丙型肝炎病毒包膜区结构变异与临床的关系

Relationship between diversity of hepatitis C virus quasispecies and activity of liver disease

目的探讨丙型肝炎病毒（HCV）准种复杂性对疾病的影响。方法对44例未经干扰素治疗的HCVRNA阳性血清采用RT-PCR扩增HCV包膜区2（E2），单链构象多态性聚合酶链反应法（SSCP）获得HCV准种数，准种数大于2为复杂准种。结合病例的性别、年龄、HCV基因型及患者临床肝脏活动度指标ALT，用Logistic回归方法分析影响肝脏功能及丙型肝炎转归的因素。结果在ALT正常和异常的两组患者中，准种平均数分别为2．54±1．05和4．48±2．14（P〈0．05）。采用Logistic回归分析，在纳入了性别、年龄、基因型、疾病种类后，准种数目对ALT的影响仍然有意义，OR值为11．429，可信区间为2．449～53．342。但准种数目对肝硬化的影响无统计学意义。结论准种的复杂性是影响ALT指标的正常与否的重要因素，准种变异的数目越多，对肝脏的损害程度越高；ALT高于正常值的患者准种数目显著大于ALT在正常范围之内的患者。

Objective To evaluate the influence of quasispecies on different alanine aminotransferase（ALT） level in the patients with HCV infection. Methods Forty-four chronic hepatitis C patients were categorized into two groups according to ALT level. None of them received any antiviral therapy. HCV quasispecies diversity was determined by RT-PCR single-strand conformational polymorphism analysis of HVR1 in E2/NS1. The results were used to analyze the influence of quasispecies bands number on the patients with different disease progression. Results The quasispecies bands numbers for the two groups were 2. 54±1.05 and 4. 48±2. 14, respectively. Logistic regression analysis showed that the diversity was a role factor in ALT level. But we could not identify the relationship between cirrhosis and qusispecies. Quasispecies diversity is correlated with ALT level.