周围血白细胞的复制型丙型肝炎病毒RNA的检测及临床意义

DETECTION OF REPLICATIVE FORM OF HCV RNA IN PERIPHERAL BLOOD LEUKOCYTES AND ITS CLINICAL SIGNIFICANCE

用简并引物作套式反转录。聚合酶链反应检测正、负链丙型肝炎病毒（ＨＣＶ）ＲＮＡ。显示３０例急、慢性丙型肝炎患者的血清及血浆中，７例无症状抗－ＨＣＶ阳性者的血清、血浆及周围血白细胞（ＰＢＬ／Ｃ）中，均未检出负链ＨＣＶＲＮＡ。慢性丙型肝炎者ＰＢＩ（中正、负链ＨＣＶＲＮＡ的检出率高于急性丙型肝炎及无症状抗－ＨＣＶ阳性者（Ｐ＜０．０５～０．００１）。１７例经肝组织学检查的患者中，急性肝炎（ＡＨ）者ＰＢＬ／Ｃ的正、负链ＨＣＶＲＮＡ检出率低于慢性活动性肝炎（ＣＡＨ）者（Ｐ＜０．０５）。１例ＡＨ及６例ＣＡＨ患者肝组织内正、负链ＨＣＶＲＮＡ全部阳性。证实丙型肝炎患者的ＰＢＬ／Ｃ确可被ＨＣＶ感染，病程越长，被ＨＣＶ感染的可能性越大；病情活动者，ＰＢＬ／Ｃ中负链ＨＣＶＲＮＡ的检出率越高。提示ＨＣＶ不仅可以感染ＰＢＬＣ，而且可在其中复制；负链ＨＣＶＲＮＡ的出现与病情活动有关。

ested RT-PCR,done by using degenerated primer pair,was used to detect hepatitis C virus RNA(HCV RNA)in serum, plasma,liver and peripheral blood leukocytes(PBLC)of 30 patients with acute and chronic posttransfusion hepatitis C and 7 asyrnptomatic anti-HCV positive subjects. The results showed that the percentage of positive HCV RNA in PBLC,including both the plus and minus strands,in patients with chronic hepatitis C was significantly higher than that in acute hepatitis C and asymptomatic anti-HCV positive suects(P<0.05～0.001 ).All the 7 asymptomatic anti- HCV positive subjects did not have detectable minus strand of HCV RNA in their PBLC,serum or plasma。 In 17 patients who had liver histologic examination,the positive rate of both strands of HCV RNA in PBLC of acute hepatitis(AH) was lower than that of chronic active heoatitis (CAH)(P<0.05).Both strands of HCV RNA were detected in he liver of one AH and 6 CAH patients,The present data confirmed thdt PBLC of patients with hepatitis Cwere indeed infected by HCV,The longer the infection time,the more the chance of PBLC being infect- ed by HCV. Patients with active liver disease(CAH)had usually higher positive rate of minus strands of HCV RNA in PBLC. In the serum and plasma of all the 37 cases,minus strand of HCV RNA was not de- tected and the positive rate of the plus strand of HCV RNA in their serum and plaxma was similar. Fur- thermore,the positive rate of both plus and minus strands of HCV RNA in PBLC of 3 0 patients with chronic hepatitis Cwas also similar.It is suggested that HCV not only may infect PBLC,but also replicate in PBLC and that the occurrence of minus strand of HCV RNA is associated with activitv of liver disease.