初次及再次感染HCV后不同功能区抗体的研究

１４例初次ＨＣＶ感染者及１１例再次ＨＣＶ感染者系列血清系在无法检测ＨＣＶ时留存的２８９位手术受血者系列血清中筛选获得。系列血清包括受血前、受血后不同时期收集的血清。回顾性地研究其不同功能区抗体出现的动态变化，抗Ｃ与抗ＮＳ３抗体有早期诊断价值。抗ＮＳ３、抗Ｃ、抗ＮＳ５及抗ＮＳ４抗体在ＨＣＶ感染后系列血清中检出率分别为８４．７６％、７９．２７％、７２．５４％和６８．３９％。感染过程中各区抗体可以全部出现、部分出现或单独出现抗Ｃ、抗ＮＳ３及抗ＮＳ５抗体，未发现单独含抗Ｅ、抗ＮＳ１及抗ＮＳ４区抗体的血清。抗Ｅ、抗ＮＳ１及抗ＮＳ４抗体消失较早。研究表明：以ＨＣＶＣ区、ＮＳ３区及ＮＳ５区编码的优势抗原包被的ＥＬＩＳＡ抗体诊断试剂盒将提高ＨＣＶ的诊断。     

HCV感染后NS5区抗体的动态观察与检测意义

本文报道用ＨＣＶＮＳ５区两段抗原性较好的合成肽研制的ＥＬＩＳＡ试剂盒及ＵＢＩＨＣＶＮＳ５区抗体检测ＥＬＩＳＡ试剂盒观察１４例ＨＣＶ感染者ＮＳ５区抗体的动态变化，证实ＮＳ５区抗体如同ＮＳ４区抗体一样比Ｃ及ＮＳ３区抗体出现晚。ＮＳ５区抗体总体检出率近似于ＮＳ４区抗体；１．５５％的血清为单独ＮＳ５区抗体阳性；存在ＮＳ５区抗体与其他区抗体滴度有互补作用的标本等提示ＮＳ５区抗体仍有一定的诊断价值。采用ＵＢＩＮＳ５区抗体检测试剂盒发现，９５．６５％（２２／２３）ＵＢＩ试剂盒诊断为ＮＳ５区抗体阳性的标本中含ＨＣＶＲＮＡ，６／１４ＨＣｖ感染者用ＵＢＩ试剂盒检出的抗体出现在ＡＬＴ再次异常升高或剧烈升高（高于参考值的３倍以上）前后，４／１４的感染者抗体出现于ＡＬＴ首次升高前后（其余４／１４的感染者未检出抗ＮＳ５抗体），因此ＵＢＩ抗ＨＣＶＮＳ５抗体诊断试剂盒检测的抗体似与疾病的活动有关。     

输血后丙型肝炎病毒血症,抗体及转氨酶动态研究

对１０例输血后丙型肝炎进行了病毒血症、抗体及丙氨酸转氨酶（ＡＬＴ）动态研究。用套式ＰＣＲ法检测丙型肝炎病毒（ＨＣＶ）ＲＮＡ，首次检出时间为输血后１５～８７天，平均４０．３±２０．１天，持续或间歇阳性超过１年者７例。抗ＨＣＶＣ１００．Ｎ１４、Ｐ２２和ＳｃＮＳ３／４和５抗体首次阳转时间分别为输血后３３～４３７（１１９．７±１１９．５）天、５２～１６６（７７．９±３５．６）天、３３～１０３（５５．０±２３．８）天和３３～６６（４０．１±１３．５）天，该４种抗体阳转后都持续１年以上。ＡＬＴ首次异常时间为输血后１５～６０天，平均３７．９±１３．９天，异常超过１年者６例。     

