Cribier B, Uhl G, Schmitt C, Doffoël M, Vetter D, Kirn A, Stoll-Keller F
INSERM U 74, University Hospital, Strasbourg, France.
Arch Virol. 1999;144(2):355-64. doi: 10.1007/s007050050509.
Mononuclear cells can be infected in vitro by hepatitis C virus and the viral RNA can be detected in mononuclear cells of chronically infected patients. It was suggested that the virus could persist in the mononuclear cells of some patients treated by interferon. The aim of this study was to follow the presence of viral RNA in the plasma and peripheral blood mononuclear cells of 16 chronically infected patients treated by alpha 2b interferon for 1 year. The RNA was detected by reverse transcription followed by nested PCR and quantified using the branched DNA method at regular intervals for at least one year. Before PCR, the mononuclear cells were treated by RNase and trypsin in order to eliminate the viral particles that could be stuck at the cell surface. Six patients were non responders and had persistent plasmatic viral RNA during the treatment. Two patients were good responders and had persistently negative PCR in both plasma and mononuclear cells. Eight patients had initial negativation of plasmatic hepatitis C virus RNA but showed a relapse characterized by positive plasmatic PCR. Positive PCR in mononuclear cells despite negativity of plasmatic PCR was noted 18 times in 8 patients. Persistently positive PCR in mononuclear cells in absence of detectable viraemia was followed by a virological relapse in 5 of these patients. This study confirms that hepatitis C virus RNA can be detected in mononuclear cells despite negative plasmatic PCR in patients treated by interferon. Moreover, the persistence of viral RNA in peripheral mononuclear cells could be a predictive factor of treatment failure. Our data also suggest that detection of viral RNA in mononuclear cells is probably not only due to passive virus adsorption from plasma.
单核细胞在体外可被丙型肝炎病毒感染，并且在慢性感染患者的单核细胞中可检测到病毒RNA。有人提出，该病毒可能在一些接受干扰素治疗的患者的单核细胞中持续存在。本研究的目的是追踪16例接受α2b干扰素治疗1年的慢性感染患者血浆和外周血单核细胞中病毒RNA的存在情况。通过逆转录随后进行巢式PCR检测RNA，并使用分支DNA方法定期进行定量，至少持续一年。在进行PCR之前，用核糖核酸酶和胰蛋白酶处理单核细胞，以消除可能黏附在细胞表面的病毒颗粒。6例患者无反应，治疗期间血浆病毒RNA持续存在。2例患者反应良好，血浆和单核细胞中的PCR持续呈阴性。8例患者血浆丙型肝炎病毒RNA最初呈阴性，但随后出现以血浆PCR阳性为特征的复发。8例患者中有18次在血浆PCR阴性的情况下单核细胞PCR呈阳性。在5例患者中，单核细胞PCR持续阳性且无可检测到的病毒血症，随后出现病毒学复发。本研究证实，在接受干扰素治疗的患者中，尽管血浆PCR呈阴性，但在单核细胞中仍可检测到丙型肝炎病毒RNA。此外，病毒RNA在外周单核细胞中的持续存在可能是治疗失败的一个预测因素。我们的数据还表明，单核细胞中病毒RNA的检测可能不仅仅是由于病毒从血浆中的被动吸附。
