41例女性慢性输血后丙型肝炎10～15年后的感染状态

目的　了解我国女性输血后丙型肝炎病毒 (HCV)感染的慢性化规律和影响因素。方法　对河北省固安县 1989～ 1993年 4 1例女性慢性输血后丙型肝炎患者的现状进行调查 ,包括临床表现 ,血清生物化学指标 ,病毒学标志检测及B型超声检查。其中 ,HCVRNA的测定采用荧光定量PCR方法 ,抗 HIV ,抗 HCV和HBsAg测定采用酶联免疫吸附试验。结果　 4 1例女性丙型肝炎患者平均年龄 (40± 7)岁 ,随访时间 10～ 15年 ,HCVRNA间隔半年两次检测 ,自然阴转率为 19 5 1% (8 4 1)。 30例(73% )现在有症状 ,以乏力最为常见 (77% )。总的丙氨酸转氨酶 (ALT)和 (或 )天冬氨酸转氨酶 (AST)异常率为 32 % (13 4 1) ,均为轻度异常 ,无中度和重度。B超轻度慢性肝炎占 83% (34 4 1) ,中度占 17%(7 4 1) ,无重度。结论　平均感染 (13± 1)年的女性输血后慢性丙型肝炎患者多数肝脏炎症轻微慢性感染进程中有部分感染者出现HCVRNA自发阴转。

Clinical outcomes of women with transfusion-associated hepatitis C after 10-15 years follow-up

BACKGROUND: To investigate natural history of hepatitis C virus (HCV) infection and related factors in China. METHODS: Totally 41 women infected with HCV 10-15 years ago were evaluated in this study. Their clinical manifestations were recorded and sera tested for alamine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyltransferase (gamma-GT), alkaline phosphatase (ALP), total bilirubin (TBIL), direct bilirubin (DBIL), total protein (TP), albumin (ALB), and alpha-fetoprotein (alpha-FP), as well as virus markers. The B-type ultrasound examination was performed on the liver, gall bladder, spleen and pancreas. For virus markers, HCV RNA was detected with fluorogenic-quantitative polymerase-chain-reaction, HBsAg and anti-HCV antibody, with enzyme-linked immunosorbent assay (ELISA). RESULTS: Ten to 15 years after infection, the infection was cleared spontaneously in 8 cases (19.51%); 73%(30/41) cases had signs at present, 32% (13/41) cases had mild ALT and/or AST elevation. On ultrasound examination, 83%(34/41) had mild degree 17%(7/41) moderate degree changes of the viral hepatitis. CONCLUSION: Women with HCV infection for 13 +/- 1 (10-15) years after transfusion had slight hepatic inflammation. A part of them had cleared the virus spontaneously.