庚型肝炎

庚型肝炎,台湾译作G型肝炎,是一种病毒性肝炎。GB 病毒 C (GBV-C),以前稱為庚型肝炎病毒 (HGV),也稱為人類 豬流感 – HPgV 是黃病毒科的一種病毒,是 豬流感 的成員,已知會感染人類,但未知會導致人類疾病。據報導,合併感染 GBV-C 的 HIV 患者比未感染 GBV-C 的患者存活時間更長,但患者可能在其他方面有所不同。正在積極研究該病毒對同時感染 GBV-C 和 HIV 的患者的免疫系統的影響。

病原体

所谓的庚型肝炎病毒是属于黃病毒科的一种带外壳的、单链核糖核酸病毒,所属的“属”未定。

发现历史

1995年庚型肝炎病毒(Hepatitis G virus)与GB病毒C (GBV-C)分别独立被发现。1995年8月28日~9月3日召开的第三届国际丙型肝炎及相关病毒会议上,美国人报道,采用分子生物学技术在1名输血后非甲型乙型丙型丁型戊型肝炎患者血浆中,发现了1个新的黄病毒样核糖核酸(RNA)序列,暂称为庚型肝炎病毒(HGV,简称庚肝病毒)。早在1966年,Deinhardt等将1名因手术意外创伤而患急性非甲-非乙型肝炎的外科医生(G. Barker)的血清,静脉内感染狨猴和绢毛猴,导致该两种动物均患肝炎,当时将这种人源性传染动物的血清用这位外科医生的名字命名为GB因子。由于该因子可在狨、绢毛猴中连续传代感染,也可感染人,并引发肝炎,当时称为GB肝炎。随着肝炎病原学研究的进展,发现GB肝炎与甲型、乙型、丙型、丁型、戊型肝炎均无关,通过各种特异性免疫技术筛选证实,GB肝炎不属于已确认的5型肝炎中任何一型,被称为非甲、非乙、非丙、非丁、非戊型肝炎(HNA~E)。 美国Abbott公司采用差式聚合酶链反应法从感染GB因子的绢毛猴急性期血浆中发现了两种病毒样RNA序列[1];随后,Simmons等用GB肝炎病毒(GBV)重组蛋白建立的酶联免疫吸附(ELISA)技术,从1名西非HNA~E患者血清中发现了另一种黄病毒样基因序列[2],被分别命名为GBV-A,GBV-B,GBV-C亚型。随后的基因测序证实HGV与GBV-C是同一病毒的两个孤立群体。

感染后果

虽然最初GBV-C被认为与某些慢性肝炎相关,但是大量研究未能发现GBV-C与任何临床疾病有关[3]

从系统发生学角度,GBV-C与丙型肝炎病毒相关,但GBV-C主要在淋巴细胞中复制,在肝实质细胞中几乎不能复制。

另外还发现艾滋病患者如果感染了GBV-C,比没有感染GBV-C的艾滋病患者存活时间显著更长。看起来GBV-C有减慢人類免疫缺陷病毒复制的作用,这个作用的原理不明。但同时感染了HIV和GBV-C病人的免疫系统的研究目前十分活跃[4][5]

传播

通过肠外途径(血液、血制品)、性传播、垂直感染都已被证实。由于与艾滋病有类似传播模式,艾滋病患者中常见GBV-C感染,GBV-C病毒携带率在14-43%。

免疫系统正常的人感染GBV-C后,大多在几年的时间内能清除体内该病毒颗粒(血浆中GBV-C RNA检测不到)。有些感染者的体内病毒可以保持几十年。

大约2%的健康美国献血者检出了GBV-C颗粒。最高13%的美国献血者E2蛋白抗体阳性,表明早先有过感染。

诊断

可以通过抗体以及病毒核糖核酸检验。

参考文献

  1. ^ Simons JN, Pilot-Matias TJ, Leary TP, et al. Identification of two flavivirus-like genomes in the GB hepatitis agent. Proc. Natl. Acad. Sci. USA. 1995年4月, 92 (8): 3401–5. Bibcode:1995PNAS...92.3401S. PMC 42174可免费查阅. PMID 7724574. doi:10.1073/pnas.92.8.3401. 
  2. ^ Simons JN, Leary TP, Dawson GJ, et al. Isolation of Novel Virus-like Sequences Associated with Human Hepatitis. Nat. Med. 1995年6月, 1 (6): 564–9. PMID 7585124. doi:10.1038/nm0695-564. 
  3. ^ Alter, H. J. The Cloning and Clinical Implications of HGV and HGBV-C. N. Engl. J. Med. 1996年6月, 334 (23): 1536–7. PMID 8618611. doi:10.1056/NEJM199606063342310. 
  4. ^ Mosam A, Sathar MA, Dawood H, Cassol E, Esterhuizen TM, Coovadia HM. Effect of GB Virus C Co-infection on Response to Generic HAART in African Patients with HIV-1 Clade C Infection. AIDS. 2007, 21 (10): 1377–9. PMID 17545721. doi:10.1097/QAD.0b013e3281532cb8. 
  5. ^ Jung S, Eichenmüller M, Donhauser N, et al. HIV Entry Inhibition by the Envelope 2 Glycoprotein of GB Virus C. AIDS. 2007, 21 (5): 645–7. PMID 17314528. doi:10.1097/QAD.0b013e32803277c7. 

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