Negro F, Rubbia-Brandt L, Giostra E, Seium Y, Mentha G, Quadri R, Hadengue A
Division of Gastroenterology and Hepatology, University Hospital, Geneva, Switzerland.
Dig Dis Sci. 1998 Dec;43(12):2577-83. doi: 10.1023/a:1026674421447.
Hepatitis G virus (HGV) causes persistent infection in man, but its disease association is controversial. We studied the HGV disease association in 25 liver transplantation (LT) recipients without evidence of hepatitis B and C infection. HGV RNA was tested by semiquantitative RT-PCR in serial serum samples and its presence was correlated with the biochemical and histological evidence of liver damage. The overall prevalence of HGV infection in this population was 9/25 (36%), one patient being HGV RNA positive since before LT, while the other eight apparently acquired de novo infections after LT. In five cases, appearance of HGV was followed by biochemical and histological evidence of liver damage: the liver biopsy showed acute rejection in two cases, acute cholangitis in two, and acute hepatitis in one. At the end of follow-up, histological evidence of chronic hepatitis was found in one HGV-positive patient but also in three HGV-negative patients, whereas the only patient with acute hepatitis at the time HGV RNA was first detected in serum developed an intralobular gigantocellular granuloma. In conclusion, HGV infection after LT may be seldom associated with acute and chronic liver damage, but comparable histological features can be observed also among HGV-negative controls.
庚型肝炎病毒(HGV)可导致人类持续感染,但其与疾病的关联存在争议。我们对25例无乙肝和丙肝感染证据的肝移植(LT)受者的HGV与疾病的关联进行了研究。通过半定量逆转录聚合酶链反应(RT-PCR)检测系列血清样本中的HGV RNA,并将其存在情况与肝损伤的生化和组织学证据相关联。该人群中HGV感染的总体患病率为9/25(36%),1例患者在肝移植前即为HGV RNA阳性,而其他8例显然是在肝移植后获得了新发感染。在5例病例中,HGV出现后伴有肝损伤的生化和组织学证据:肝活检显示2例为急性排斥反应,2例为急性胆管炎,1例为急性肝炎。随访结束时,在1例HGV阳性患者以及3例HGV阴性患者中均发现了慢性肝炎的组织学证据,而血清中首次检测到HGV RNA时唯一的急性肝炎患者出现了小叶内巨细胞肉芽肿。总之,肝移植后HGV感染可能很少与急性和慢性肝损伤相关,但在HGV阴性对照中也可观察到类似的组织学特征。