输血后丙型肝炎前瞻性研究

A Prospective Study on Posttransfusion Hepatitis C

在开展筛查丙型肝炎抗体（抗－ＨＣＶ）之前，在河北省甲、乙两地前瞻性调查了输血后丙型肝炎（ＰＴＨＣ）。甲地献血员在献血前筛查ＨＢｓＡｇ和ＡＬＴ，观察了６４名受血者；乙地献血员献血前不筛查任何指标，观察了９０名受血者。ＰＴＨＣ发生率，甲地为２１．９％，乙地为４４．４％；输血后抗－ＨＣＶ阳转率分别为１８．８％和４５．６％；输入抗－ＨＣＶ阳性血发病率甲地为５５．６％，乙地为８３．３％；输入抗－ＨＣＶ阴性血发病率甲地为７．３％，乙地为４．２％。ＡＬＴ首次异常距输血时间甲地为５１．９±２０．９天，乙地为４８．２±１６．８天；抗－ＨＣＶ阳转距输血时间甲地为４２．４±１５． ９天，乙地为３８． ４±１１．８天。对ＰＴＨＣ病例随访 ５年，临床痊愈率，病后１、２、３、４、５年分别为４５．８％、５１．７％、５５．９％、６２．１％和７４．５％；ＡＬＴ异常率各为４０．７％、４４．８％、３２．２％、１５．５％和１２．８％；抗－ＨＣＶ阳性率各为９８．３％、９４．８％、７９．７％、７２．４％和７５．５％；ＨＣＶ ＲＮＡ阳性率各为７３．９％、６９．６％、５８．８％、缺和４１．２％。这些结果表明抗－ＨＣＶ阳性血有强传染性．抗－ＨＣＶ和ＨＣＶＲＮＡ?

Before screening of anti - HCV in blood donors,a prospective study on posttransfusion hepatitis C (PTHC) was performed in two county hospitals (A and B) during 1990 to 1991. Blood donors were screeded with ALT and HBsAg before donations in hospital A, and neither in hospital B. 64 blood recipients in hospital A and 90 recipients in B were followed up. The PTHC attack rates were 21. 9% in A and 44. 4% in B. The positive conversion rates of anti - HCV were 18. 8% in A and 45. 6% in B. The attack rates of PTHC for recipients who were transfused blood with anti -HCV were 55. 6% in A and 83. 3% in B, however,for those who were transfused blood of negative of anti-HCV were 7. 3% in A and 4. 2% in B. The time of first abnomal ALT detected to transfusion were 51. 9± 20. 9 days in A and 48. 2 ± 16. 8 days in B in average. The positive conversion time of anti- HCV to transfusion were 42. 4 ± 15. 9 days in A and 38. 4± 11. 8 days in B. The most PTHC cases had been followed up for 5 years. The clinical cure rates were 45. 8%, 51. 7%, 55. 9%, 62. 1% and 74. 5% in 1,2,3,4and 5 years after onset, receptively. The abnomal rates of ALT were 40. 7%, 44. 8%, 32, 2% 15. 5% and 12. 8% corresponding above time. The positive rates of anti - HCV were 98. 3%, 94. 8%, 79. 7%, .72. 4% and 75. 5% respectively. The positive of HCV RCA were 73. 9%, 69. 6%, 58. 8% and 41. 2% in 1, 2, 3and 5 years after onset. The results of this study suggest that blood with anti - HCV has strong infectivity, and anti -HCV and HCV RNA persist a long time.