated as a cause of post-transfusion hepatitis. We investigated the frequency of TTV viraemia in UK blood donors, and the extent to which TTV contaminates blood products such as factor VIII and IX clotting factors. We also investigated the possible aetiological role of TTV in cryptogenic fulminant hepatic failure (FHF).
We extracted DNA from plasma of blood donors and patients with FHF, and from blood products (factor VIII and IX clotting-factor concentrates, immunoglobulin preparations). We detected TTV by PCR using primers from a conserved region in the TTV genome.
TTV viraemia was detected in 19 (1.9%) of 1000 non-remunerated regular blood donors. Infection occurred more frequently in older donors (mean age 53 years), compared with the age prolife of donors infected with hepatitis C virus and other parenterally-transmitted viruses. TTV contamination was found in ten (56%) of 18 batches of factor VIII and IX concentrate manufactured from such non-remunerated donors, and in seven (44%) of 16 batches of commercially available products. Whereas solvent or detergent treatment had little effect on the detection of TTV in factor VIII and IX by PCR, this virucidal step seemed to inactivate TTV infectivity. TTV infection was detected in four (19%) of 21 patients with FHF; in three cases, infection was detected at the onset of disease and could thus not be excluded from its aetiology.
TTV viraemia is frequent in the blood-donor population, and transmission of TTV through transfusion of blood components may have occurred extensively. Clinical assessment of infected donors and recipients of blood and blood products, and assessment of TTV's aetiological role in hepatic and extra-hepatic disease, are urgently needed.
一种新发现的DNA病毒——输血传播病毒（TTV），被认为是输血后肝炎的病因之一。我们调查了英国献血者中TTV病毒血症的发生率，以及TTV污染血液制品（如凝血因子VIII和IX）的程度。我们还研究了TTV在隐源性暴发性肝衰竭（FHF）中可能的病因学作用。
我们从献血者和FHF患者的血浆以及血液制品（凝血因子VIII和IX浓缩物、免疫球蛋白制剂）中提取DNA。我们使用来自TTV基因组保守区域的引物通过PCR检测TTV。
在1000名无偿献血者中，有19人（1.9%）检测到TTV病毒血症。与感染丙型肝炎病毒和其他经肠道外传播病毒的献血者年龄分布相比，TTV感染在年龄较大的献血者（平均年龄53岁）中更常见。在由这些无偿献血者制备的18批凝血因子VIII和IX浓缩物中，有10批（56%）检测到TTV污染，在16批市售产品中有7批（44%）检测到TTV污染。虽然溶剂或去污剂处理对通过PCR检测凝血因子VIII和IX中的TTV影响不大，但这一灭病毒步骤似乎可使TTV失去感染性。在21例FHF患者中，有4例（19%）检测到TTV感染；在3例患者中，疾病发作时检测到感染，因此不能排除其病因学作用。
TTV病毒血症在献血人群中很常见，通过输血成分传播TTV可能已经广泛发生。迫切需要对受感染的献血者和血液及血液制品接受者进行临床评估，以及评估TTV在肝脏和肝外疾病中的病因学作用。
