Schmidt W N, Wu P, Cederna J, Mitros F A, LaBrecque D R, Stapleton J T
Department of Internal Medicine and Pathology, University of Iowa College of Medicine, and VA Medical Center, Iowa City, USA.
J Infect Dis. 1997 Jul;176(1):27-33. doi: 10.1086/514033.
Reverse transcription-polymerase chain reaction was used to identify hepatitis C virus (HCV) RNA in peripheral whole blood (WB) and plasma samples from 15 patients with chronic, unexplained hepatitis. These patients were serologically negative for hepatitis A, B, and C and were classified as having chronic non-A, non-B, non-C hepatitis (NANBNC). HCV RNA was repeatedly detected in WB samples from 10 (67%). In contrast, plasma samples from only 5 were intermittently positive. Statistically, HCV RNA detection in WB was significantly more sensitive than in plasma. Nucleic acid hybridization and HCV genotypic analysis confirmed the specificity of the HCV RNA assay. Liver biopsies from these patients suggested histopathologic differences between HCV RNA-positive and -negative groups. These data demonstrate that HCV infection is present in patients with unexplained chronic hepatitis more frequently than previously believed. Additionally, WB HCV RNA detection is more sensitive than plasma assays in identifying antibody-negative HCV infection.
采用逆转录-聚合酶链反应法，对15例慢性不明原因肝炎患者的外周全血（WB）和血浆样本进行丙型肝炎病毒（HCV）RNA检测。这些患者甲型、乙型和丙型肝炎血清学检测均为阴性，被归类为慢性非甲、非乙、非丙型肝炎（NANBNC）。10例（67%）患者的全血样本中反复检测到HCV RNA。相比之下，仅5例患者的血浆样本呈间歇性阳性。从统计学角度看，全血中HCV RNA检测比血浆检测更敏感。核酸杂交和HCV基因分型分析证实了HCV RNA检测方法的特异性。对这些患者进行的肝活检显示，HCV RNA阳性和阴性组之间存在组织病理学差异。这些数据表明，不明原因慢性肝炎患者中HCV感染的存在比以前认为的更为常见。此外，在识别抗体阴性的HCV感染方面，全血HCV RNA检测比血浆检测更敏感。
