Mita E, Hayashi N, Kanazawa Y, Hagiwara H, Ueda K, Kasahara A, Fusamoto H, Kamada T
First Department of Medicine, Osaka University School of Medicine, Japan.
J Hepatol. 1994 Sep;21(3):468-73. doi: 10.1016/s0168-8278(05)80330-7.
Hepatitis C virus genotype and the amounts of circulating HCV RNA are the most important factors in determining the efficacy of interferon therapy for chronic hepatitis C. To clarify the correlation of these two factors to the progression of liver disease, we classified 148 Japanese patients with type C chronic liver disease into genotypes and also measured their HCV RNA titers (logarithmic transformed copy number/ml serum) by competitive reverse transcription-polymerase chain reaction. We found type II in 23 (76.7%) of 30 patients with chronic persistent hepatitis, 34 (79.1%) of 43 with chronic active hepatitis, 29 (72.5%) of 40 with cirrhosis and 30 (85.7%) of 35 with hepatocellular carcinoma. Thus, there was no significant difference in the prevalence of type II among the various stages of chronic liver disease. We also found the RNA titer to be significantly higher in patients with chronic active hepatitis (8.0 +/- 0.8) than in those with chronic persistent hepatitis (7.0 +/- 1.0, p < 0.001), and also those with cirrhosis (7.6 +/- 0.8, p < 0.05) or hepatocellular carcinoma (7.7 +/- 0.8, p < 0.05). When the titers were compared among genotypes, there was no significant difference between type II and III at any stage (type II vs. type III: chronic persistent hepatitis, 7.2 +/- 1.0 vs. 6.7 +/- 0.8; chronic active hepatitis, 8.1 +/- 0.7 vs. 7.8 +/- 1.0; cirrhosis, 7.7 +/- 0.8 vs. 7.8 +/- 0.7; hepatocellular carcinoma, 7.7 +/- 0.8 vs. 7.8 +/- 0.5). In conclusion, although genotype affects interferon therapy efficacy, it seems to have little influence on serum RNA levels and the progression of type C chronic liver disease.
丙型肝炎病毒基因型和循环中的丙型肝炎病毒核糖核酸（HCV RNA）量是决定慢性丙型肝炎干扰素治疗疗效的最重要因素。为阐明这两个因素与肝脏疾病进展的相关性，我们将148例日本丙型慢性肝病患者按基因型分类，并通过竞争性逆转录 - 聚合酶链反应测定其HCV RNA滴度（对数转换后的拷贝数/毫升血清）。我们发现，在30例慢性持续性肝炎患者中有23例（76.7%）为II型，43例慢性活动性肝炎患者中有34例（79.1%）为II型，40例肝硬化患者中有29例（72.5%）为II型，35例肝细胞癌患者中有30例（85.7%）为II型。因此，在慢性肝病的各个阶段，II型的患病率无显著差异。我们还发现，慢性活动性肝炎患者的RNA滴度（8.0±0.8）显著高于慢性持续性肝炎患者（7.0±1.0，p<0.001），也高于肝硬化患者（7.6±0.8，p<0.05）和肝细胞癌患者（7.7±0.8，p<0.05）。当比较各基因型的滴度时，在任何阶段II型和III型之间均无显著差异（II型与III型比较：慢性持续性肝炎，7.2±1.0对6.7±0.8；慢性活动性肝炎，8.1±0.7对7.8±1.0；肝硬化，7.7±0.8对7.8±0.7；肝细胞癌，7.7±0.8对7.8±0.5）。总之，虽然基因型影响干扰素治疗疗效，但它似乎对血清RNA水平和丙型慢性肝病的进展影响很小。