丙型肝炎病毒基因型与血清HCV RNA含量关系及与干扰素应答的研究

目的探讨丙型肝炎病毒（ＨＣＶ）基因型与血清ＨＣＶＲＮＡ含量的关系及其对干扰素应答的影响。方法应用定量荧光ＰＣＲ（Ａｍｐｌｉｓｅｎｓｏｒ－ＰＣＲ）技术检测了１３５例不同基因型ＨＣＶ感染的慢性丙型肝炎患者血清ＨＣＶＲＮＡ含量，另对其中７７例进行干扰素治疗并随访１２个月以上。结果ＨＣＶ－Ⅱ型感染血清ＨＣＶＲＮＡ水平（１０７．８±３．４拷贝／ｍｌ）显著高于ＨＣＶ－Ⅲ型感染（１０６．３±２．５拷贝／ｍｌ）（Ｐ＜０．０１），Ⅲ型感染的应答率（７／１３，５３．８％）显著高于Ⅱ型感染（２０／６４，３１．３％）（Ｐ＜０．０５）。应答组治疗前血清ＨＣＶＲＮＡ含量（１０６．８±２．７拷贝／ｍｌ）显著低于无应答组（１０８．３±３．２拷贝／ｍｌ）（Ｐ＜０．０１）。ＨＣＶＲＮＡ含量低于１０６．５拷贝／ｍｌ者，无论何种型别ＨＣＶ感染均应答较好，而ＨＣＶＲＮＡ高于１０８．０拷贝／ｍｌ者则应答极差。结论ＨＣＶ基因型及病毒血症水平是预测干扰素疗效的重要因素，且后者比前者意义更大。Ⅱ型感染病毒血症水平较高可能是影响其疗效的原因之一。     

血透析单位HCV感染情况－HCV－RNA和抗HCV流行率

血透析单位ＨＣＶ感染情况－ＨＣＶ－ＲＮＡ和抗ＨＣＶ流行率［英］／ＳｅｅｌｉｇＲ…／／ＡｎｎＭｅｄ．－１９９４，２６（１），－４５～５２ＮＣＶ感染引起血透析病人严重的并发症，这将导致血透析单位病人的管理问题。检测ＨＣＶ－ＲＮＡ是现今监测ＨＣＶ感染过程的...     

小鼠口眼HCV基因工程菌产生的细胞和体液免疫

近年来研究表明ＤＮＡ直接接种动物体内可诱导机体产生免疫反应，很可能成为预防感染的新型疫苗，即基因疫苗。含ＨＣＶ基因重组质粒ＤＮＡ的工程菌是否也有可能在预防ＨＣＶ感染中发挥一定的作用？本文初步观察了经口眼途径接种含ＨＣＶ核心基因重组质粒（ＨＣＶ，ｃｏｒｅ／ｐＭＡＬ）的大肠杆菌后，ＢＡＬＢ／ｃ小鼠体内的细胞和休液免疫反应。研究分为①实验组，分别口服１～３次（Ｈ１－Ｈ３）含ＨＣＶ．ｃｏｒｅ／ｐＭＡＬ的大肠杆菌；②口眼含ＰＭＡＬ质粒的大肠杆菌的对照组（Ｐ）；③不给细菌的对照组（Ｃ）。实验组小鼠淋巴细胞在…     

丙型慢性肝病患者配偶中的HCV感染

丙型慢性肝病患者配偶中的ＨＣＶ感染［英］／ＡｋａｈａｎｅＹ…／／ＡｎｎＩｎｔｅｒｎＭｅｄ．－１９９４，１．２０（９）．－７４８～７５２为确定长期配偶ＨＣＶ感染的危险是否增加，作者对１５４例ＨＣＶ相关慢性肝病患者的配偶中的ＨＣＶ相关抗体和ＨＣＶＲＮＡ作...     

丙型肝炎病毒（HCV）E2／NS1相对保守区多肽抗原在检？…

目的 研究（ＨＣＶ）Ｅ２／ＮＳ１相对保守区多肽抗原在检测抗－ＨＣＶ中的意义。方法 利用ＨＣＶＥ２／ＮＳ１基因编码的膜区糖蛋白合成Ｅ２／ＮＳ１相对保守区多肽抗原,建立酶免疫试验（ＥＩＡ）,对９６例ＨＣＶ感染者及４０例正常献血员进行ＨＣＶＥ２／ＮＳ１抗体的检测,同时平行检测ＨＣＶＲＮＡ肝炎为１３．５５％,慢性丙型肝炎为２５．０４％,无症状感染者为２．０８％;正常献血员中发现３例抗ＨＣＶＥ２／ＮＳ１抗体     

