丙型肝炎病毒感染的检测

丙型肝炎病毒（HCV）感染的检测包括血清学检测和核酸检测（NAT）,前者包括HCV抗体（抗-HCV）、核心抗原检测,后者包括定性/定量RNA检测和基因型/亚型检测。抗-HCV检测是应用最广的HCV感染筛查试验,操作简便、耗时短、成本低,但其缺点是窗口期较长,不能判别是活动性感染还是病毒已被清除,不适用于免疫缺陷人群。HCV RNA是病毒感染的直接证据,既往定性RNA检测灵敏度较高,但随着实时定量PCR技术的成熟,定量检测灵敏度不断提高,线性范围不断拓宽,适用于临床抗病毒治疗应答的监测,也正逐步取代定性检测用于血液制品的筛查。近年HCV抗原检测和抗原抗体联合检测试剂盒已用于HCV感染的筛查及治疗监测,但其灵敏度尚不及NAT。目前主流的HCV基因分型试剂检测基因型有较高的符合率,而检测亚型的结果存在较大差异,需要方法学上的改进。     

AASLD基因1型慢性丙型肝炎病毒感染治疗指南2011年更新版

本指南由美国肝病学会（AASLD）讨论批准,并经美国感染性疾病协会和美国胃肠病学会和全国病毒性肝炎圆桌会议认可。     

隐匿性丙型肝炎病毒感染与慢性丙型肝炎的比较分析

目的:比较隐匿性丙型肝炎病毒(HCV)感染者与慢性丙型肝炎(CHC)患者的特点.方法:选择51例隐匿性HCV感染者和52例未经治疗的CHC患者,两组患者的年龄、性别、肝功能异常的持续时间相匹配,分别比较两组患者的肝功能指标和外周血单个核细胞(PBMCs)中的丙型肝炎病毒核酸(HCV RNA)含量.结果:CHC患者的天门冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、甲胎蛋白(AFP)显著高于隐匿性HCV感染者(P<0.01),而胆固醇(Ch)和甘油三酯(TG)则显著低于后者(P<0.01),γ谷氨酰转肽酶(GGT)在两组感染者中差异无显著性意义(P>0.05);CHC患者的PBMCs中HCV RNA平均含量显著高于隐匿性HCV感染者(P<0.01).结论:隐匿性HCV感染者病情严重程度不如CHC患者,这可能与其PBMCs中的病毒载量高低相关.     

丙型肝炎病毒感染与500例肝炎临床类型的关系

应用抗-HCV与HCV-RNA(RT-PCR法)检测了低温保存的500例各型肝炎的血清标本,结果抗-HCV与HCVRNA阳性率以CAH及Lc-D为高;而ASC两项指标阳性率较低;余均无显著性意义,     

丙型肝炎核心抗原检测在丙型肝炎诊断中的意义

目的了解丙型肝炎核心抗原（HCV-cAg）检测方法的敏感性及特异性,确定具有临床意义的S/CO值,探讨其在丙型肝炎诊断中的意义。方法使用ELASA方法检测丙型肝炎核心抗原,RT-PCR检测HCV RNA定量,观察不同S/CO值所对应的HCV RNA定量之间的关系,以HCV RNA为诊断金标准,列四格表做诊断实验。结果 HCV-cAg抗原检测的敏感性为87.05%,特异性为76.67%,阳性预测值为96.53%,阴性预测值为44.23%。结论 （1）随着HCV-cAg的S/CO值逐渐增大,其与HCV RNA阳性符合率明显增高,随着HCV-cAg的S/CO值减小,其与HCV RNA阴性符合率明显增高;（2）S/CO值=2可以作为临床判断HCV感染病毒血症存在的一个标准;（3）本实验的敏感性和特异性较好,检测方法简单,可以作为丙型肝炎临床诊断的补充试验及筛查。     

酒精性肝病与丙型肝炎病毒感染

酒精性肝病与丙型肝炎病毒感染魏来１陶其敏２ＳｕｂｊｅｃｔｈｅａｄｉｎｇｓｈｅｐａｔｉｔｉｓＣ；ｈｅｐａｔｉｔｉｓＣｖｉｒｕｓ；ｌｉｖｅｒｄｉｓｅａｓｅｓ，ａｌｃｏｈｏｌｉｃ；ｈｅｐａｔｉｔｉｓ，ａｌｃｏｈｏｌｉｃ；ｌｉｖｅｒｎｅｏｐｌａｓｍｓ主题词...     

肝特异性自身抗体与丙型肝炎病毒感染的关系

本研究探讨了HCV感染时体内产生免疫应答并出现多种自身抗体的特点,试图通过检测分析HCV感染与自身抗体的相关性,对丙型肝炎的诊断及治疗提供一些实验数据.     

