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B型肝炎ウイルスと非A型,非B型 fulminant 型肝炎のようです
T L Wright1, D Mamish, C Combs
1Department of Veterans Affairs Medical Center, San Francisco, California 94121.
Lancet (London, England)
|April 18, 1992
まとめ
B型肝炎ウイルス (HBV) のDNAは,非A型,非B型肝炎患者の肝臓サンプルで検出され,HBVは感染の血清学的証拠がない場合でも,フルミナント肝不全を引き起こす可能性があることを示唆しています.
科学分野:
- 肝臓病理学 肝臓病理学
- ウイルス学 ウイルス学 ウイルス学
- 移植 移植 移植
背景:
- フルミナント肝不全 (FHF) の病因はしばしば不明であり,特に非A,非B型肝炎の症例では不明である.
- C型肝炎ウイルス (HCV) はFHFの原因とは考えられず,原因は不明である.
- B型肝炎ウイルス (HBV) 感染症は,世界中で急性肝不全の重要な原因です.
研究 の 目的:
- 急性肝不全および非A,非B型肝炎の患者におけるB型肝炎ウイルス (HBV) の役割を調査する.
- 敏感な分子技術を使用して,血清と肝臓のサンプルにHBVDNAの存在を決定する.
- FHFにおけるHBV検出のためのPCRと対比して,血清学的マーカーの診断的有用性を評価する.
主な方法:
- 肝臓移植を受ける急性肝不全患者の26人から血清と肝臓のサンプルを採取する.
- 2段階のポリメラーゼ連鎖反応 (PCR) で,血清と肝臓組織におけるHBVDNAを検出する.
- A型肝炎ウイルス (HAV) とHBVの血清学的マーカーが評価されました.
- 移植前のサンプルにおけるPCRを用いたHCV RNA検出.
主要な成果:
- HBV DNAは,すべての26人の患者の移植前の血清に含まれていなかった.
- 17人の非A,非B型肝炎患者のうち,6人の肝臓サンプルでHBVDNAが検出されました (35%).
- HAVまたは毒素誘発性急性肝不全の患者からの肝臓サンプルではHBVDNAが見つかりませんでした.
- HCV RNAは,移植前のサンプルでは検出されませんでした.
- 移植後の血清HBVDNAは,明らかに非A,非B型肝炎を有する17人の患者のうち7人に検出されました.
結論:
- B型肝炎ウイルス (HBV) は,非A型,非B型肝炎を呈する患者におけるフルミナン性肝不全 (FHF) の潜在的一般的な原因である.
- 標準的な血清検査では,FHFにおけるHBVの役割を過小評価することがあります.
- 肝臓組織におけるHBVDNAの敏感なPCR検出は,原因不明のFHFの診断に不可欠です.
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