病毒性肝炎可能引发自身免疫性肝病

E. Sbikina, S. Batskikh, A. Dorofeev, E. Vinnitskaya, J.B. Borunova, K. Saliev, Y. Sandler, T. Khaimenova, D. Bordin
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摘要

近年来,自身免疫性肝病(AILD)的发病率在所有年龄组的男性和女性中都有所增加,其病因尚不清楚。研究的目的。目的:确认肝炎病毒在AILD发展中的可能作用。材料和方法。在2019-2021年期间,以莫斯科卫生部A.S. Loginov命名的莫斯科临床科学与实践中心的慢性肝病科对141名AILD患者进行了检查。检查包括抗hav IgG、抗hev IgG、HBsAg、抗hbcor_ IgG、抗hbs、抗HCV、DNA HBV、RNA HCV、ANA-НЕр-2、肝纤维弹性测定(FE)、磁共振胰胆管造影(MRCP)、肝活检(LB)。通过计算优势比来评估患有甲型、乙型和戊型肝炎病毒感染的人发生AILD的风险。采用标准方法进行统计处理。结果。主要组为AILD患者(n = 139),其中合并AIH (n = 46)、PBC (n = 74)、PSC (n = 19),对照组(KG) (n = 125)无慢性肝病。抗肝炎病毒(HV) A、B、E的IgG类抗体在AILD患者中有较高的流行率(n = 104;74.8%)与KG相比(n = 68;54.4%), P < 0.001,最常检测到抗- hcv (n = 87;63%), p < 0.002; anti-HBcore (n = 36;25%), p < 0.031。抗hav和抗hbcore的最高患病率在PBC组分别为70% (p < 0.001)和29% (p < 0.016)。PSC和AIH无显著性差异。在2例患者的血液中检测到HBV DNA n = 2(2.5%),表明存在乙肝潜伏病毒DNA。研究结果揭示了转移性病毒性甲型肝炎和乙型肝炎与AILD(特别是PBС)的流行病学关系。获得的数据证实肝炎病毒可能是AILD的触发因素,HBV感染可能参与PBC的发病机制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Viral Hepatitis Is a Possible Trigger for Autoimmune Liver Diseases
In recent years, there has been an increase in the incidence of autoimmune liver diseases (AILD) among women and men in all age groups, their etiology remains unknown. The purpose of the study. To confirm the possible role of hepatitis viruses in the development of AILD. Material and methods. During the period 2019–2021, 141 patients with AILD were examined in the department of chronic liver Diseases of Moscow Clinical Scientific and Practical center named after A.S. Loginov of the Moscow Department of Health. The examination included the determination of anti-HAV IgG, anti-HEV IgG, HBsAg, anti-HBcorе IgG, anti-HBs, anti-HCV, DNA HBV, RNA HCV, ANA-НЕр-2, liver fibroelastometry (FE), magnetic resonance cholangiopancreatography (MRCP), liver biopsy (LB). The risk of developing AILD in people who have had hepatitis A, B, and E virus infections was assessed by calculating the odds ratio. Statistical processing was carried out by standard methods. Results. The main group consisted of patients with AILD (n = 139) of them with AIH (n = 46), PBC (n = 74), PSC (n = 19), the control group (KG) (n = 125) – without chronic liver diseases. The high prevalence of IgG class antibodies to hepatitis viruses (HV) A, B, E was reliably demonstrated among patients with AILD (n = 104; 74.8%) compared with KG (n = 68; 54.4%), P < 0.001, and anti-HCV was most often detected (n = 87; 63%), p < 0.002 and anti-HBcore (n = 36;25%), p < 0.031. The highest prevalence of anti-HAV and anti-HBcore was determined – 70% (p < 0.001) and 29% (p < 0.016), respectively, in the PBC group. No significant differences were obtained for PSC and AIH. HBV DNA was detected in the blood of two patients n = 2 (2.5%), that the presence of DNA latent viral hepatitis B. Conclusion. As a result of the study, the epidemiological relationship of transferred viral hepatitis A and B with AILD (in particular, PBС) was revealed. The data obtained confirm the role of hepatitis viruses as possible triggers of AILD and the probable involvement of HBV infection in the pathogenesis of PBC.
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