Gil B, Qian C, Riezu-Boj J I, Civeira M P, Prieto J
Department of Internal Medicine, School of Medicine, University of Navarra, Pamplona, Spain.
Hepatology. 1993 Nov;18(5):1050-4.
We investigated the presence of positive (genomic) and negative (replicative intermediate) hepatitis C virus RNA strands in liver, peripheral mononuclear cells and serum from patients with chronic hepatitis C using a selective and semiquantitative polymerase chain reaction procedure. Negative and positive hepatitis C virus RNA strands were present in liver, serum and lymphoid cells in all untreated patients and in all those who did not respond to interferon therapy. In the latter group of patients, the titers of RNA strands in the liver and peripheral mononuclear cells at the end of the treatment were similar to those encountered in untreated patients, but the serum titers were about 100 times lower than pretreatment values. In patients who responded to interferon with normalization of serum aminotransferase levels (n = 10), the rate of detection and the titer of the two viral strands in liver, serum and mononuclear cells were markedly decreased at the end of the therapy. In the six responders who did not relapse after interferon withdrawal, both hepatitis C virus RNA strands were absent from the liver, serum and lymphoid cells. By contrast, the positive RNA strand was present in liver cells, mononuclear cells or both at the end of therapy in all patients who experienced posttherapy relapse. In conclusion, our results indicate that interferon can clear hepatitis C virus from hepatic and extrahepatic sites only in responder patients. Disappearance of genomic hepatitis C virus RNA from the liver and from mononuclear cells may predict complete response without posttherapy relapse.
我们采用选择性半定量聚合酶链反应方法，对慢性丙型肝炎患者肝脏、外周血单个核细胞及血清中丙型肝炎病毒正链（基因组）和负链（复制中间体）RNA的存在情况进行了研究。在所有未经治疗的患者以及所有对干扰素治疗无反应的患者中，肝脏、血清及淋巴细胞中均存在丙型肝炎病毒RNA负链和正链。在后一组患者中，治疗结束时肝脏和外周血单个核细胞中RNA链的滴度与未经治疗的患者相似，但血清滴度比治疗前值低约100倍。血清转氨酶水平恢复正常的干扰素应答患者（n = 10），治疗结束时肝脏、血清及单个核细胞中两种病毒链的检测率和滴度均显著降低。在6例停用干扰素后未复发的应答者中，肝脏、血清及淋巴细胞中均未检测到丙型肝炎病毒RNA链。相比之下，所有治疗后复发的患者在治疗结束时，肝细胞、单个核细胞或两者中均存在正链RNA。总之，我们的结果表明，干扰素仅能使应答患者肝脏及肝外部位的丙型肝炎病毒清除。肝脏和单个核细胞中基因组丙型肝炎病毒RNA的消失可能预示着完全应答且无治疗后复发。
