丙型肝炎病毒抗体检测的诊断价值

用国产第二代丙型肝炎病毒抗体（抗－ＨＣＶ）检测试剂盒检测了２９６例临床血清标本以及２８例供血者血清标本。并用聚合酶链反应（ＰＣＲ）方法检测了这些标本的丙型肝炎病毒（ＨＣＶ）ＲＮＡ，以了解抗－ＨＣＶ检测对ＨＣＶ感染的诊断价值。同时探讨其在供血员筛选中的应用价值。结果在临床标本中，抗－ＨＣＶ阳性者有８１．１％ＨＣＶＲＮＡ阳性。抗－ＨＣＶ阴性者有２１．７％ＨＣＶＲＮＡ阳性。但是２８例抗－ＨＣＶ阴性的供血者ＨＣＶＲＮＡ全部阴性。提示：抗－ＨＣＶ阳性对于ＨＣＶ感染的诊断价值很高。临床怀疑为ＨＣＶ感染而进行检测的血清标本即使抗－ＨＣＶ阴性，也不能除外ＨＣＶ感染。用抗－ＨＣＶ筛选供血者可能使供血中ＨＣＶＲＮＡ阳性率大大降低。     

输血后乙型和丙型肝炎病毒感染的前瞻性调查

目的 了解输血所致ＨＢＶ和ＨＣＶ感染现状及ＨＢｓＡｇ抗ＨＣＶ和ＡＬＴ筛检供血的效果。方法 对１３８例输血者输血前，后１，３，６，９个月血清标本及其供血检测ＨＢｓＡｇ，抗ＨＢｓ，抗ＨＢｃ，抗ＨＣＶ和ＡＬＴ，并对部分血清标本用ＰＣＲ及巢式ＲＴ－ＰＣＲ法检测ＨＢＶＤＮＡ和ＨＣＶＲＮＡ，结果和结论 输血后ＨＢＶ和ＨＣＶ感染率分别为１．４％（２／１３８）和３４．８％（４８／１３８），输血后乙型和丙型肝炎发生     

不同HCV感染者各区段抗HCV抗体的反应性及HCV-RNA检测结果分析

利用丙型肝炎病毒（ＨＣＶ）不同区段抗原的单片段酶免疫（ＥＩＡ）试剂及反转录聚合酶链反应（ＲＴ－ＰＣＲ）技术,对不同ＨＣＶ感染者血清不同区段抗ＨＣＶ抗体及丙型肝炎病毒核糖核酸（ＨＣＶ－ＲＮＡ）进行检测。结果显示,慢性肝炎患者各抗体检出率及Ｓ／Ｃｏ（Ｓ为样品光密度值,Ｃｏ为临界值）值均高,肝癌患者各抗体检出率及ＨＣＶ－ＲＮＡ阳性率均较低;ＡＬＴ正常而抗ＨＣＶ阳性者各区段抗体阳性率低于急、慢性肝炎患者,而其ＨＣＶ－ＲＮＡ的阳性率高于其他各组;抗－ＮＳ３和抗－Ｃ抗体在各组的检出率和反应性均强。表明抗－Ｃ和抗－ＮＳ３抗体的检测对ＨＣＶ感染最有诊断价值,同时用ＲＴ－ＰＣＲ技术检测血清ＨＣＶ－ＲＮＡ有助于ＨＣＶ感染的早期诊断     

肾移植患者丙型肝炎病毒感染的临床研究

目的：了解肾移植患者丙型肝炎病毒（ＨＣＶ）的感染情况及ＨＣＶ感染后的临床影响。 方法：对６７例肾移植患者进行至少１年的随访，用第二代ＥＬＩＳＡ法和Ｎｅｓｔ－ＰＣＲ测定血清中抗ＨＣＶ和ＨＣＶ ＲＮＡ。 结果：抗ＨＣＶ的阳性率５０．７％（３４例），ＨＣＶ ＲＮＡ的阳性率为４７．８％（３２例）。ＨＣＶ ＲＮＡ阳性组术前血透时间和输血量及丙氨酸转移酶（ＡＬＴ）水平明显高于ＨＣＶ ＲＮＡ阴性组，ＨＣＶ ＲＮ     