儿童丙型肝炎病毒感染临床研究

丙型肝炎病毒(HCV)慢性感染是一个世界范围内的严重公共问题,全球约1.8亿人感染,但仅约50％可在现有的治疗方法下获得持续性病毒学应答(sustained virological response,SVR).欧美儿童HCV感染率约为0.05％～0.36％,而发展中国家可达1.80％～5.00％,可能是因为卫生经济条件的差异所致[1].由于尚无HCV疫苗及妊娠期用药的限制,垂直传播仍是新生儿感染的主要原因.因为只有5％的垂直传播率[2],且有25％～30％的自发清除率[3-4],HCV的垂直传播一直被忽视.新生儿一旦确诊感染HCV,超过80％会表现为慢性化[5],而多达30％的慢性感染儿童会在儿童期或成年后出现相应临床症状,是肝硬化及肝细胞癌(HCC)的高危人群[6].     

丙型肝炎病毒感染与肝癌

丙型肝炎病毒感染与肝癌余竹元，郑宁（上海医科大学肝癌研究所上海２０００３２）肝癌（ｈｅｐａｔｏｃｅｌｌｕｌａｒｃａｒｃｉｎｏｍａ，ＨＣＣ）居我国癌症死亡的第三位，除已知的乙肝病毒（ＨＢＶ），黄曲霉毒素及饮水污染为重要的致癌因素外，近年来丙型肝炎病毒（...     

人类免疫缺陷病毒/丙型肝炎病毒混合感染者抗丙型肝炎病毒治疗的进展

由于人类免疫缺陷病毒（HIV）和丙型肝炎病毒（HCV）有相同的传播途径,HIV/HCV混合感染现象十分普遍,已成为严重的公共卫生问题。高效抗逆转录病毒治疗（HAART）的应用显著减少了与HIV感染相关的发病率和病死率,而HCV混合感染引起的慢性肝脏疾病日益成为HIV/HCV混合感染者发病和死亡的重要因素。HIV/HCV混合感染者HCV相关肝病的风险增加,有效的抗HCV治疗对延长这一人群的生存期至关重要。本文就抗HCV治疗对象的评估、治疗时机的选择、治疗的方法、治疗监测和疗效评估以及治疗注意的问题作一综述。     

Hepatitis G virus RNA and its relation to hepatitis C infection in adult haemophilic patients

The prevalence of hepatitis C virus (HCV) infection and hepatitis G virus (HGV) RNA were studied in 50 adult haemophilic patients who had received commercial clotting factors prior to 1980. HGV RNA was detectable in 6/50 patients (12%); 49/50 (98%) had antibody to HCV and 40/49 (82%) of these were viraemic with detectable HCV RNA; 5/6 patients with detectable HGV RNA had co-existing HCV infection and viraemia. The HGV PCR products from all six patients were directly sequenced and all were shown to be similar to that of HGV but more diverse from that of GB virus C. One patient who had persistent abnormal liver function tests had detectable HGV RNA but no evidence of hepatitis B or C. The presence of HGV RNA in the absence of hepatitis B and C infection indicates that this virus is capable of independent transmission. Independent response to interferon was demonstrated in one patient with co-infection who lost HGV but not HCV after interferon therapy.     

丙型肝炎病毒高变区1抗体的交叉反应性分析

目的探索检测丙型肝炎病毒（HCVJ高变区1（HVR1）抗体交叉反应性的意义。方法采用16种重组的HVRI抗原包被,酶联免疫吸附检测不同病程及不同干扰素治疗效果HCV感染者血清中HVR1抗体的情况,分析其高变区抗体交叉反应性。结果在慢性丙型肝炎、肝硬化和肝细胞癌这三组患者血清中HVR1抗体交叉反应阳性数目分别为10．93±4．98、12±5．57和10．64±4．83,三组间差异无统计学意义（P〉0．05）;对干扰素治疗效果好的患者HVR1抗体交叉反应阳性数为13．85±2．85,治疗效果差的患者为7±5．27,前者显著高于后者（P〈0．05）。但两者治疗前HCV病毒载量差异无统计学意义（P〉0．05）。结论HVRI抗体的交叉反应性与HCV感染的严重程度无明显关系,但可能成为一项干扰素疗效的辅助预测指标。     

Hepatitis C virus infection in patients with leukemia

We have studied 30 patients with acute leukemia by the second-generation assay for antibodies to hepatitis C virus (HCV) to determine the incidence of HCV infection and the impact of anti-HCV positivity on liver disease. After a complete remission, 21/30 (70%) patients were anti-HCV-positive. During chemotherapy the anti-HCV-positive patients had more severe liver disease than the anti-HCV-negative patients, and they had a higher incidence of chronic hepatitis (13/21; 62% vs. 1/9; 11%, P < 0.01). During subsequent follow-up, 15/30 (50%) patients relapsed and 15/30 (50%) patients completed the chemotherapy protocols. After a relapse 12/15 (80%) patients were anti-HCV-positive and they had more severe liver disease than the anti-HCV-negative patients. Among the patients who completed chemotherapy (n = 15), biochemical evidence of chronic hepatitis was found in 9/9 (100%) anti-HCV-positive, and 2/6 (33%) anti-HCV-negative cases during off-therapy follow-up after therapy-withdrawal (P < 0.05). These results indicate that HCV plays an important role in the etiology of chronic hepatitis which could worsen the final prognosis of successfully treated patients with leukemia. © 1994 Wiley-Liss, Inc.     

