Lunel F, Pawlotsky J M
Laboratoire de Bactériologie-Virologie-Hygiène, ANGERS, France.
Pathol Biol (Paris). 1995 Oct;43(8):681-90.
Hepatitis C virus (HCV) has been discovered in 1989 and is probably the most common cause of chronic hepatitis, cirrhosis and hepatocellular carcinoma. HCV is a single-stranded, positive-sense RNA virus, 9.4 kilobases in length. The genetic organisation and the properties of viral proteins have been characterized. At least 50 HCV genotypes or subtypes have been identified. Genotypes 1, 2 and 3 are the most commonly observed in patients from Europe and USA. Genotype 1 is more resistant to interferon treatment. The hypervariability of HCV is responsible, within a single patient, of the existence of a spectrum of very closely-related genomes reffered as quasispecies that may be a mechanism of escape from the immune response and may explain chronicity. Virological diagnosis of HCV infection is based on the detection of anti-HCV antibodies by ELISA. In some cases (acute hepatitis, problems in the interpretation of ELISA tests, or in immunosuppressed patients), it is necessary to search for HCV RNA using genomic amplification or amplification of hybridization. These technics can also be useful to predict the response to interferon, as it has been demonstrated that patients with low viremia are better responders than others. HCV RNA detection or quantification could also be useful to follow the efficiency of anti-viral drugs.
丙型肝炎病毒（HCV）于1989年被发现，可能是慢性肝炎、肝硬化和肝细胞癌的最常见病因。HCV是一种单链正义RNA病毒，长度为9.4千碱基。其基因结构和病毒蛋白特性已得到表征。已鉴定出至少50种HCV基因型或亚型。1型、2型和3型基因型在欧美患者中最为常见。1型基因型对干扰素治疗更具抗性。HCV的高变异性在单个患者体内导致了一系列被称为准种的密切相关基因组的存在，这可能是一种逃避免疫反应的机制，并且可以解释慢性感染。HCV感染的病毒学诊断基于通过ELISA检测抗HCV抗体。在某些情况下（急性肝炎、ELISA检测结果解读存在问题或免疫抑制患者），有必要使用基因组扩增或杂交扩增来检测HCV RNA。这些技术对于预测对干扰素的反应也可能有用，因为已经证明病毒血症水平低的患者比其他患者对干扰素的反应更好。HCV RNA检测或定量对于监测抗病毒药物的疗效也可能有用。