丙型肝炎病毒感染及其性传播途径的研究

目的 探讨丙型肝炎病毒（ＨＣＶ）经性传播的可能性和ＨＣＶ感染的危险因素。方法 采用ＥＩＡ－Ⅱ检测抗－ＨＣＶ阳性者及其配偶、性病门诊就医者、暗娼及嫖客及嫖客、ＨＩＶ『／ＡＤＩＳ患者的血清抗－ＨＣＶ,并用逆转录巢式聚合酶链反应（ＲＴ－ＰＣＲ）法检测 述血标本的ＨＣＶ ＲＮＡ。另设抗－ＨＣＶ及ＨＣＶ ＲＮＡ阴性的健康者及其配偶（２０对）作为对照。结果 （１）８４例ＨＣＶ感染者及丙肝患者中ＨＣＦ ＲＮＡ阳     

地高辛标记探针原位杂交检测肝组织中丙型肝炎病毒RNA

用地高辛标记ＨＣＶ５′－ＮＣ区ｃＤＮＡ探针原位杂交检测了２４例ＨＣＶ感染的慢性肝病患者肝组织中ＨＣＶＲＮＡ。结果：１７例同时血清抗ＨＣＶ（ⅡＥＬＩＳＡ法）和ＨＶＣＲＮＡ（套式ＰＣＲ法）均阳性病人中，１４例（８２．３％），肝组织检出了ＨＣＶＲＮＡ。７例仅有抗ＨＣＶ阳性病人，肝组织中没有检出ＨＣＶＲＮＡ。ＨＣＶＲＮＡ特异性信号主要位于肝细胞浆。感染ＨＣＶ的肝细胞呈散在，灶状或弥漫形式分布，与ＡＬＴ水平     

丙肝患者血清抗一HCV IgM与HCV RNA的比较

丙肝患者血清抗一ＨＣＶＩｇＭ与ＨＣＶＲＮＡ的比较雷周云，逯好英，韩凤连，施红，陆江春丙型肝炎病毒（ＨＣＶ）感染后血清ＩｇＭ抗－ＨＣＶ抗体（抗－ＨＣＶＩｇＭ）及ＨＣＶＲＮＡ检测结果对丙型肝炎早期诊断、肝病的活动及病毒复制的判断都具有一定的意义。我们对住...     

检测慢性丙型肝炎患者抗－HCVIgM的临床意义

对８２例输血后慢性丙型肝炎病人丙型肝炎病毒抗体（抗－ＨＣＶ）ＩｇＭ动态变化进行观察，８２例患者均检测到抗－ＨＣＶ抗体，其中５１例抗－ＨＣＶＩｇＭ阳性。抗－ＨＣＶＩｇＭ出现规律表现为４种类型：（１）持续检出型２４例（２９．２７％）；（２）间断检出型８例（９．７６％）；（３）短暂检出型１９例（２３．１７％）；（４）阴性型３１例（３７．８０％）。将８２例输血后慢性丙型肝炎抗－ＨＣＶＩｇＭ出现类型与丙氨酸转氨酶（ＡＬＴ）、ＨＣＶＲＮＡ消长情况比较，发现阴性型具有较低的ＡＬＴ峰值，而其它３型ＡＬＴ峰值较高（Ｐ＜０．０１）。８例经干扰素治疗的慢性活动性丙型肝炎患者，治疗前均有ＡＬＴ明显异常及ＨＣＶＲＮＡ、抗－ＨＣＶＩｇＭ阳性，治疗后１～３个月ＡＬＴ均转为正常，ＨＣＶＲＮＡ转为阴性，但其中只有３例伴抗－ＨＣＶＩｇＭ的阴转，随访１年发现，只有抗，ＨＣＶＩｇＭ阴转的３例病人得以痊愈，其余５例均在治疗后半年内病情复发。提示治疗中伴有抗－ＨＣＶＩｇＭ阴转的患者预后良好。     

周围血白细胞的复制型丙型肝炎病毒RNA的检测及临床意义

用简并引物作套式反转录。聚合酶链反应检测正、负链丙型肝炎病毒（ＨＣＶ）ＲＮＡ。显示３０例急、慢性丙型肝炎患者的血清及血浆中，７例无症状抗－ＨＣＶ阳性者的血清、血浆及周围血白细胞（ＰＢＬ／Ｃ）中，均未检出负链ＨＣＶＲＮＡ。慢性丙型肝炎者ＰＢＩ（中正、负链ＨＣＶＲＮＡ的检出率高于急性丙型肝炎及无症状抗－ＨＣＶ阳性者（Ｐ＜０．０５～０．００１）。１７例经肝组织学检查的患者中，急性肝炎（ＡＨ）者ＰＢＬ／Ｃ的正、负链ＨＣＶＲＮＡ检出率低于慢性活动性肝炎（ＣＡＨ）者（Ｐ＜０．０５）。１例ＡＨ及６例ＣＡＨ患者肝组织内正、负链ＨＣＶＲＮＡ全部阳性。证实丙型肝炎患者的ＰＢＬ／Ｃ确可被ＨＣＶ感染，病程越长，被ＨＣＶ感染的可能性越大；病情活动者，ＰＢＬ／Ｃ中负链ＨＣＶＲＮＡ的检出率越高。提示ＨＣＶ不仅可以感染ＰＢＬＣ，而且可在其中复制；负链ＨＣＶＲＮＡ的出现与病情活动有关。     

