Xu Dao-Zhen, Xie Yao, Li Zheng-Qin
Beijing Ditan Hospital, Beijing 100011, China.
Hepatobiliary Pancreat Dis Int. 2005 Nov;4(4):550-3.
The resolution of hepatitis C, evidenced by normalization of liver function and disappearance of hepatitis C virus RNA from serum as determined by conventional laboratory assays, reflects virus eradication. But in interferon treated patients the HCV RNA in serum sometimes could not show the virus in cells. Such factors as virus genotype, HCV RNA contents in serum, HCV specific cellular immunities after treatment were reported to predict the response to interferon therapy. In most patients, HCV RNA could detect the virus in peripheral blood mononuclear cell. The aim of this study was to investigate the predictive value of HCV RNA in PBMC of patients with chronic hepatitis C after interferon treatment.
Sixteen patients with chronic hepatitis C were treated with interferon for 24 weeks, and they all get complete responses at 12 weeks of treatment. At the end of treatment, the HCV RNA in PBMC and serum were detected by RT-PCR, and after stopping treatment, HCV RNA in serum was monitored continually.
In 9 patients who were HCV RNA positive in their PBMC at the end of treatment, 8 showed serum HCV RNA positive after 24 weeks and another 1 after 1 year. In 7 patients with negative HCV RNA in their PBMC, only 2 patients relapsed in serum HCV RNA after 1-year follow-up, and others remained viral response after 3.5 years.
HCV RNA in PBMC at the end of IFN treatment is a predictor of durable response to antiviral therapy in patients with chronic hepatitis C.
丙型肝炎的缓解表现为肝功能正常以及通过传统实验室检测血清中丙型肝炎病毒RNA消失,这反映了病毒的清除。但在接受干扰素治疗的患者中,血清中的HCV RNA有时无法显示细胞内的病毒情况。据报道,病毒基因型、血清中HCV RNA含量、治疗后HCV特异性细胞免疫等因素可预测对干扰素治疗的反应。在大多数患者中,HCV RNA可检测外周血单个核细胞中的病毒。本研究旨在探讨干扰素治疗后慢性丙型肝炎患者外周血单个核细胞中HCV RNA的预测价值。
16例慢性丙型肝炎患者接受干扰素治疗24周,且在治疗12周时均获得完全缓解。治疗结束时,通过逆转录聚合酶链反应检测外周血单个核细胞和血清中的HCV RNA,停药后持续监测血清中的HCV RNA。
治疗结束时外周血单个核细胞中HCV RNA阳性的9例患者中,8例在24周后血清HCV RNA仍为阳性,1例在1年后仍为阳性。外周血单个核细胞中HCV RNA阴性的7例患者中,仅2例在1年随访后血清HCV RNA复发,其他患者在3.5年后仍保持病毒学应答。
干扰素治疗结束时外周血单个核细胞中的HCV RNA是慢性丙型肝炎患者抗病毒治疗持久应答预测指标。