Zarski J P, Thelu M A, Moulin C, Rachail M, Seigneurin J M
Clinique d'Hépato-gastroentérologie, CHRU, Grenoble, France.
J Hepatol. 1993 Jan;17(1):10-4. doi: 10.1016/s0168-8278(05)80514-8.
HCV-RNA detection was investigated in 66 chronic alcoholic patients divided into 3 groups according to the severity of liver injury: group 1 included 22 chronic alcoholics without cirrhosis, group 2, 20 patients with alcoholic cirrhosis and group 3, 24 patients with alcoholic cirrhosis and hepatocellular carcinoma. The 'nested' polymerase chain reaction (PCR) technique amplifying the 5' non-coding region was used to detect HCV-RNA. For comparison, ELISA1, ELISA2 and RIBA2 tests (Ortho Diagnostics System) were also used to detect anti-HCV antibodies. Finally HBV markers (HBsAg, anti-HBc and anti-HBs antibodies) were detected in all patients as well as HBV-DNA by PCR. In group 1, only 1 patient (4.5%) showed an HCV-RNA-positive PCR, while 3 patients (13.6%) were found to have anti-HCV antibodies detected by RIBA2. In group 2, 3 patients (15%) showed positive PCRs, whereas 4 patients (20%) had anti-HCV antibodies. Finally, in group 3, the PCR was positive in 3 patients (12.5%), while 9 (37.5%) had anti-HCV antibodies. All patients with positive PCRs showed positive anti-HCV antibodies detected by second-generation assays. On the other hand, these patients often had past HBV infection markers but rarely had HBV-DNA detected by PCR. These results suggest that in chronic alcoholic patients, regardless of the severity of liver injury, HCV replication is rarely observed by PCR. Indeed, replication is only observed when anti-HCV antibody detection is positive in second-generation assays, particularly with strong reactivity against C33-C and C22-3 antigens. The relatively high prevalence of anti-HCV antibodies in this population compared to the usual rates could be explained by the age, geographic and perhaps even socioeconomic origin of the patients.
对66例慢性酒精性肝病患者进行了丙型肝炎病毒核糖核酸（HCV-RNA）检测，根据肝损伤严重程度将患者分为3组：第1组包括22例无肝硬化的慢性酒精性肝病患者，第2组为20例酒精性肝硬化患者，第3组为24例酒精性肝硬化合并肝细胞癌患者。采用扩增5'非编码区的“巢式”聚合酶链反应（PCR）技术检测HCV-RNA。为作比较，还采用酶联免疫吸附试验1（ELISA1）、酶联免疫吸附试验2（ELISA2）和重组免疫印迹法2（RIBA2）检测抗丙型肝炎病毒（抗-HCV）抗体（Ortho诊断系统）。最后，对所有患者检测乙型肝炎病毒（HBV）标志物（乙肝表面抗原、抗-HBc和抗-HBs抗体），并采用PCR检测HBV-DNA。第1组中，仅1例患者（4.5%）PCR检测HCV-RNA呈阳性，而采用RIBA2检测发现3例患者（13.6%）有抗-HCV抗体。第2组中，3例患者（15%）PCR检测呈阳性，4例患者（20%）有抗-HCV抗体。最后，第3组中，3例患者（12.5%）PCR检测呈阳性，9例患者（37.5%）有抗-HCV抗体。所有PCR检测呈阳性的患者采用第二代检测法检测抗-HCV抗体均呈阳性。另一方面，这些患者常有既往HBV感染标志物，但采用PCR检测很少发现HBV-DNA。这些结果表明，在慢性酒精性肝病患者中，无论肝损伤严重程度如何，采用PCR很少观察到HCV复制。实际上，仅在第二代检测法中抗-HCV抗体检测呈阳性时，特别是对C33-C和C22-3抗原具有强反应性时，才观察到复制。与通常发生率相比，该人群中抗-HCV抗体相对较高的患病率可由患者的年龄、地域甚至社会经济来源来解释。
