急性丙型肝炎中的抗丙型肝炎病毒IgG亲和力指数

Anti-HCV IgG avidity index in acute hepatitis C.

作者信息

Coppola Nicola, Pisapia Raffaella, Marrocco Cecilia, Martini Salvatore, Vatiero Luisa Maria, Messina Vincenzo, Tonziello Gilda, Sagnelli Caterina, Filippini Pietro, Piccinino Felice, Sagnelli Evangelista

机构信息

Department of Public Medicine, Section of Infectious Diseases, Second University of Naples, Italy.

出版信息

J Clin Virol. 2007 Oct;40(2):110-5. doi: 10.1016/j.jcv.2007.07.005. Epub 2007 Aug 27.

DOI:10.1016/j.jcv.2007.07.005

PMID:17720621

Abstract

BACKGROUND

The diagnosis of acute hepatitis C (AHC) is based on seroconversion to positive anti-HCV, which is usually not clinically possible.

OBJECTIVE

To determine if avidity of anti-HCV IgG can be used for the diagnosis of AHC infection.

STUDY DESIGN

We enrolled 40 consecutive patients with AHC, 16 drug addicts (IVDA) with exacerbation of chronic hepatitis C (IVDA e-CHC group), 21 non-IVDA with exacerbation of chronic hepatitis C (IVDA-free e-CHC group) and 40 with chronic hepatitis C (CHC group). HCV avidity index (HCV-AI) was determined by ELISA on sera pre-diluted 1:10 with 1M guanidine.

RESULTS

On admission, HCV-AI values were significantly lower in the AHC group (mean+/-S.D.: 0.50+/-0.30) than in IVDA-free e-CHC group (0.97+/-0.08, p<0.0001), IVDA e-CHC group (0.90+/-0.29, p<0.0001) or CHC group (1.06+/-0.20, p<0.0001). An HCV-AI lower than 0.7 obtained within the 8th day of illness distinguished patients with AHC infection from the IVDA-free e-CHC cases. An increase in HCV-AI was observed in 24 (72.7%) of 33 in AHC group, in none of 13 in IVDA-free e-CHC group and in 3 (27.3%) of 11 in IVDA e-CHC group.

CONCLUSION

HCV-AI is useful in identifying AHC infection in patients observed within the 8th day from the onset of symptoms.

摘要

背景

急性丙型肝炎（AHC）的诊断基于抗-HCV血清学转换为阳性，而这在临床上通常无法实现。

目的

确定抗-HCV IgG的亲和力是否可用于诊断AHC感染。

研究设计

我们连续纳入了40例AHC患者、16例慢性丙型肝炎病情加重的药物成瘾者（静脉注射毒品者，IVDA e-CHC组）、21例非IVDA的慢性丙型肝炎病情加重患者（非IVDA e-CHC组）以及40例慢性丙型肝炎患者（CHC组）。采用ELISA法，对用1M胍预稀释1:10的血清测定HCV亲和力指数（HCV-AI）。

结果

入院时，AHC组的HCV-AI值（均值±标准差：0.50±0.30）显著低于非IVDA e-CHC组（0.97±0.08，p<0.0001）、IVDA e-CHC组（0.90±0.29，p<0.0001）或CHC组（1.06±0.20，p<0.0001）。发病第8天内获得的HCV-AI低于0.7可将AHC感染患者与非IVDA e-CHC病例区分开来。AHC组33例中有24例（72.7%）HCV-AI升高，非IVDA e-CHC组13例中无一例升高，IVDA e-CHC组11例中有3例（27.3%）升高。