Zaman Nasib, Asad Muhammad Javaid, Raza Abida, Raja Ghazala Kaukab, Akhter Shamim, Mahmood Majid, Mahmood Raja Tahir
Dr. Muhammad Javaid Asad, Department of Biochemistry, Pir Mehr Ali Shah Arid Agriculture University, Rawalpindi, Pakistan,
Ann Saudi Med. 2014 Sep-Oct;34(5):401-6. doi: 10.5144/0256-4947.2014.401.
Hepatitis C virus (HCV) is considered a hepatotropic virus, but it can repli.cate in peripheral blood mononuclear cells (PBMCs), which influence the sustained virological response (SVR) of the patients, as well as relapse in successfully treated patients. The main objective of this study was to establish the importance of PBMC HCV RNA detection as a primary test to declare the patient as a responder, and the secondary objective was to investigate the risk of non-SVR or relapse in individuals who showed an end-of-treatment (ETR).
Blood samples were collected after the completion of 6 months of therapy, and they were collected 6 months after the completion of treatment.
A total 103 patients infected with the 3a genotype of HCV and those who were treated with interferon-a-2b and ribavirin for 24 weeks were selected. HCV RNA in plasma of at the end of treatment and 6 months after the completion of treatment was determined with the help of quantitative real-time polymerase chain reaction (qRT-PCR).
Of the 103 patients, 74.8% (number [n]=77) were end-of-treatment responders, while 25.2% (n=26) were nonresponders. Seventy-seven responders were tested for HCV RNA in their PBMCs. The HCV RNA was detected in the PBMCs of 29 patients (37.7%). After 6 months of the end of treatment, 15 (19.5%) of 77 ETR patients showed virological relapse, while 62 (80.5%) patients attained SVR. Relapse appeared significantly more often in patients with HCV RNA in their PBMCs at the ETR stage when compared to the patients who did not have the viral RNA (34.5% versus 10.4%, respectively; R2=6.67, P=.01; odds ratio [OR]: 1.3; 95% confidence interval [CI]=1.032-1.811).
Patients with HCV RNA in their PBMCs after attaining an ETR are more likely to show relapse as compared to patients who are negative for viral RNA in PBMCs at the ETR stage.
丙型肝炎病毒（HCV）被认为是一种嗜肝病毒，但它可在外周血单个核细胞（PBMC）中复制，这会影响患者的持续病毒学应答（SVR）以及成功治疗患者的复发情况。本研究的主要目的是确定检测PBMC HCV RNA作为判定患者为应答者的首要检测的重要性，次要目的是调查治疗结束（ETR）时显示病毒学应答的个体出现非SVR或复发的风险。
在治疗6个月结束后采集血样，并在治疗结束6个月后再次采集。
总共选取了103例感染HCV 3a基因型且接受干扰素-α-2b和利巴韦林治疗24周的患者。借助定量实时聚合酶链反应（qRT-PCR）测定治疗结束时及治疗结束6个月后血浆中的HCV RNA。
103例患者中，74.8%（n = 77）为治疗结束时的应答者，而25.2%（n = 26）为无应答者。对77例应答者检测其PBMC中的HCV RNA。29例患者（37.7%）的PBMC中检测到HCV RNA。治疗结束6个月后，77例ETR患者中有15例（19.5%）出现病毒学复发，而62例（80.5%）患者获得SVR。与PBMC中无病毒RNA的患者相比，ETR阶段PBMC中有HCV RNA的患者复发明显更常见（分别为34.5%和10.4%；R2 = 6.67，P = 0.01；优势比[OR]：1.3；95%置信区间[CI] = 1.032 - 1.811）。
与ETR阶段PBMC中病毒RNA阴性的患者相比，ETR后PBMC中有HCV RNA的患者更易出现复发。
