丙型肝炎患者5080例Anti-HCV、HCV-RNA及基因分型分析

目的:对5 080例丙型肝炎患者Anti-HCV、HCV-RNA及基因分型三项检验结果进行分析。方法:采用增强发光免疫法检测Anti-HCV;实时荧光定量PCR法检验HCV-RNA;HCV-RNA含量≥103的标本同时进行基因分型检测。结果:5 080例丙型肝炎患者中Anti-HCV检测阳性率为99.8%,HCV-RNA阳性率为49.1%。HCV-RNA阳性患者年龄和抗体含量均明显高于HCV-RNA阴性患者(P<0.01)。在进行基因分型的1 723例HCV-RNA阳性标本中,1b、2a分别占59.49%和36.20%,两型总占比达到95.69%;另外3b和4不常见型以及1b/2a、1b/4混合感染也检测到。结论:Anti-HCV含量与患者的病毒载量之间缺乏相关性,不能作为丙型肝炎治疗过程中的动态观察指标;HCV-RNA定量适于丙型肝炎疗效评价和预后判断指标;临床丙型肝炎患者中主要基因型是1b、2a型,对HCV-RNA阳性患者进行基因分型,可为丙型肝炎的个性化治疗提供决策依据。

The detection of Anti-HCV,HCV-RNA and its genotype in 5 080 patients with hepatitis C

Objective:To analyze the hepatitis C antibody( Anti-HCV) ,HCV-RNA and genotype in 5 080 patients with hepatitis C. Methods:The levels of Anti-HCV and HCV-RNA in all patients were determined by automatic enhanced luminescence immunity analyzer and quantitative fluorescent PCR,respectively. The genotypes in the patients with more than or equal to 103 of HCV-RNA were detected. Results:The positive rates of Anti-HCV and HCV-RNA were 99. 8% and 49. 1%,respectively. The ages and antibody content in positive HCV-RNA patients were significantly higher than those in the negative HCV-RNA patients(P<0. 01). Among the 1 723 positive HCV-RNA specimens,the 1b and 2a genotypes accounted for 59. 49% and 36. 20%,respectively,the total ratio of 1b and 2a genotypes was 95. 69%. The unusual types of 3b and 4,and mixed infection types of 1b/2a and 1b/4 also were detected. Conclusions:The Anti-HCV content and viral load are lack of correlation, which can not be used as the observation indexes in estimating the treatment. The quantitation of HCV-RNA can be used to evaluate the curative effect and prognosis of patients with hepatitis C. The 1b and 2a are the major genotypes in patients with hepatitis C. To analyze the genotype of the positive HCV-RNA patients can provide the basis in personalized therapy.