摘要
目的 明确儿童慢性乙型肝炎 (CHB)患儿庚型肝炎病毒 (HGV)感染的状况及意义 ,并探讨HGV的致病性。方法 45例CHB患儿应用Menghini法行肝脏穿刺活组织检查 ,应用免疫组织化学链霉菌亲生物素蛋白 过氧化物酶连接法 (S P法 )检测肝组织HGV Ag、HBcAg ,应用酶联免疫吸附试验 (ELISA)法检测血清乙型肝炎病毒标志 (HBVM) ,应用逆转录 聚合酶链反应 (RT PCR)、PCR法检测血清HGV RNA、HBV DNA ,应用定量PCR法检测血清HBV DNA含量 ,并将HGV Ag阳性与阴性患儿分别进行临床与病理学比较。结果 肝组织HGV Ag阳性 10例 ,血清HGV RNA阳性 9例 ,阳性率分别为 2 2 %、2 0 %。HGV抗原主要定位于肝细胞浆 ,阳性细胞呈散在、灶性或弥漫分布 ,阳性肝细胞未见特殊病理变化。HGV Ag阳性与阴性患者血清丙氨酸转氨酶 (ALT)、总胆红素 (TBIL)、白蛋白(ALB)、电泳γ球蛋白 (γ G)、凝血酶原活动度 (PTA)水平、血清HBeAg、HBV DNA阳性率、血清HBV DNA定量水平及肝脏病理损害的炎症活动度与纤维化程度、肝组织HBcAg形态学表现、检出率等方面差异均无显著性 (P >0 .0 5 )。结论 儿童CHB患者HGV感染常见。HGV感染对CHB患儿肝脏损害及HBV复制无明显影响。HGV对肝脏的致病性可能较弱。
Objective Hepatitis G virus (HGV) is a newly described RNA virus associated with hepatitis in humans. Virological and epidemiological studies have shown that HGV coinfection in patients with chronic hepatitis is common. The mixed infection of hepatitis virus may exacerbate the liver lesions and lead to interference in viral replication, but the significance of HGV coinfection in chronic hepatitis is not yet clarified. The aim of this study was to determine the status and significance of HGV infection in children with chronic hepatitis B(CHB)and explore HGV hepatic pathogenicity. Methods Totally 45 children hospitalized for CHB between 1997 and 1999 were enrolled in this study. Among these children, 32 were male and 13 were female. The age of these cases ranged from 9 years to 16 years. All the patients were diagnosed as CHB according to the viral hepatitis prevention and treatment scheme laid down by Chinese Society of Infectious Disease and Parasitic Disease, Chinese Medical Association on May 1995. Liver biopsy by Menghini method was performed for all the patients and HGV- antigen (HGV-Ag) and HBcAg were detected in their liver tissue by streptavidin-peroxidase (S-P) immunohistochemical staining assay, respectively. In the meantime, the level of alanine transaminase (ALT), total bilirubin(TBIL), albumin (ALB), γ-globulin (γ-G), prothrombin activity (PTA) in serum were detected by routine method, HBV markers (HBVM) in serum were detected by enzyme-linked immunosorbent assay (ELISA), serum HGV-RNA, HBV-DNA were detected by reverse transcription-polymerase chain reaction (RT-PCR) and PCR, and the amounts of HBV-DNA in serum were detected by a quantitive PCR, respectively. Then the results of the above-mentioned parameters, the severity of liver pathologic lesions, HBcAg expression in liver tissue from HGV-Ag positive patients were compared with those of HGV-Ag negative patients. Results Ten and 9 patients were positive respectively for liver tissue HGV-Ag and serum HGV-RNA. HGV antigen staining signals were mainly found in cytoplasm of hepatocytes and the positive cells were distributed scatteredly, focally or diffusely, but there were not special pathologic changes. There were no significant difference in levels of ALT, TBIL, ALB, γ-G, PTA, HBeAg, HBV-DNA positive rate in serum, the amount of HBV-DNA in serum, the severity of inflammatory activity grade and fibrosis, HBcAg positive rate and the morphologic feature of HBcAg expression in liver tissue between HGV-Ag positive and negative patients with CHB ( P >0.05). Conclusion HGV infection in children with CHB is common. HGV infection does not affect the liver lesions of children with CHB and HBV replication. HGV hepatic pathogenicity may be mild.
出处
《中华儿科杂志》
CAS
CSCD
北大核心
2000年第12期755-758,共4页
Chinese Journal of Pediatrics
