Bonacini M, Govindarajan S, Blatt L M, Schmid P, Conrad A, Lindsay K L
University of Southern California School of Medicine Liver Unit, Downey, CA 90242, USA.
J Viral Hepat. 1999 May;6(3):203-8. doi: 10.1046/j.1365-2893.1999.00153.x.
Serum and liver hepatitis C virus (HCV) RNA levels in patients with hepatitis C have previously been quantified using different techniques. In this work, we used an automated, multicycle, polymerase chain reaction (PCR)-based technique to quantify HCV RNA in 1-2 mm of frozen liver tissue, and in serum, from 70 patients with antibodies to HCV (anti-HCV), with and without human immunodeficiency virus (HIV) co-infection. Stored liver tissue and sera collected at the time of liver biopsy were used for measurement of HCV RNA. Forty-eight HCV patients and 22 HIV/HCV co-infected patients were studied. Co-infected patients had significantly higher median serum and liver HCV RNA (6.7 log copies ml-1 serum and 2.90 log copies microg-1 liver nucleic acids) than patients with HCV alone (6.2 log copies ml-1 serum and 2.19 log copies microg-1 liver nucleic acids). There was only a weak correlation between serum and liver HCV RNA (r = 0.43). There was no correlation between liver and serum HCV RNA and host factors such as duration of disease, CD4 counts, alanine aminotransferase levels or histological score. There was no correlation with HCV genotype. Co-infected patients were more likely to harbour HCV genotype 1 (85%) when compared to patients with HCV alone (58%). An identical genotype was found in liver and serum in 89% of those tested; in 11%, a mixed genotype was present in serum. Patients with HCV genotypes 1 and non-1 had similar histological scores. Hence, an automated PCR-based technique is useful for measuring both liver and serum HCV RNA. Serum HCV genotypes closely paralleled those found in liver tissue. HIV co-infection was associated with higher serum, as well as intrahepatic, HCV RNA levels, by mechanisms not directly related to CD4 counts. The lack of correlation between liver HCV RNA and histology suggests that HCV is not directly cytopathic.
此前，已采用不同技术对丙型肝炎患者的血清和肝脏丙型肝炎病毒（HCV）RNA水平进行定量。在本研究中，我们使用了一种基于自动化多循环聚合酶链反应（PCR）的技术，对70例抗丙型肝炎病毒（抗-HCV）患者（无论是否合并人类免疫缺陷病毒（HIV）感染）的1 - 2毫米冷冻肝组织及血清中的HCV RNA进行定量。肝活检时收集的储存肝组织和血清用于HCV RNA检测。研究了48例HCV患者和22例HIV/HCV合并感染患者。合并感染患者的血清和肝脏HCV RNA中位数（血清6.7 log拷贝/ml，肝脏核酸2.90 log拷贝/μg）显著高于单纯HCV患者（血清6.2 log拷贝/ml，肝脏核酸2.19 log拷贝/μg）。血清和肝脏HCV RNA之间仅存在弱相关性（r = 0.43）。肝脏和血清HCV RNA与宿主因素（如病程、CD4计数、丙氨酸转氨酶水平或组织学评分）之间无相关性。与HCV基因型无关。与单纯HCV患者（58%）相比，合并感染患者更易感染HCV 1型（85%）。在89%的检测者中，肝脏和血清中发现相同基因型；11%的患者血清中存在混合基因型。HCV 1型和非1型患者的组织学评分相似。因此，基于PCR的自动化技术可用于检测肝脏和血清中的HCV RNA。血清HCV基因型与肝组织中发现的基因型密切平行。HIV合并感染与更高的血清以及肝内HCV RNA水平相关，其机制与CD4计数无直接关系。肝脏HCV RNA与组织学之间缺乏相关性表明HCV并非直接致病。