IgM类抗HCV独特型抗体（抗HCV—Ab2）的ELISA法检测及意义

用抗人μ链单克隆抗体建立的ＥＬＩＳＡ法检测１５２例肝病患者ＩｇＭ类抗ＨＣＶ独特型抗体，甲肝阳性率０％（０／１５），乙肝８．５％（４／４７），丙肝３２．１％（２６／８１），丙肝合并乙肝者２２．２％（２／９）。丙肝组内频率为急肝０％（０／１７），慢性迁延性肝炎３８．１％（８／２１），慢性活动性肝炎４３．８％（１４／３２），肝炎肝硬化３６．４％（４／１１）。本法重复性好，批内变异系数４．６％，批间变异系数８．５％。用纯化人抗ＨＣＶ抗体进行阻断，阻断率＞８５％，丙肝组与乙肝组有显著性差异（Ｐ＜０．０１），与各种自身免疫性疾病无交叉，有较好的特异性和精密度，且与血清中ＩｇＭ抗ＨＣＶ关系密切，提示丙型肝炎ＩｇＭ类抗ＨＣＶ－Ａｂ２具有模拟抗原的作用，是慢性丙型肝炎的重要检测指标并与丙肝慢性化有关。     

线探针核酸杂交分析贵州地区HCV感染株基因型

目的　分析贵州地区丙型肝炎病毒（ＨＣＶ）感染株的基因型。方法　用第二代线探针核酸杂交方法,对９８ 例ＨＣＶ感染者血清进行基因分型。结果　１２ 例献血员血清,均为ＨＣＶ１ｂ 型;１５ 例血液病患者中,１４ 例（９３－３％ ）为ＨＣＶ１ｂ ,１ 例（６－７％ ）为ＨＣＶ１ｂ ＋ ２ 型。慢性丙肝患者３７ 例中,ＨＣＶ１ｂ 型３４例（９１－９％ ） ,混合感染基因型３ 例（ＨＣＶ１ａ ＋ １ｂ 、ＨＣＶ１ｂ ＋ ２ 、ＨＣＶ１ａ ．１ｂ ＋ ２ａ２ｃ 各１ 例）。静脉药瘾者３４ 例,其中ＨＣＶ１ｂ 感染１３ 例（３８－２％ ） ,ＨＣＶ６ａ１０ 例（２９－４％ ） ,ＨＣＶ３ｂ４ 例（１１－８％ ） ,ＨＣＶ３ａ１ 例（２－９ ％） ,混合感染６ 例（１７－６ ％） ,大多为ＨＣＶ２ 复合其他基因型。结论　贵州地区ＨＣＶ感染者中,以ＨＣＶ１ｂ 基因型为主,其次为ＨＣＶ６ａ ,尚存在ＨＣＶ３ａ 和ＨＣＶ３ｂ 。其中ＨＣＶ３ａ、３ｂ 、６ａ ,在本地区系首次报告,但主要存在于静脉药瘾者中。虽然有混合感染基因型的存在,但其基因基础需测序分析     

Comparison of HCV core antigen and anti-HCV with HCV RNA results

Background

The measurement of anti-HCV antibodies using immunological methods and the confirmation of viral nuclear acid based on molecular methods is important in diagnosis and follow-up of the HCV infection.

Objectives

In this study, we aimed to analyse HCV core Antigen positivity among anti-HCV antibody positive sera to determine the significance of testing of HCV core Ag for the laboratory diagnosis of HCV infection, by considering the correlation between serum HCV core Ag and HCV RNA levels.

Methods

115 patients suspected of having hepatitis C and who were positive for anti-HCV antibody were investigated using chemiluminescent and molecular methods. Anti-HCV antibody, HCV core Ag and HCV RNA levels were detected by the Vitros ECiQ immunodiagnostic system, Architect i2000 system and RT-PCR, respectively.

Results

The sensitivity, specificity, positive and negative predictive values and accuracy rate of HCV core Antigen assay were detected as 86.5%(83/96), 100%(19/19), 100%(83/83), 59.4%(19/32), 88.7%(102/115) respectively.

Conclusion

HCV core Ag assay could be used for diagnosis of HCV infection as it is easy to perform, cost-effective, has high specificity and positive predictive value. However, it should be kept in mind that it may have lack of sensitivity and negative predictive value.     

