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HCV RNA存在情况及其临床意义。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例慢性丙肝患者血清和PBMC中HCV RNA.结果 慢性丙肝患者PBMC中HCV RNA检出率显著高于急性丙肝患者(P<0.001);急、慢性丙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阳性者(P<0.001);2例患者血清中HCV RNA阴性,PBMC中可测及,12例患者血清抗-HCV阴性,而血清HCV RNA阳性。结论 血清HCV RNA检测有助于抗-HCV阴性丙肝的诊断和早期诊断;丙肝的肝损害可能与HCV RNA血症有关;PBMC中HCV感染在丙肝的慢性化和慢性肝损害中可能起一定作用,PBMC中可贮存HCV RNA。

Detection of Hepatitis C Virus Rna in Serum and in Peripheral Blood Mononuclear Cells of Patients With Hepatitis C

Objective In order to investigate the existence of hepatitis C virus(HCV) RNA in serum and in peripheral blood mononuclear cells(PBMC) of patients with hepatitis C and to explore its clinical significance. Methods HCV RNA was detected by nested - polymerase Chain reaction(Nested - PCR) in serum and in PBMC of 46 patients with acute hepatitis C(AHC) and 42 patients with chronic hepatitis C (CHC) . Results It was found that the positive rate of HCV RNA in PBMC of patients with CHC has been markedly higher than that of patients with AHC(P<0.001).The positive rates of HCV RNA in serum of patients with AHC and CHC and in PBMC of patients with CHC have been significantly higher than those of end - HCV positive patients with normal ALT level (P< 0.001); 2 patients were negative of HCV RNA in serum but positive in PBMC, 12 were negative of anti - HCV, but positive of HCV RNA in serum. Conclusion (1) Detection of serum HCV RNA by nested - PCR might be helpful to the diagnosis or early diagnosis of anti - HCV negative hepatitis C; (2) the liver damage in patients with hepatitis C might be correlated with HCV- viremia; (3) infection of HCV in PBMC might play an important role in chronic liver damage and chronicity in patients with HC and therefore chronicity of the clinical course; (4) PBMC might be considered as a "reservoir" of HCV.