丙型肝炎患者血清和外周血单个核细胞中HCV RNA检测及意义

目的 了解丙肝患者血清和外周血单个核细胞（ＰＢＭＣ）中ＨＣＶＲＮＡ存在情况及有其临床意义，方法 应用套式ＰＣＲ检测４６例急性丙型肝炎（丙型肝炎以下简称丙肝）和４２例慢性丙型肝炎患者血清和ＰＢＭＣ中ＨＣＶＲＮＡ。结果 慢性丙型肝炎患者ＰＢＭＣ中ＨＣＶＲＮＡ检出率显著高于急性丙型患者（Ｐ〈０．００１），急，慢性丙型肝患者血清和慢性丙肝患者ＰＢＭＣ中ＨＣＶ ＲＮＡ检出率显著高于ＡＬＴ正常的抗－ＨＣＶ阳性     

不同人群血清单项丙型肝炎病毒核心抗体存在状态

为调查不同人群血清单项丙型肝炎病毒核心抗体（抗－ＨＣＶｃ）存在状态，应用合成肽酶免疫分析筛选抗－ＨＣＶｃ，经重组免疫印迹和中和抑制试验鉴定。发现孕妇、供血员、慢性乙型肝炎、非甲非乙型肝炎、透析患者、原因不明肝硬化和输血后肝炎单项抗－ＨＣＶｃ阳性率分别为０．８％（１１／１４３６）、２．８％（１５／５４１）、３．１％（１５／４８４）、１３．６％（９／６６）、１１．５％（１０／８７）、２８．６％（４／１４）和３０％（３／１０）。单项抗－ＨＣＶ阳性的孕妇和供血员血清仅２６．７％～２７．３％检出ＨＣＶＲＮＡ，透析和各种肝病患者检出率高达５５．６％～１００％。８例单项抗－ＨＣＶｃ阳性肝炎患者病理检查显示不同程度的肝损害。结果提示：不同人群单项抗－ＨＣＶｃ阳性的意义有差别，检测ＨＣＶＲＮＡ对区别抗－ＨＣＶｃ存在属既往或现症感染十分重要。     

Hepatitis C virus RNA in peripheral blood mononuclear cells: Comparing acute and chronic hepatitis C virus infection

Hepatitis C virus (HCV) can infect peripheral blood mononuclear cells (PBMC) of patients with chronic HCV infection. No data are available on PBMC testing for HCV RNA in acute hepatitis C. This study investigated the presence of HCV RNA in PBMC of patients with acute posttransfusion hepatitis C, compared with those with chronic HCV infection. Nested polymerase chain reaction (PCR) was applied to detect HCV RNA in 111 and 48 paired samples of serum and PBMC of 11 patients with acute posttransfusion hepatitis C and 48 patients with chronic HCV infection, respectively. In patients with acute posttransfusion hepatitis C, HCV RNA was detected in 17 of 29 (59%) and 67 of 82 (82%) serum samples collected during the incubation period and acute phase, respectively. Meanwhile, of the 48 patients with chronic HCV infection, 41 had serum HCV RNA (85%). HCV RNA was not detected in PBMC samples from incubation period or from acute-phase hepatitis, although it was detected in 12 of the 48 PBMC samples of chronically infected patients (25%) P < .005). Of the 12 PBMC specimens positive for positive-stranded HCV RNA, 6 were also positive for negative-stranded HCV RNA. Among patients with chronic HCV infection, HCV infection of PBMC was not related to age, sex, blood transfusion, serum alanine transaminase (ALT) levels, or serum virus titers. In conclusion, HCV infection of PBMC rarely exists in patients with acute hepatitis C. As HCV infection persists, the incidence of HCV infection of PBMC becomes higher. (Hepatology 1996 May;23(5):977-81)     

Hepatitis C virus RNA detection in serum and peripheral blood mononuclear cells of patients with hepatitis C

ＨｅｐａｔｉｔｉｓＣｖｉｒｕｓＲＮＡｄｅｔｅｃｔｉｏｎｉｎｓｅｒｕｍａｎｄｐｅｒｉｐｈｅｒａｌｂｌｏｏｄｍｏｎｏｎｕｃｌｅａｒｃｅｌｓｏｆｐａｔｉｅｎｔｓｗｉｔｈｈｅｐａｔｉｔｉｓＣＺＨＯＵＰｉｎｇ，ＣＡＩＱｉｎｇ，ＣＨＥＮＹｏｕＣｈｕｎ，ＺＨＡ...     

