丙型肝炎病毒基因型与血清HCVRNA含量关系及与干扰素应答的研究.docVIP

???? 丙型肝炎病毒基因型与血清HCV?RNA?含量关系及与干扰素应答的研究 ???? ????【 摘要 】　目的　探讨丙型肝炎病毒(HCV)基因型与血清HCV RNA含量的关系及其对干扰素应答的影响。 方法　应用定量荧光PCR(Amplisensor-PCR)技术检测了135例不同基因型HCV感染的慢性丙型肝炎患者血清HCV RNA含量，另对其中77例进行干扰素治疗并随访12个月以上。 结果　HCV-Ⅱ型感染血清HCV RNA水平(107.8±3.4拷贝/ml)显著高于HCV-Ⅲ型感染(106.3±2.5拷贝/ml)(P＜0.01)，Ⅲ型感染的应答率(7/13，53.8%)显著高于Ⅱ型感染(20/64，31.3%)(P＜0.05)。应答组治疗前血清HCV RNA含量(106.8±2.7拷贝/ml)显著低于无应答组(108.3±3.2拷贝/ml)(P＜0.01)。HCV RNA含量低于106.5拷贝/ml者，无论何种型别HCV感染均应答较好，而HCV RNA高于108.0拷贝/ml者则应答极差。 结论　HCV基因型及病毒血症水平是预测干扰素疗效的重要因素，且后者比前者意义更大。Ⅱ型感染病毒血症水平较高可能是影响其疗效的原因之一。　　【 主题词 】　肝炎，丙型　　丙型肝炎病毒核糖核酸　　丙型肝炎病毒基因型　　聚合酶链反应　　干扰素 The amount of HCV RNA in chronic hepatitis C patients with different HCV-genotypes infections and their relationships to the response to interferon Zhang Fuchun, Tang Xiaoping, Cai Xiaoli, et al. Institute of Infectious Diseases, The Eighth People?s Hospital of Guangzhou, Guangzhou 510060 　　Abstract To investigate the relationship between HCV RNA quantification and HCV genotype and their predictive role on response to interferon therapy,serum HCV RNA was quantified in 135 chronic hepatitis C patients with different HCV genotypes infections by quantitative PCR based on Amplisensor assay.Seventy seven of them were treated with recombinant interferon alpha(IFN) for 16 weeks and were followed for more than one year.It was shown that serum HCV RNA concentration in patients with HCV-Ⅱ infection(107.8±3.4 copies/ml) was significantly higher than that in patients with HCV-Ⅲ infection(106.3±2.5 copies/ml,P＜0.01).The sustained response(SR) rate to IFN in HCV-Ⅲ infected patients(7/13,53.8%) was significantly higher than that in HCV-Ⅱ infected patients(20/64,31.3%,P＜0.05).HCV RNA level prior to treatment in patients with SR(106.8±2.7copies/ml)was significantly lower than that in patients without response(108.3±3.2 copies/ml,P＜0.01).Patients with HCV RNA level less than 106.5 copies/ml,no matter what genotype they had,got a higher SR rate.But patients with HCV RNA level more than 108 copies/ml got almost no re