Asian perspectives on viral hepatitis: Hepatitis C virus infection

Abstract Hepatitis C virus (HCV) infection is widespread throughout Asia. Unusual features of HCV in Asia include a novel genotype distribution with a significant representation of 3a. This is particularly important as genotype 3 is very sensitive to interferon-based therapies. A major concern in the Asian region is the high prevalence of hepatocellular cancer complicating HCV-associated cirrhosis, particularly in Japan. Finally, liver transplantation for advanced HCV infection with cirrhosis is an option via cadaveric and living donor programmes.     

Hepatitis B virus and hepatitis C virus dual infection

Hepatitis B virus (HBV) and hepatitis C virus (HCV) share common mode of transmission and both are able to induce a chronic infection. Dual HBV/HCV chronic coinfection is a fairly frequent occurrence, especially in high endemic areas and among individuals at high risk of parenterally transmitted infections. The intracellular interplay between HBV and HCV has not yet been sufficiently clarified, also due to the lack of a proper in vitro cellular model. Longitudinal evaluation of serum HBV DNA and HCV RNA amounts has revealed that complex virological profiles may be present in coinfected patients. Dual HBV/HCV infection has been associated to a severe course of the liver disease and to a high risk of developing hepatocellular carcinoma. Despite the clinical importance, solid evidence and clear guidelines for treatment of this special population are still lacking. This review summarizes the available data on the virological and clinical features as well as the therapeutic options of the dual HBV/HCV infection, and highlights the aspects that need to be better clarified.     

Hepatitis C virus infection facilitates gallstone formation

BACKGROUND: Bile duct damage and hepatic steatosis are two characteristic histological findings in hepatitis C virus infection; and high prevalence of hepatitis C antibody is noted in patients with cholangiocarcinoma. The purpose of the present study was to examine the relationship between biliary diseases and hepatitis C virus infection. METHODS: Persons who received a general checkup in Chang Gung Memorial Hospital between 2000 and 2002 were included. All of them had hemogram, serum biochemistry, hepatitis B surface antigen, hepatitis C antibody and ultrasonography studies. The prevalence of gallbladder stone, bile duct stone and gallbladder polyp/cholesterolosis were compared in different viral infection groups. RESULTS: Of the 28 486 persons, 22 967 were negative for both hepatitis B surface antigen and hepatitis C antibody (group NBNC), 4152 were hepatitis B surface antigen carriers (broup B), 1195 were positive for hepatitis C antibody (group C), and 172 were positive for both markers. The 379 persons (1.3%) having had cholecystectomy were considered to have gallbladder stone at the time when cholecystectomy was done. Gallbladder stone was found in 6.0% persons of group NBNC, 5.4% in group B and 11.7% in group C. The prevalence of gallbladder stone in group C was found especially high for age groups 31-40 years and 61-70 years. The prevalence of bile duct stone was higher in group C (0.4%) than in group NBNC or B (both 0.1%). Stepwise logistic regression analysis showed that age, liver cirrhosis, body mass index, hepatitis C virus infection and gender were independent factors associated with gallbladder stone. CONCLUSIONS: Hepatitis C virus infection facilitates gallstone formation.     

Hepatitis C virus infection in the human immunodeficiency virus infected patient

Human immunodeficiency virus(HIV)and hepatitis C virus(HCV)share the same transmission routes;therefore,coinfection is frequent.An estimated 5-10 million individuals alone in the western world are infected with both viruses.The majority of people acquire HCV by injection drug use and,to a lesser extent,through blood transfusion and blood products.Recently,there has been an increase in HCV infections among men who have sex with men.In the context of effective antiretroviral treatment,liver-related deaths are now more common than Acquired Immune Deficiency Syndromerelated deaths among HIV-HCV coinfected individuals.Morbidity and mortality rates from chronic HCV infection will increase because the infection incidence peaked in the mid-1980s and because liver disease progresses slowly and is clinically silent to cirrhosis and end-stage-liver disease over a 15-20 year time period for 15%-20%of chronically infected individuals.HCV treatment has rapidly changed with the development of new direct-acting antiviral agents;therefore,cure rates have greatly improved because the new treatment regimens target different parts of the HCV life cycle.In this review,we focus on the epidemiology,diagnosis and the natural course of HCV as well as current and future strategies for HCV therapy in the context of HIV-HCV coinfection in the western world.