Bukh J, Miller R H, Kew M C, Purcell R H
Hepatitis Viruses Section, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892.
Proc Natl Acad Sci U S A. 1993 Mar 1;90(5):1848-51. doi: 10.1073/pnas.90.5.1848.
We used a sensitive and specific cDNA polymerase chain reaction assay to detect hepatitis C virus (HCV) RNA in serum samples from 128 unselected southern African Blacks with hepatocellular carcinoma (HCC) and found HCV RNA in 26 (20.3%) of these patients. Antibodies to HCV (anti-HCV) were detected in 59 patients (46.1%) with a first-generation ELISA test, and only 19 of these patients were HCV RNA-positive. Anti-HCV was detected in 25 patients (19.5%) with a second-generation ELISA test, and 17 of these patients were HCV RNA-positive. Among the second-generation ELISA- and HCV RNA-positive patients, 14 were anti-HCV positive, 2 were indeterminate, and 1 was anti-HCV negative in a second-generation recombinant immunoblot assay, whereas all patients who were second-generation ELISA positive, but HCV RNA negative, were anti-HCV negative in this immunoblot assay. A total of 5 patients were negative in both ELISA tests but were HCV RNA positive. Seventy-one patients (55.5%) had evidence of a current HBV infection, 50 (39.1%) had evidence of a previous infection, and 7 (5.5%) had no evidence of a current or previous HBV infection. The prevalence of current HBV infection was significantly lower in patients who were positive for HCV RNA than in those who were negative (P = 0.001). This difference was not dependent on sex, age, or geographical location of the patients. The mean age of HCC patients positive for HCV RNA (52.3 years) was significantly higher (P < 0.001) than that of negative patients (40.3 years), and the difference was not dependent on HBV status or geographical location. Patients positive for HCV RNA were more likely to be urban than were negative patients. Thus, a significant number of southern African Blacks with HCC had a current HCV infection but not a current HBV infection, further suggesting that infection with HCV plays a role, albeit minor, in the development of HCC in this population.
我们采用一种灵敏且特异的cDNA聚合酶链反应检测法，对128例未经挑选的南非黑人肝细胞癌（HCC）患者的血清样本进行丙型肝炎病毒（HCV）RNA检测，结果在其中26例（20.3%）患者中检测到HCV RNA。采用第一代酶联免疫吸附试验（ELISA）在59例患者（46.1%）中检测到抗HCV抗体，其中仅19例患者HCV RNA呈阳性。采用第二代ELISA检测在25例患者（19.5%）中检测到抗HCV抗体，其中17例患者HCV RNA呈阳性。在第二代ELISA及HCV RNA均呈阳性的患者中，14例在第二代重组免疫印迹试验中抗HCV呈阳性，2例结果不确定，1例抗HCV呈阴性；而所有第二代ELISA呈阳性但HCV RNA呈阴性的患者在该免疫印迹试验中抗HCV均呈阴性。共有5例患者两种ELISA检测均为阴性，但HCV RNA呈阳性。71例患者（55.5%）有当前HBV感染的证据，50例（39.1%）有既往感染的证据，7例（5.5%）无当前或既往HBV感染的证据。HCV RNA呈阳性的患者中当前HBV感染的患病率显著低于HCV RNA呈阴性的患者（P = 0.001）。这种差异不取决于患者的性别、年龄或地理位置。HCV RNA呈阳性的HCC患者的平均年龄（52.3岁）显著高于HCV RNA呈阴性的患者（40.3岁）（P < 0.001），且这种差异不取决于HBV状态或地理位置。HCV RNA呈阳性的患者比HCV RNA呈阴性的患者更可能居住在城市。因此，相当数量的南非黑人HCC患者有当前HCV感染但无当前HBV感染，这进一步表明HCV感染在该人群HCC的发生中起一定作用，尽管作用较小。
