Ishiguro N, Tomimatsu M, Nagahara H, Obata H
Division of Medicine, Tokyo Women's Medical College, Japan.
J Gastroenterol Hepatol. 1992 Nov-Dec;7(6):602-7. doi: 10.1111/j.1440-1746.1992.tb01493.x.
To develop a more dependable method of diagnosing hepatitis C, serum anti-hepatitis C virus (HCV) was examined by using a new assay (anti-HCV second generation). The results were compared with those of either the conventional assay (anti-HCV first generation) or HCV-RNA analysis. With the first generation assay, anti-HCV was detected in 69% of post-transfusion acute hepatitis (AH), 44% of sporadic AH, 50% of needlestick exposed AH, 72% of chronic hepatitis (CH), 77% of liver cirrhosis (LC) and 86% of hepatocellular carcinoma (HCC). These results were remarkably increased by using the second generation assay (92% in post-transfusion AH, 72% in sporadic AH, 100% in needlestick exposed AH, 96% in CH, 96% in LC and 97% in HCC). Furthermore, in the early stages of AH (from 1-5 weeks after onset), anti-HCV was not detected in all 18 patients by the first generation assay, but was found in 10 of them by using the second generation assay. The failure to detect anti-HCV with the first generation assay was mainly due to a lack of the core region coding peptide (C22-3) in this assay. In the AH-resolving group, anti-HCV second generation did not disappear, but the titre tended to be lower than that in the CH-developing group. Thus, the second generation assay for anti-HCV was considered to be a more useful tool for not only the diagnosis of hepatitis C but also for determining prognosis.
为开发一种更可靠的丙型肝炎诊断方法，采用一种新的检测方法（抗丙型肝炎病毒第二代检测法）检测血清抗丙型肝炎病毒（HCV）。将结果与传统检测方法（抗丙型肝炎病毒第一代检测法）或HCV-RNA分析结果进行比较。采用第一代检测法时，在输血后急性肝炎（AH）患者中抗-HCV的检出率为69%，散发性AH患者中为44%，针刺暴露后AH患者中为50%，慢性肝炎（CH）患者中为72%，肝硬化（LC）患者中为77%，肝细胞癌（HCC）患者中为86%。采用第二代检测法后，这些结果显著提高（输血后AH患者中为92%，散发性AH患者中为72%，针刺暴露后AH患者中为100%，CH患者中为96%，LC患者中为96%，HCC患者中为97%）。此外，在AH的早期阶段（发病后1至5周），第一代检测法在所有18例患者中均未检测到抗-HCV，但采用第二代检测法在其中10例患者中检测到了抗-HCV。第一代检测法未能检测到抗-HCV主要是因为该检测法缺乏核心区域编码肽（C22-3）。在AH缓解组中，抗-HCV第二代检测结果并未消失，但滴度往往低于CH发展组。因此，抗-HCV第二代检测法不仅被认为是诊断丙型肝炎的更有用工具，而且对判断预后也更有用。
