抗HCV阳性患者体液中正链和负链HCV RNA的检测及意义

DETECTION AND SIGNIFICANCE OF PLUS-AND MINUS HCV RNA IN BODY FLUIDS OF ANTI-HCV POSITIVE PATIENTS

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HCV RNA。患者血清和体液中HCV RNA的检出率分别为: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)。其是,血清HCV RNA阴性患者的体液HCV RNA均为阴性,而体液HCV RNA阳性患者血清HCV RNA均阳性,这表明体液和血清中HCV存在状况密切相关。仅4例患者唾液中负链HCV RNA检测结果阳性,而所有受检精液和阴道分泌物中负链HCV RNA均为阴性,提示部分患者唾液腺中可能存HCV复制中间体。本研究结果提示家庭内接触(包括性接触)存在传播HCV感染的潜在危险性。为此,有必要对HCV感染者进行抗病毒治疗和适当隔离。

The saliva, sperm .vaginal discharge as well as the sera of anti-HCV positive patients were examined for HCV RNA with RT-nested PCR technique. The positive rates of HCV RNA were 23. 81% (10/42) in saliva,36. 36% (4/ 11) in sperm, 15. 38% (2/13) in vaginal discharge and 69. 05% (29/42) in serum .respectively. All body fluids HCV RNA positive patients were serum HCV RNA positive,while no case of body fluids HCV RNA positive was found among those whose sera were HCV RNA negative. This suggests strongly that the status of HCV in body fluids could be closely associated with the existance of HCV in serum. Only 4 patients were minus HCV RNA positive in their saliva,but none in the sperm or vaginal discharge. This meant that HCV probably replicated in saliva glands as reported previously. Our results showed that there were potential risks of transmission of HCV infection through household contact (including sexual contact) with HCV infected patients. The serum HCV RNA positive patients should be subject to antiviral treatment and adequately isolated.