We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Aplastic anemia and viral hepatitis. Non-A, Non-B, Non-C?
- Authors
Hibbs, J R; Frickhofen, N; Rosenfeld, S J; Feinstone, S M; Kojima, S; Bacigalupo, A; Locasciulli, A; Tzakis, A G; Alter, H J; Young, N S
- Abstract
<bold>Objective: </bold>To test the hypothesis that the rare, often fatal, syndrome of hepatitis-associated aplasia is associated with hepatitis C virus infection.<bold>Design: </bold>Case series.<bold>Setting: </bold>Tertiary referral centers in the United States, Japan, Italy, and Germany.<bold>Patients: </bold>Twenty-eight patients with onset of aplastic anemia within 90 days after seeking medical attention for jaundice, or having serum transaminase levels 150% or more of normal (hepatitis-associated aplasia patients) and three patients who developed aplastic anemia following liver transplantation for non-A, non-B hepatitis.<bold>Outcome Measures: </bold>Presence of hepatitis C in serum, bone marrow, and liver samples, detected by the polymerase chain reaction; antibody testing; and percentage of activated peripheral cytotoxic T lymphocytes determined by immunophenotyping.<bold>Results: </bold>Hepatitis ribonucleic acid was present in the serum samples of 10 (36%) patients with hepatitis-associated aplasia. However, hepatitis C virus viremia was associated with transfusions received after the onset of aplasia: seven (58%) of 12 patients with hepatitis-associated aplasia who had received 21 or more units of blood products at the time of serum sampling were viremic, compared with only three (19%) of 16 patients with hepatitis-associated aplasia who had received 20 or less units of blood products (P less than .05). Hepatitis C virus was not found in blood and bone marrow samples of three National Institutes of Health case patients tested at the time of diagnosis. None of three livers from non-A, non-B hepatitis patients who developed aplastic anemia after liver transplantation contained hepatitis C virus ribonucleic acid. Activated CD8+ T lymphocytes were elevated three- to 20-fold early in the course of hepatitis-associated aplasia.<bold>Conclusions: </bold>Our results implicate a novel, non-A, non-B, and non-C agent in both hepatitis-associated aplasia and fulminant hepatitis.
- Subjects
HEPATITIS C diagnosis; RNA analysis; APLASTIC anemia; COMPARATIVE studies; HEPATITIS C; HEPATITIS viruses; RESEARCH methodology; MEDICAL cooperation; POLYMERASE chain reaction; RESEARCH; EVALUATION research; DISEASE complications
- Publication
JAMA: Journal of the American Medical Association, 1992, Vol 267, Issue 15, p2051
- ISSN
0098-7484
- Publication type
journal article
- DOI
10.1001/jama.267.15.2051