P0315 TTV INFECTION AS ONE OF CAUSES AND AGGRAVATING FACTORS IN COGENITAL BILIARY ATRESIA

Abstract

Introduction: The causes of congenital Biliary Atresia(CBA) have been unknown. There were some hypotheses that viral agents might destroy outer and inner hepatic biliary ducts.We have reported that TTV(N22) infection in uterus or around peri-natal periods might influence the growth and formation of bile ducts. We reported here the infectious rates of TTV(N22) in CBA and the prognoses of the cases with TTV(N22) infected or not infected. Methods: 7 cases(3 males,4 females) aged from 6 years-old to 23 years-old were enrolled in this studies. When we diagnosed as TTV(N22) infected, we used the sera of the cases who din’t use blood transfusion or blood products. The serial sera of the cases were frozen at the temperature,−30c. TTV(N22)-DNA was measured by Okamoto’s method(Hepatology Research10:1–16,1998). TTV(UTR) was measured by Takahashi’s method-(Hepatology research 12:233–239,1998). The quantification of TTV(N22)-DNA was measured by 10 folds-dilution method. no diluted sera:1+,10 folds-diluted sera:2+,100 folds-diluted sera:3+,1000 folds-diluted sera: 4 +. TTVI gG, TTVI gM were measured by Tsuda’method(hepatology research 19(1):1–11). Genotypes of TTV were measured by genotyping kits manufactured by the Institute of Special Immunology(Tokyo). Results: We divided 7 cases into 5 ones(group A:T-TV(N22)(+)) and 2 ones(groupB:TTV(N22)(−). There were some reports that Cytomegalovirus infection might be one of the causes for CBA. So, we measured CMVIgM, CMVIgG, CMV-DNA(PCR). There was no positive case in group A.but, there was 1 case with positive CMVIgM, CMVIgG, CMV-DNA in group B. In group A, the movements for TTVIgM, TTVIgG were positive and increased or decreased with fluctuations of liver damages. Immunological reactions were detected for TTV(N22) infection. In group B, there was no immunological reaction for TTV(N22) infection. About the prognoses of CBA with TTV(N22) positive or with TTV(N22) negative, in group A,3 cases out of 5 ones underwent live -related liver transplantation(LRLV). They had liver failure in the early stages of clinical courses of CBA after Kasai’s peration.2 cases out of 5 ones had T-Bil 2~10mg/dl and liver failure of progressive biliary congestion. The prognosis for group A was anticipated very bad. In group B,23 years-old female,2 years-old female had no biliary congestion. The prognosis for group B were thought to be very good. Conclusion: TTV(N22) infection might be one of the causes for the formation of CBA, and could be related with prognosis for CBA.