Chevaliez Stéphane, Pawlotsky Jean-Michel
Department of Virology & INSERM U841, French National Reference Center for Viral Hepatitis B, C and delta, Hôpital Henri Mondor, Université Paris 12, Créteil, France.
Liver Int. 2009 Jan;29 Suppl 1:9-14. doi: 10.1111/j.1478-3231.2008.01926.x.
Chronic hepatitis C is a global health problem that may cause cirrhosis and progression to hepatocellular carcinoma. Currently available antiviral treatments are moderately effective. Several virological assays are available to help diagnose and manage patients infected with the hepatitis C virus (HCV). These include the anti-HCV antibody assays, measurement of HCV RNA viral load and HCV genotyping. HCV RNA can be assayed by two types of molecular biology-based techniques: target amplification as in polymerase chain reaction methods and signal amplification such as the branched DNA assay. Monitoring of viral kinetics during the early phases of antiviral treatment is crucial in making treatment decisions such as early stopping rules and also in optimizing the length of treatment. The HCV genotype can be determined by several methods. Whatever the method, pretreatment determination allows treatment length and ribavirin dose to be optimized and also offers prognostic information on treatment outcomes as certain genotypes respond more favourably to treatment. Thus, virological assays are indispensable in the diagnosis and management of individuals infected with the HCV.
慢性丙型肝炎是一个全球性的健康问题，可能导致肝硬化并进展为肝细胞癌。目前可用的抗病毒治疗效果一般。有几种病毒学检测方法可用于帮助诊断和管理丙型肝炎病毒（HCV）感染患者。这些方法包括抗-HCV抗体检测、HCV RNA病毒载量测定和HCV基因分型。HCV RNA可通过两种基于分子生物学的技术进行检测：如聚合酶链反应方法中的靶标扩增和如分支DNA检测法中的信号扩增。在抗病毒治疗的早期阶段监测病毒动力学对于做出治疗决策（如早期停药规则）以及优化治疗时长至关重要。HCV基因型可通过多种方法确定。无论采用何种方法，治疗前确定基因型都可以优化治疗时长和利巴韦林剂量，并且还能提供有关治疗结果的预后信息，因为某些基因型对治疗的反应更为良好。因此，病毒学检测在HCV感染个体的诊断和管理中不可或缺。
