Ballardini G, Manzin A, Giostra F, Francesconi R, Groff P, Grassi A, Solforosi L, Ghetti S, Zauli D, Clementi M, Bianchi F B
Semeiotica Medica II, Azienda Ospedaliera, University of Bologna, Italy.
J Hepatol. 1997 Apr;26(4):779-86. doi: 10.1016/s0168-8278(97)80242-5.
BACKGROUND/AIMS: This study aimed to evaluate the relation between the number of hepatocytes positive for HCV antigens and the amount of HCV RNA in the liver and to evaluate the relationship between the above parameters and viremia levels, HCV genotype and response to interferon treatment.
This was a retrospective study on 31 consecutive patients with chronic HCV-related liver disease, selected on the basis of the availability of frozen liver tissue for both liver HCV antigens detection and liver HCV RNA quantitation. HCV antigens (immunohistochemistry), liver and plasma HCV RNA (competitive RT-PCR), and HCV genotype (commercial kit) were studied.
A significant correlation (p=0.0005) was found between the amount of liver HCV RNA (log 10 copy/microg of extracted RNA) and the number of HCV-infected hepatocytes (scored from 0 to 3). These parameters were not significantly correlated with viremia levels. The highest liver HCV RNA levels and HCV antigen scores were found in patients infected with genotype 1b. Liver HCV RNA (median 541 x 10(3) vs 118 x 10(3) copy number/microg, p=0.031) and liver HCV antigens (mean score 2.3 vs 1.3, p=0.018) but not plasma HCV RNA (median 14956 x 10(3) vs 2885 [correction of 2.885] x 10(3) copy number/ml, ns) were significantly higher in patients not responding to interferon treatment compared to responders.
The tissue parameters tested in this study were significantly correlated, shared the same clinical implications and predicted short-term response to interferon treatment better than viremia levels. We suggest that these tests should be included in the study protocol of patients under evaluation for interferon treatment, basing the choice on local facilities.
背景/目的：本研究旨在评估丙型肝炎病毒（HCV）抗原阳性的肝细胞数量与肝脏中HCV RNA含量之间的关系，并评估上述参数与病毒血症水平、HCV基因型及干扰素治疗反应之间的关系。
这是一项对31例连续性慢性HCV相关性肝病患者的回顾性研究，入选标准为有可供检测肝脏HCV抗原及定量肝脏HCV RNA的冷冻肝组织。研究了HCV抗原（免疫组织化学法）、肝脏及血浆HCV RNA（竞争性逆转录聚合酶链反应）和HCV基因型（商用试剂盒）。
肝脏HCV RNA含量（每微克提取RNA的log 10拷贝数）与HCV感染的肝细胞数量（评分从0至3）之间存在显著相关性（p = 0.0005）。这些参数与病毒血症水平无显著相关性。在感染1b型HCV的患者中发现肝脏HCV RNA水平最高及HCV抗原评分最高。与干扰素治疗有反应的患者相比，未对干扰素治疗产生反应的患者肝脏HCV RNA（中位数541×10³对118×10³拷贝数/微克，p = 0.031）和肝脏HCV抗原（平均评分2.3对1.3，p = 0.018）显著更高，但血浆HCV RNA（中位数14956×10³对2885[校正为2.885]×10³拷贝数/毫升，无显著性差异）无显著差异。
本研究中检测的组织参数显著相关，具有相同的临床意义，并且比病毒血症水平能更好地预测干扰素治疗的短期反应。我们建议，基于当地设备情况，这些检测应纳入接受干扰素治疗评估患者的研究方案中。
