Kobayashi Y, Watanabe S, Konishi M, Yokoi M, Kakehashi R, Kaito M, Kondo M, Hayashi Y, Jomori T, Suzuki S
Third Department of Internal Medicine, Mie University School of Medicine, Japan.
Hepatology. 1993 Dec;18(6):1319-25.
We quantified serum hepatitis C virus RNA titers and determined hepatitis C virus subtypes in chronic hepatitis C patients treated with interferon-beta to investigate relationships among serum ALT response, serum hepatitis C virus titer and hepatitis C virus subtype. Of 146 chronic hepatitis C patients who received interferon-beta therapy, 24 patients with sustained serum ALT normalization (complete responders) and 26 patients without serum ALT normalization (nonresponders) were randomly selected. Detection, typing and quantitation of hepatitis C virus were performed by means of the "single-tube" polymerase chain reaction method. Of the 24 complete responders, 21 (87.5%) became negative for hepatitis C virus RNA, whereas 21 (80.8%) of the 26 nonresponders remained positive. Hepatitis C virus infections with types I, II, III, IV, II + III and III + IV occurred in 0 (0%), 22 (51.2%), 10 (23.3%), 1 (2.3%), 7 (16.5%) and 3 (7.9%) patients, respectively. The mean pretreatment hepatitis C virus RNA titer of complete responders (0.4 +/- 2.0 x 10(4) CID50/ml) was significantly lower than that of nonresponders (3.8 +/- 4.5 x 10(4) CID50/ml) (p < 0.01). Regardless of HCV subtype, patients with more than 10(4) CID50/ml of HCV did not show serum ALT normalization, whereas complete serum ALT response was seen in most cases with less than 10(2) CID50/ml HCV. These results show that mixed infections with different hepatitis C virus subtypes appear to be more common than previously reported and that the pretreatment serum level of hepatitis C virus RNA is a more important predictor of outcome of interferon therapy than is virus genotype.
我们对接受β干扰素治疗的慢性丙型肝炎患者的血清丙型肝炎病毒RNA滴度进行了定量，并确定了丙型肝炎病毒亚型，以研究血清ALT反应、血清丙型肝炎病毒滴度和丙型肝炎病毒亚型之间的关系。在146例接受β干扰素治疗的慢性丙型肝炎患者中，随机选择了24例血清ALT持续正常化的患者（完全应答者）和26例血清ALT未正常化的患者（无应答者）。采用“单管”聚合酶链反应法进行丙型肝炎病毒的检测、分型和定量。在24例完全应答者中，21例（87.5%）丙型肝炎病毒RNA转为阴性，而26例无应答者中有21例（80.8%）仍为阳性。I型、II型、III型、IV型、II + III型和III + IV型丙型肝炎病毒感染分别发生在0例（0%）、22例（51.2%）、10例（23.3%）、1例（2.3%）、7例（16.5%）和3例（7.9%）患者中。完全应答者治疗前丙型肝炎病毒RNA的平均滴度（0.4±2.0×10⁴CID50/ml）显著低于无应答者（3.8±4.5×10⁴CID50/ml）（p<0.01）。无论HCV亚型如何，HCV滴度超过10⁴CID50/ml的患者血清ALT均未正常化，而在大多数HCV滴度低于10²CID50/ml的病例中，血清ALT完全应答。这些结果表明，不同丙型肝炎病毒亚型的混合感染似乎比以前报道的更为常见，并且丙型肝炎病毒RNA的治疗前血清水平比病毒基因型更能预测干扰素治疗的结果。
