Ben Moussa M, Barguellil F, Bouziani A, Amor A
Laboratoire de microbiologie, Hôpital militaire de Tunis, Montfleury, Tunisie.
Ann Biol Clin (Paris). 2003 Mar-Apr;61(2):234-8.
In patients with hepatitis C, it is necessary to determine the genotype of the hepatitis C virus (HCV) to tailor treatment schedules. HCV-positive sera from 60 chronically infected patients were analyzed by two methods: serotyping and genotyping, to evaluate the suitability of serotyping method for routine determination of HCV genotype; 47 men and 13 women were included in this study, nine were renal transplant patients and five were hemodialysis patients. Anti-HCV antibodies were detected by Elisa (HCV Ab III, Innogenetics SA) and confirmed by immunoblot assay (INNO-LIA-HCV Ab III update, Innogenetics SA). Genotyping analysis was performed by a line probe assay (Inno-LiPA-HCV, Innogenetics SA) and serotypes were determined by an Elisa-based serotyping assay (Murex HCV serotyping 1-6 HCO2, Murex SA) which detect type specific antibodies against NS4-derived epitopes. Among 60 patients positive for anti-HCV antibodies and confirmed by immunoblot assay only 90% show a strong reactivity with NS4. We found the following genotype distribution : 1b (73.3%), 4 (10%), 1a (5%), 3a (5%), 4c/4d (5%) and 1 not classified (1.7%). The most prevalent serotype was type 1 (60%) followed by serotype 6 (20%), 4 (8.3%), 2 (1.7%) and 10% were no type specific antibodies. The sensitivity of the serotyping and the genotyping assays was 90% with a total concordance of 68.3%. Thirteen samples revealed discrepant results with genotype : 1b (4), 1a (3), 3a (3), 4 (2) and 4c/4d (1). This study indicates that the serotyping assay is less specific than genotyping. However, the test is rapid, relatively easy to perform and represent a reliable alternative in laboratories that lack the specific expertise to typing the HCV by molecular methods.
对于丙型肝炎患者,确定丙型肝炎病毒(HCV)的基因型以制定个性化治疗方案很有必要。采用两种方法对60例慢性感染患者的HCV阳性血清进行分析:血清分型和基因分型,以评估血清分型方法用于常规确定HCV基因型的适用性;本研究纳入47名男性和13名女性,其中9例为肾移植患者,5例为血液透析患者。采用酶联免疫吸附测定法(HCV Ab III,Innogenetics SA公司)检测抗HCV抗体,并通过免疫印迹法(INNO-LIA-HCV Ab III升级版,Innogenetics SA公司)进行确认。基因分型分析采用线性探针测定法(Inno-LiPA-HCV,Innogenetics SA公司),血清型通过基于酶联免疫吸附测定的血清分型检测法(Murex HCV血清分型1-6 HCO2,Murex SA公司)确定,该方法可检测针对NS4衍生表位的型特异性抗体。在60例抗HCV抗体阳性且经免疫印迹法确认的患者中,仅90%显示与NS4有强反应性。我们发现基因型分布如下:1b型(73.3%)、4型(10%)、1a型(5%)、3a型(5%)、4c/4d型(5%)和1例未分型(1.7%)。最常见的血清型是1型(60%),其次是6型(20%)、4型(8.3%)、2型(1.7%),10%没有型特异性抗体。血清分型和基因分型检测的灵敏度均为90%,总一致性为68.3%。13个样本的基因型结果存在差异:1b型(4个)、1a型(3个)、3a型(3个)、4型(2个)和4c/4d型(1个)。本研究表明,血清分型检测的特异性低于基因分型。然而,该检测方法快速、相对易于操作,对于缺乏通过分子方法对HCV进行分型的专业技术的实验室而言,是一种可靠的替代方法。