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目的 从临床和病理学方面探讨庚型肝炎病毒 (GBV C/HGV)的致病性。方法 收集2 4例单纯血清GBV C/HGVRNA阳性人体的穿刺活检肝组织及血清标本 ,其中 8例作间隔 2年以上的二次肝穿 ,进行血清和肝组织GBV C/HGVRNA、血清抗E2抗体及ALT水平、肝组织NS3和NS5抗原检测 ,并作肝组织光、电镜观察。结果 2 4例血清GBV C/HGVRNA阳性者首次肝穿前 3d内平均ALT水平为 6 0 .17IU/ml(4 2～ 87IU/ml) ,抗E2抗体阳性率 4 17% ,首次肝组织GBV C/HGVRNA阳性率为 75 0 0 % ,NS3和 (或 )NS5抗原阳性率为 5 4 17%。GBV C/HGVRNA及NS3和NS5抗原主要于肝细胞胞质内检出 ,阳性细胞呈散在分布 ,少数浸润的单个核细胞内有病毒RNA检出。肝细胞呈极轻度急、慢性炎症病变者占 79 17%。与 2年前比较 ,2年后 2 4例观测对象血清GBV C/HGVRNA自然转阴率 6 6 6 7% (P <0 0 0 1) ,血清ALT复常率 75 0 0 % (P <0 0 0 1) ,E2抗体阳性率为 41 6 7% (P <0 0 0 1) ,8例二次穿刺肝组织除 2例有灶状肝细胞水样变性外 ,余均复常。结论 庚型肝炎病毒可引起极轻度自限性肝炎 ,提示其致肝损伤作用微弱且具自限性 ;血清E2抗体是GBV C/HGV感染恢复性标志 ,是否存在其他恢复性血清标志物尚待研究
Objective To investigate the pathogenicity of Hepatitis G virus (GBV C / HGV) in clinical and pathological aspects. Methods Twenty-four cases of biopsies of liver biopsy and serum from 24 cases of pure GBV C / HGV RNA-positive human were collected. Among them, 8 cases were performed secondary hepatic perfusion with more than 2 years interval. Serum and hepatic tissue GBV C / HGVRNA, serum anti-E2 antibody And ALT levels, liver tissue NS3 and NS5 antigen detection, and liver tissue light and electron microscopy. Results The mean serum ALT levels of 24 cases with positive serum GBV C / HGVRNA were 60.17 IU / ml (42 2-87 IU / ml), the positive rate of anti-E2 antibody was 41.7% and the first liver tissue GBV C The positive rate of HGV RNA was 75 0%, and the positive rate of NS3 and / or NS5 antigen was 5417%. The GBV C / HGV RNA and NS3 and NS5 antigens were mainly detected in the cytoplasm of hepatocytes. The positive cells were scattered and the viral RNA was detected in a few infiltrating mononuclear cells. Liver cells were extremely mild and chronic inflammatory disease accounted for 79 17%. Compared with 2 years ago, the natural conversion rate of serum GBV C / HGVRNA in 26 subjects 2 years later was 66.7% (P <0.01), and the normal rate of serum ALT 75 75% (P <0) The positive rate of E2 antibody was 41 6 7% (P 0 01). All the 8 cases of secondary liver biopsy except two cases showed focal hepatocellular degeneration. Conclusion Hepatitis G virus can cause very mild self-limiting hepatitis, suggesting that its hepatic injury is weak and self-limiting. Serum E2 antibody is a recovery marker of GBV C / HGV infection and is there any other restorative serum markers To be studied