Serum hepatitis C virus sequences in posttransfusion non-A, non-B hepatitis.

We investigated 17 patients (12 males and 5 females, ages 2 to 57 years old) with posttransfusion non-A, non-B hepatitis to determine relationships between clinical courses and hepatitis C virus (HCV) markers. The patients were grouped according to time course of abnormal serum alanine aminotransferase (ALT) levels into three categories (chronic biochemical disease, biochemically resolved chronic disease, and acute disease). Latest serum samples (1.3 to 10.8 years after blood transfusion) were used to detect antibodies against C100-3 antigen (anti-HCV) by enzyme-linked immunosorbent assay and HCV sequences by polymerase chain reaction (PCR) assay. Of the 17 patients, 13 patients (76.5%) were anti-HCV positive and 8 patients (47.1%), including one anti-HCV negative case, were positive for HCV RNA. In total, 14 patients (82.4%) were positive for either HCV markers. With respect to clinical course, HCV RNA was detected in six of eight patients (75%) with chronic biochemical disease, and in two of five patients (40%) with biochemically resolved chronic disease. HCV RNA was not detectable in convalescent sera from four patients with acute disease. These results show that there is a relationship between clinical status and HCV viremia, but that normal liver function tests do not always represent the clearance of the virus. Viremia in two patients with normal ALT level suggests that hepatitis is not only caused by viral cytopathic effects, but also by immunologic reactions against virus-infected cells. Thus, PCR is useful in determining the persistence of HCV infection as well as to diagnose anti-HCV negative HCV infection.     

血液病患者丙型肝炎病毒的感染

为了解血液病患者丙型肝炎病毒（ＨＣＶ）感染率，探讨相对危险因素。采用第二代ＥＬＩＳＡ检测抗－ＨＣＶ，逆转录巢式双ＰＣＲ法检测ＨＣＶＲＮＡ。结果发现：４５例血液病患者１１例抗－ＨＣＶ阳性，３４例抗－ＨＣＶ阴性患者中，３例ＨＣＶＲＮ阳性。综合评价，ＨＣＶ感染率１４／４５（３１．１％）。相关危险因素为反复大量输注注未经抗－ＨＣＶ筛选的血液及血制品和免疫功能低下。结果表明：血液病患者ＨＣＶ感染率高于普通人     

Three cases of posttransfusion hepatitis C treated with interferon-α

Summary Interferon therapy is useful for decreasing the serum ALT level and improving liver histology in patients with chronic non-A, non-B hepatitis. This study examined the effect of interferon therapy in acute cases of posttransfusion hepatitis C. we report on three cases in which interferon alpha was administered at 100–220.5 million units. HCV RNA became undetectable during interferon administration and the ALT level declined to the normal range. However, after the cessation of the therapy, the ALT level began to fluctuate and HCV RNA reappeared in two patients. We concluded that interferon therapy for the acute phase of posttransfusion hepatitis is useful for suppressing viral replication and quickly improving the ALT level, but it can not always prevent the development of chronic hepatitis. Furthermore, there was a close correlation between the profile of HCV RNA and that of the ALT level, indicating that the replication of HCV plays an important role in liver injury.     

De novo hepatitis B virus infection in hepatocellular carcinoma following eradication of hepatitis C virus by interferon therapy

Epidemiological studies have revealed that hepatocellular carcinoma (HCC) is still observed in hepatitis C virus (HCV)‐positive patients with a sustained response to interferon (IFN) treatment, although a substantial decrease in the incidence of hepatocellular carcinoma (HCC) has been achieved in those patients. Why HCC develops in patients who have a complete clearance of HCV remains unclear. Here, we provided evidence of latent hepatitis B virus (HBV) infection in an initially HCV‐positive chronic hepatitis patient who developed HCC after the complete eradication of HCV by IFN therapy. Although he was initially negative for anti‐hepatitis B surface antigen (HBsAg) or circulating HBV DNA but positive for anti‐hepatitis B core antigen (anti‐HBc) in his sera, he developed HBsAg and HBV DNA during the course of the management of a series of cancers. HBV DNA was detectable in the liver tissues before HBV reactivation and the viral sequences derived from his anti‐HBc‐positive liver showed 100% homology to that from the serum after HBsAg appearance. These findings indicates that HCV‐positive individuals who are positive for anti‐HBc in the absence of HBsAg could have latent HBV infection in their liver tissues and intrahepatic HBV infection may play a pivotal role in the development of HCC after the IFN‐mediated eradication of HCV.     

