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背景 近来发现一种新的经输血途径传播的人DNA病毒,即TT病毒(TTV)。作者试图探明受血者感染TTV的发生率及感染TTV的临床后果。研究设计和方法 应用巢式PCR方法对连续采集的血清标本进行了TTV DNA检测,作为输血后肝炎的前瞻性研究。结果:150例成人心脏病手术患者中,59例患者的输血后血样为TTV DNA阳性,其中有13例患者的输血前血清标本为TT DNA阳性。因而在137例中有46例(33.6％)以前未感染的患者在输血后发展为TTV病毒血症。在这46例输血TTV感染者中,3例伴随着HCV感染,5例伴随有HGV感染,另外的38例为单纯TTV感染。TTV感染者平均血清ALT活性为311U/1,而38例单纯TTV感染者中有34例的血清ALT活性持续在正常范围之内。在8例以后发展为非A-G的肝炎患者中,3例为TTV阳性(1/8:46/137,P=0.8)。对12例患者进行一年时间以上的随访,12例均表现为持续地TTV病毒血症。结论:在本组心脏病手术患者中,输血传播的TTV感染率大约为30％,大多数感染者为持续感染。TTV感染率高但似乎不引发肝炎。
Background Recently a new human DNA virus transmitted by the transfusion route was found, namely the TT virus (TTV). The authors sought to determine the incidence of TTV infection and the clinical consequences of TTV infection. RESEARCH DESIGN AND METHODS Nested PCR was used to detect TTV DNA in serially collected serum samples as a prospective study of post-transfusion hepatitis. RESULTS: Of the 150 adult patients undergoing cardiac surgery, blood transfusion samples from 59 patients were positive for TTV DNA, of which 13 were positive for TT DNA prior to transfusion. Thus, 46 of 137 (33.6%) of the 137 uninfected patients developed TTV viremia after transfusion. Of the 46 transfusion-transmitted TTV infections, 3 were associated with HCV infection, 5 were accompanied by HGV infection, and the other 38 were pure TTV infection. Mean serum ALT activity was 311 U / 1 in TTV-infected individuals, while 34 of the 38 TTV-infected individuals continued to have serum ALT activity within the normal range. Of the 8 hepatitis B patients who developed non-A-G later, 3 were TTV positive (1/8: 46/137, P = 0.8). Twelve patients were followed up for more than a year, and all 12 patients showed persistent TTV viremia. Conclusion: In this group of patients with cardiac surgery, the rate of TTV infection transmitted by blood transfusions is about 30%, and most of the infected patients are persistent infections. TTV infection rate is high but does not seem to trigger hepatitis.