HCV及其与HBV重叠感染患者血清HCVRNA检测的临床意义

目的探讨HCV及其与HBV重叠感染患者血清HCV RNA检测的临床意义。方法收集我院HCV感染及其与HBV重叠患者血清标本共179例,分为慢性丙型肝炎组（n=101）、肝硬化组（n=45）和肝癌组（n=33）。采用ELISA法检测血清抗HCV,用荧光定量PCR检测HCV RNA;对重叠感染HCV和HBV的31例患者同时检测HBVDNA。结果 179例患者抗HCV的总阳性率为97.8%,高于HCV RNA的阳性率（69.8%）（P〈0.01）。肝硬化组和肝癌组HCV RNA的阳性率分别为82.2%和84.8%,高于慢性丙型肝炎组阳性率64.4%（P〈0.05）。HCV与HBV重叠感染组的HCV RNA的阳性率为48.4%,低于单纯HCV感染组的HCV RNA阳性率（71.6%）（P〈0.05）。HCV与HBV重叠感染患者的HBV DNA阳性率为35.5%,也显著低于单纯HBV感染患者阳性率（76.7%）（P〈0.01）。HCVRNA阳性组ALT异常率（60.8%）高于HCV RNA阴性组（35.2%）（P〈0.05）。结论对HCV感染相关的不同疾病患者联合检测抗HCV、HCV RNA和ALT,对于HCV和HBV重叠感染者同时检测HBV DNA,有利于疾病的明确诊断、病情观察及预后判断。

Clinical significance of HCV RNA assay in patients with HCV infection or co-infection of HBV

Objective To investigate the clinical significance of HCV RNA assay in patients of HCV infection or co-infection with HBV.Methods 179 cases of patients includes chronic hepatitis C group(n = 101),liver cirrhosis group(n = 45) and hepatomas group(n = 33).Anti-HCV and HCV RNA in 179 serum samples from patients with HCV infection or co-infection with HBV were detected.HBV DNA was assayed for 31 co-infection patients.Results The positive rate of Anti-HCV was higher than HCV RNA in the 179 patients(97.8% vs 69.8%,P < 0.01).The positive rate in liver cirrhosis group and hepatomas group were 82.2% and 84.8%,inspectively,which were higher than that in chronic hepatitis C group(64.4%,P < 0.05).HCV RNA positive rate of HCV and HBV co-infection group was lower than that in simple HCV infection group(48.4% vs 71.6%,P < 0.05).HBV DNA positive rate of HCV and HBV co-infection group was also lower than that in simple HBV infection group(35.5% vs 76.7%,P < 0.01).ALT abnormal rate in HCV RNA positive group was higher than that in HCV RNA negative group(60.8% vs 35.2%,P < 0.05).Conclusion Combined detection of anti-HCV,HCV RNA and ALT is helpful to diagnosis,curative effect observation and prognosis for patients with HCV infection related diseases.And HBV DNA should be detected simultaneously for HCV and HBV co-infection patients.