Takase S, Takada N, Sawada M, Tsutsumi M, Takada A
Department of Internal Medicine, Kanazawa Medical University, Ishikawa, Japan.
Alcohol Alcohol Suppl. 1993;1A:77-84. doi: 10.1093/alcalc/28.supplement_1a.77.
The high prevalence of hepatitis C virus (HCV) markers in alcoholic liver cirrhosis (AL-LC) and hepatocellular carcinoma (HCC) suggests a close aetiopathogenic relationship between alcoholic liver disease (ALD) and HCV infection. In the present study, HCV markers in ALD were measured by the highly sensitive methods, and the changes of sequential HCV markers after abstinence in ALD patients were analysed in order to elucidate the effect of alcohol on HCV. Antibodies to HCV-related antigen were determined using the first or second generation test kit. HCV-RNA genomes encoding the NS-5 region were detected using the RT-PCR method. In the HCV-NS5 negative serum, HCV genomes of the 5'-noncoding region were detected using the two-stage PCR method. Titres of HCV-RNA were measured by multiple cyclic PCR and cDNA dot blotting. Typing of HCV genomes was carried out on the PCR product from the NS-5 region by slot blot hybridization using type-specific cDNA probes, or by restriction fragment length polymorphisms analysis. In alcoholic fibrosis and alcoholic hepatitis, the prevalence of HCV markers was low, suggesting that the main aetiological factor is alcohol but not HCV in these types of ALD. HCV markers were positive in the half of the patients with AL-LC, and in more than 80% of patients with AL-CH and AL-HCC, indicating that HCV infection closely relates to these types of ALD. The ratio of the K1 type to the K2 type of HCV genomes was 4:1 in all types of NANB liver disease.(ABSTRACT TRUNCATED AT 250 WORDS)
丙型肝炎病毒(HCV)标志物在酒精性肝硬化(AL-LC)和肝细胞癌(HCC)中高流行,提示酒精性肝病(ALD)与HCV感染之间存在密切的病因病理关系。在本研究中,采用高灵敏度方法检测ALD中的HCV标志物,并分析ALD患者戒酒前后连续HCV标志物的变化,以阐明酒精对HCV的影响。使用第一代或第二代检测试剂盒测定抗HCV相关抗原的抗体。采用逆转录聚合酶链反应(RT-PCR)法检测编码NS-5区的HCV-RNA基因组。在HCV-NS5阴性血清中,采用两步PCR法检测5'-非编码区的HCV基因组。通过多重循环PCR和cDNA斑点杂交测定HCV-RNA的滴度。通过使用型特异性cDNA探针的狭缝印迹杂交或限制性片段长度多态性分析,对来自NS-5区的PCR产物进行HCV基因组分型。在酒精性肝纤维化和酒精性肝炎中,HCV标志物的流行率较低,提示在这些类型的ALD中主要病因是酒精而非HCV。在一半的AL-LC患者、超过80%的AL-CH和AL-HCC患者中HCV标志物呈阳性,表明HCV感染与这些类型的ALD密切相关。在所有类型的非甲非乙型肝病中,HCV基因组的K1型与K2型之比为4:1。(摘要截短于250字)