合并丙型肝炎病毒感染的系统性红斑狼疮患者临床与免疫学特征

Analysis of clinical and immunological features of patients with systemic lupus erythematosus complicated by hepatitis C virus infection

目的探讨系统性红斑狼疮(SLE)患者丙型肝炎病毒(HCV)感染的发生率及其临床意义。方法用ELISA-3、RIBA-3及PCR检测134例SLE患者和200名正常献血者的HCV感染情况,并分析临床与免疫学其特征。结果15名SLE患者(13 %)和2名正常对照(1%)HCV抗体阳性(P<0.001)。与未合并HCV感染的SLE患者相比,合并HCV感染的SLE患者皮肤表现、dsDNA抗体阳性发生率低(P=0.01,P<0.001),肝脏损害、低补体血症、冷球蛋白血症发生率高(P<0.001,P<0.05,P=0.03)。结论SLE患者合并HCV感染的发生率显著高于正常人群,HCV抗体阳性SLE患者显示出特异的临床和免疫学表现。

Objective To investigate the prevalence and clinical significance of hepatitis C virus (HCV) infection in patients with systemic lupus erythematosus (SLE). Methods Serodiagnosis was conducted in 134 SLE patients and 200 volunteer blood donors to examine the antibodies of HCV with enzyme-linked immunosorbent assay-3 (ELISA-3). Recombinant immunoblot assay-3 (RIBA-3) and PCR were performed to verify the results. Results HCV infection was present in 15 patients with SLE (11.8%) and in 2 volunteer donors (1%, P<0.001). Compared with the SLE patients without HCV infection, the patients with HCV infection had a lower rate of cutaneous SLE features and dsDNA positivity (P=0.01 and P<0.001), but with higher incidences of hepatic damage (P<0.001) and low levels of C4 and CH50 (P=0.01 and P=0.03) as well as cryoglobulins levels (P=0.03). Conclusion The prevalence of HCV infection is higher in SLE patients than in non-SLE subjects, and SLE patients with positive HCV show a lower rate to present cutaneuos SLE features and positive dsDNA antibody, but who have higher possibilities of hepatic damage, hypocomplementemia and cryglobulinemia.