Clinical analysis of 8 cases of hepatitis-associated aplastic anemia / 南方医科大学学报

ABSTRACT

<p><b>OBJECTIVE</b>To study the clinical characteristics of hepatitis-associated aplastic anemia (HAAA). A retrospective analysis was conducted among 8 cases of established HAAA in light of the clinical and laboratory findings and the patient outcomes.</p><p><b>METHODS</b>Serum samples from 8 patients with HAAA were tested for the antibodies to hepatitis viruses A, B, C, D, E and CMV, and 7 patients showed negative serological results while only one was positive for HBsAg. The percentage of CD4(+) cells was significantly lowered while the percentage of CD8(+) cells significantly increased to result in a lowered ratio of CD4(+)/CD8(+) cells in these HAAA patients. A shift in the Th1/Th2 and Tc1/Tc2 balance to a Th1 and Tc1 dominance was noted. The percentage of Treg cells was obviously decreased. Significant increments were found in the serum levels of interleukin-2, THF-α and interferon-γ. Three of the patients responded to immunosuppresssive treatment; one patient achieved a complete remission, two had a partial remission, and five failed to respond to the therapy and died.</p><p><b>CONCLUSIONS</b>HAAA may not have an obvious association with viral infections as by hepatitis virus A, B, C, D, or E, and its pathogenesis often involves abnormalities of the T cell immunity. Commonly with a poor prognosis, HAAA is associated with a high mortality rate.</p>