全血与血液制品中HCV RNA检测及其基因分型的初步研究

对一组临床应用的全血（配血用标本）、血液制剂与丙种球蛋白制剂进行检测。血浆制剂抗ＨＣＶ阳性率显著高于全血（３２．６４％与１１．６８％、Ｐ＜０．０１）。三组标本中抗ＨＣＶ阳性者ＨＣＶ ＲＮＡ检出率基本相似。但丙球制剂组ＨＣＶ ＲＮＡ阳性标本在ＰＣＲ中的反应强度显著低于前两者。对部份标本作ＨＣＶ基因亚型检测，三组总体ＨＣＶ亚型表达频率为，原型：２．９４％；Ｋ１：４７．０６％；Ｋ２ａ：３２．３５％；Ｋ２     

抗HCV阳性患者体液中正链和负链HCVRNA的检测及意义

为了解ＨＣＶ感染者血清和体液中ＨＣＶ存在状况，利用ＲＴ－巢式ＰＣＲ方法检测了４２例抗ＨＣＶ阳性患者血清，唾液、精夜或阴道分泌物中的ＨＣＶＲＮＡ。患者血清和体液中ＨＣＶＲＮＡ的检测出率分别为：血清６９．０５％（２９／４２），唾液２３．８１％（１０／４２），精液３６．６％（４／１１），阴道分泌物１５．３８％（２／１３）。     

HCV in peripheral blood mononuclear cells are predominantly carried on the surface of cells in HIV/HCV co-infected individuals

HCV replication in extra-hepatic reservoirs has been suggested to occur in many tissues including PBMCs. A recent study showed evidence for compartmentalization and evolution of HCV in PBMCs. However, the cells that support HCV replication in PBMCs have not been identified. In this study we have fractionated the PBMC from HIV/HCV co-infected patients into T, monocytes, B and NK cells, and most of the HCV was located in CD3-cell fractions. Protease treatment of PBMCs to remove cell surface receptors resulted in the loss of HCV RNA suggesting that most of the HCV is present on the cell surface. PBMCs were treated by freeze-thaw nuclease method that would protect the HCV RNA in the virus but not the intracellular viral RNA. Data from this analysis support the conclusion that most of HCV is present on the cell surface. Even though the presence of minus strand RNA in PBMCs suggests that a low level HCV replication takes place within the PBMCs of HIV/HCV co-infected individuals, HCV in PBMC is present mainly on the surface of non-T cells, mostly on NK, monocytes and B cells. These results suggest a unique pathogenic role of NK, monocyte and B cells as carriers of HCV.     

Performance of ARCHITECT HCV core antigen test with specimens from US plasma donors and injecting drug users

BackgroundHepatitis C virus (HCV) core antigen is a serological marker of current HCV infection.ObjectivesThe aim of this study was mainly to evaluate the performance characteristics of the ARCITECT HCV core antigen assay with specimens from US plasma donors and injecting drug users.Study designA total of 551 serum and plasma samples with known anti-HCV and HCV RNA status were tested for HCV core antigen using the Abbott ARCHITECT HCV core antigen test.ResultsHCV core antigen was detectable in 100% of US plasma donor samples collected during the pre-seroconversion phase of infection (anti-HCV negative/HCV RNA positive). Overall sensitivity of the HCV core antigen assay was 88.9–94.3% in samples collected after seroconversion. The correlation between HCV core antigen and HCV RNA titers was 0.959.ConclusionsHCV core antigen testing may be reliably used to identify current HCV infection.     

Comparative evaluation of the Geenius HCV supplemental assay and Inno-LIA HCV score assay in detecting anti-HCV antibodies

ObjectiveThis study compared two assays aimed at confirming the presence of anti-HCV antibodies (Ab) after a positive screening: Geenius HCV supplemental assay (Bio-Rad, Marne la Coquette, France) and the Inno-LIA HCV score assay (Fujirebio, Les Ulis, France).Material and methodsA total of 180 archived samples were investigated including 119 samples collected at different stages of HCV infection in 25 hemodialyzed patients who underwent HCV seroconversion, 14 samples from 4 commercial seroconversion panels, 47 Ab positive/HCV-RNA positive blood donations of which 7 showing an single reactivity in confirmatory assays. Samples were investigated and results were interpreted with the two assays according to the manufacturers’ instructions.ResultsOverall, Geenius and Inno-LIA were concordant for 84% (151/180) samples: 38 negative, 17 indeterminate and 96 positive. Of the 29 discrepant results, 26 were overclassified with Inno-LIA. HCV seroconversion was detected with Inno-LIA 4 and 7 days prior to Geenius in two panels. The high positive rate observed with Inno-LIA (64%) compared to Geenius (54%) was mainly due to low reactivities considered positive according to interpretation criteria, which could affect specificity.ConclusionAlthough HCV supplemental assays are not recommended for the diagnostic of HCV infection, which is primarily based on HCV-RNA testing, both assays are suitable as second line anti-HCV tests when Ab screening is positive and RNA testing cannot be performed. Moreover, Geenius system provides an objective result in less than 30 minutes, which is compatible when a rapid diagnostic is required.     

