Sabin Caroline A, Emery Vince, Devereux Helen L, Griffioen Anja, Bishop Jeremy, Dusheiko Geoff, Yee Thynn Thynn, Herrero-Martinez Esteban, Lee Christine A
Haemophilia Centre and Haemostasis Unit and Department of Primary Care and Population Sciences, Royal Free and University Medical School, London, United Kingdom.
J Med Virol. 2002 Sep;68(1):68-75. doi: 10.1002/jmv.10171.
Little is known about the natural history of hepatitis C virus (HCV) RNA concentrations over the course of infection. The aim of this study was to describe the natural history of HCV RNA concentrations in 85 HIV negative men with bleeding disorders infected with HCV for up to 30 years. HCV RNA concentrations were measured in yearly serum samples using a branched DNA assay. HCV RNA concentrations increased over time in this cohort. Two years after exposure to HCV, 53% of patients had undetectable concentrations and no patients had levels >7 log(10)(genome Eq/ml); by 20 years, these proportions had changed to 23% and 32% respectively. The RNA concentration correlated strongly with alanine aminotransferase (ALT; correlations of 0.41-0.71 depending on stage of infection) and aspartate aminotransferase (AST; 0.20-0.51) levels. Patients with haemophilia A had significantly higher HCV concentrations than those with other disorders. An effect of HCV genotype on HCV RNA concentrations became nonsignificant after excluding patients who were persistently HCV PCR negative and who could not be genotyped. The correlation of HCV RNA concentrations with other markers of liver function, such as ALT, means that studies with clinical outcomes are required to assess whether HCV RNA concentrations provide additional prognostic information to that provided by these other markers.
关于丙型肝炎病毒（HCV）RNA浓度在感染过程中的自然史，人们所知甚少。本研究的目的是描述85名感染HCV长达30年的患有出血性疾病的HIV阴性男性中HCV RNA浓度的自然史。使用分支DNA分析法在每年的血清样本中测量HCV RNA浓度。在该队列中，HCV RNA浓度随时间增加。接触HCV两年后，53%的患者浓度检测不到，且没有患者的水平>7 log(10)(基因组当量/ml)；到20年时，这些比例分别变为23%和32%。RNA浓度与丙氨酸氨基转移酶（ALT；根据感染阶段，相关性为0.41 - 0.71）和天冬氨酸氨基转移酶（AST；0.20 - 0.51）水平密切相关。甲型血友病患者的HCV浓度显著高于其他疾病患者。在排除持续HCV PCR阴性且无法进行基因分型的患者后，HCV基因型对HCV RNA浓度的影响变得不显著。HCV RNA浓度与其他肝功能标志物（如ALT）的相关性意味着需要进行临床结局研究，以评估HCV RNA浓度是否能提供除这些其他标志物之外的额外预后信息。
