丙型肝炎患者血清中高变区1(HVR1)抗体的检测与分析

Detection of antibodies against hypervariable region 1 in sera from patients with hepatitis C

目的 了解丙型肝炎患者体内抗ＨＶＲ１ 的产生情况，并探讨其与病情发展及预后的关系．方法 用含ＨＶＲ１ 序列的合成肽对４５ 例急、慢性肝炎患者血清中抗ＨＶＲ１ 作了ＥＬＩＳＡ 检测，并对所有血清作ＨＣＶＲＮＡ 检测．结果 急性丙型肝炎患者血清中抗ＨＶＲ１ 阳性率为７０－６ ％ ，与慢性丙型肝炎患者早期血清（１２－５ ％ ） 相比差异显著性（ Ｐ＜ ０－０５） ，而且两者的平均抗体滴度相差亦非常显著（４－２ ±０－６ ｖｓ ２－８ ±０－７ ，Ｐ＜ ０－０１） ． 慢性丙型肝炎现症患者血清抗ＨＶＲ１ 的阳性率为７２－７ ％ ，其中抗ＨＶＲ１ 阳性血清中ＨＣＶＲＮＡ 的阳性率也很高（７５－０ ％ ） ．结论 ＨＣＶ 感染早期抗ＨＶＲ１ 的产生及其滴度的高低可能与疾病的转归有关；慢性丙型肝炎患者体内抗ＨＶＲ１ 的存在可能反映了ＨＶＲ１ 变异引起的免疫逃避．

AIM To investigate the antibody response directed to hypervariable region 1(HVR1) of hepatitis C virus (HCV) in hepatitis C patients and to evalulate the relationship between such antibody response and prognosis of hepatitis C. METHODS An ELISA using synthetic peptide containing HVR1 sequences was used for detection of anti_HVR1 in 45 sera cases. HCV RNA in above sera were also examined by reverse transcription polymerase chain reaction (RT PCR). RESULTS The positive rate of anti HVR1 was found to be significantly different between sera from acute hepatitis C patients (70 6%) and chronic patients within early infection period (12 5%, P <0 05), and the mean antibody titre (S/?N rate) between above two groups was also found significant (4 2±0 6 vs 2 8±0 7, P <0 01). In chronic hepatitis C infection patients, 72 7% of sera was anti HVR1 positive and 75 5% of those anti HVR1 positive sera was also found HCV RNA positive by RT PCR. CONCLUSION The antibody response against HVR1 and its level within early HCV infection may be associated with prognosis of hepatitis; the exiting anti HVR1 in chronic hepatitis C patients probably indicates immune escape caused by HVR1 mutations.