Prospective study of mother-to-infant transmission of hepatitis C virus (HCV) infection

Seventy-five women with anti-hepatitis C virus (HCV) antibody were enrolled prospectively during pregnancy or at delivery for study of mother-to-child transmission of HCV. Twenty-three women were coinfected with the human immunodeficiency virus (HIV). Seventy babies were monitored for at least 6 months. HCV infection was diagnosed in six infants (8.6%), four of whom were born to anti-HIV–positive mothers. HCV RNA was first detected between 2 and 6 months, and the genotypes of infected babies matched those of their mothers (type 1: n = 4; type 3: n = 2). Identical master sequences of the hypervariable region (HVR1) were detected in a mother–infant pair. In three babies coinfected with HCV and HIV, anti-HCV disappeared between 2 and 7 months, being persistently negative in two cases monitored for 11 and 26 months. Transmitting mothers did not differ significantly from those who did not transmit the infection with anti-HIV, HCV genotypes, and viral load at delivery, but had lower rate of reactivity to C100 by the recombinant immunoblot assay (RIBA) (P < .01). This prospective study confirms transmission of HCV from anti-HIV–negative mothers (4.4% in this series). Absence of anti-C100 antibodies at delivery is apparently related to increased risk of vertical transmission. Seronegative HCV infection can be observed in children coinfected with HIV. J. Med. Virol. 54:12–19, 1998. © 1998 Wiley-Liss, Inc.     

支持HCV 1b亚基因组复制的细胞模型的建立

目的 建立一个稳定支持中国人群HCV 1b亚基因组高效复制的体外细胞模型。方法 构建中国人群HCV 1b亚型亚基因组复制子质粒，通过体外转录的方法获得亚基因组复制子RNA，采用电穿孔技术把RNA转染到Huh-7.5.1细胞中，经过G418筛选含有HCV 1b亚基因组的细胞集落。RT-PCR检测细胞集落中的HCV亚基因组以及Western blot检测细胞集落中的HCV蛋白的表达。用干扰素（IFN）处理含有HCV亚基因组的细胞，观察细胞中HCV RNA的变化。结果 G418药物筛选得到了支持HCV1b亚基因组复制的细胞集落。RT-PCR 检测有HCV RNA NS4B的表达，Western blot检测有HCV的非结构蛋白NS5B的表达。IFN处理含有HCV复制子的细胞，HCV RNA水平明显降低。结论 成功建立了支持中国人群HCV 1b亚基因组高效复制的体外细胞模型，为进一步研究HCV致病机制、治疗药物筛选及疫苗方面的研究打下了基础。     

HBV、HCV合并感染患者血清抗丙肝抗体分片段与HCVRNA测定的意义

目的 探讨乙型肝炎病毒（HBV）、丙型肝炎病毒（HCV）合并感染患者与单HCV感染者血清抗HCV抗体分片段阳性率以及HCV RNA阳性率是否有显著性差异以及检测意义。方法 对76例同时感染HBV和HCV患者进行抗HCV抗体分片段以及HCV RNA检测,同时从同期仅感染HCV患者中随机抽取163例作为对照组进行以上检测。结果 HBV、HCV合并感染患者与单HCV感染者比较：抗HCV抗体分片段相同片段间比较差异无统计学意义,但其S/CO值比较差异有统计学意义（P〈0.01）;相同片段组合间除抗-C＋抗-NS3组合阳性率HBV、HCV合并感染患者比仅HCV感染患者显著要低（P〈0.05）外,其余各组合间比较差异无统计学意义（P〉0.05）;HBV、HCV合并感染患者HCV RNA阳性率比仅HCV感染患者低（P〈0.01或P〈0.05）。结论 HBV、HCV合并感染时HBV对HCV复制存在抑制作用,从而导致HCV RNA含量显著降低,合并感染与单独感染间抗HCV抗体分片段无显著性差异,但由于HCV复制受到抑制从而导致抗HCV抗体分片段含量降低,这对研究HBV、HCV合并感染时患者体内HBV对HCV间的抑制作用有一定意义。