Effect of human immunodeficiency virus infection on hepatitis C virus infection in hemophiliacs

Chronic liver disease due to hepatitis C virus (HCV) infection is a major problem in hemophiliacs. Recent reports suggested that hemophiliacs coinfected with hepatitis C virus and human immunodeficiency virus (HIV) have an increased incidence of liver failure but the mechanism of accelerated liver injury is not clear. We tested plasma from 100 hemophiliacs for anti-HCV by second generation ELISA, anti-HIV by EIA, and HCV RNA and HIV RNA by branched DNA and polymerase chain reaction assays to determine if hemophiliacs coinfected with HCV and HIV have higher HCV RNA levels and more active liver disease. Seventy-nine (79%) patients were anti-HCV positive, of whom 85% were HCV RNA positive. None of the anti-HCV-negative patients had detectable HCV RNA in plasma. Forty-two (42%) patients were anti-HIV positive, of whom 47% had detectable HIV RNA. All the anti-HIV-positive patients were also anti-HCV positive. The prevalence of both anti-HCV and anti-HIV increased significantly with age. There was no difference in HCV RNA levels between anti-HIV-positive and anti-HIV-negative patients (mean: 21±4 vs 18±5 Meq/ml), although HCV RNA levels were significantly higher in anti-HIV-positive patients with CD4 counts<200/mm³ (P=0.008). There was an inverse correlation between HCV RNA levels and CD4 counts but no correlation was found between HCV RNA and serum aminotransferase levels. We found a high prevalence of HCV and HIV coinfection in our hemophiliacs. Hepatitis C virus replication appears to be increased in patients with severe immunodeficiency secondary to progressive HIV infection. However, there was no correlation between HCV RNA and serum ALT level, suggesting that HCV is not directly cytopathic.     

Reactivation of hepatitis B virus during interferon‐free therapy with daclatasvir and asunaprevir in patient with hepatitis B virus/hepatitis C virus co‐infection

Direct‐acting antiviral agents (DAA) for hepatitis C virus (HCV) are not effective for hepatitis B virus (HBV), which may be suggestive of reactivation of anti‐HBe hepatitis during interferon (IFN)‐free DAA therapy in HBV/HCV co‐infected patients with inactive HBV. A 69‐year‐old male patient was diagnosed with chronic hepatitis due to HBV/HCV co‐infection with serum levels of alanine aminotransferase (ALT) of 94 U/L, HCV RNA of 4.2 log IU/mL and HBV DNA of 2.5 log copies/mL. HCV was thought to be responsible for the hepatitis activity because of low level of HBV core‐related antigen (3.1 log U/mL). He was treated with combination therapy of daclatasvir and asunaprevir. Serum ALT gradually increased, and reached 237 U/L on day 43 in spite of undetectable HCV RNA. Serum HBV DNA was increasing to 7.0 log copies/mL at that time. The treatment was stopped due to suspicion of drug‐induced liver injury and/or HBV reactivation. Administration of entecavir reduced HBV DNA levels, followed by improvement in ALT levels. This report proposes that close monitoring of HBV DNA during the anti‐HCV DAA therapy and the commencement of anti‐HBV therapy with nucleoside analogs after the increase of HBV DNA should be considered in patients with HBV/HCV co‐infection.     

慢性丙型肝炎患者外周血单个核细胞丙型肝炎病毒检测及其意义

目的 探讨外周血单个核细胞（ＰＢＭＣｓ）在丙型肝炎病毒（ＨＣＶ）的感染中的作用。方法 对２２例慢性丙型肝炎患者２１例抗－ＨＣＶ（＋）血液管析患者及１２例健康献血员的ＰＢＭＣｓ分别进行ＨＣＶＲＮＡ,ＨＣＶ抗原检测及电镜观察。结果 （１）２２生丙型肝炎肝炎患者ＰＢＭＣｓ中有７７．３％（１７／２２）ＨＣＶＲＮＡ阳性,（２）感染ＨＣＶ的ＰＢＭＣｓ中电镜下发现复制的ＨＣＶ颗粒;（３）ＨＣＶ颗粒阳笥者的血清和