慢性丙型肝炎患者外周血单个核细胞丙型肝炎病毒检测及其意义

The significance of detection of hepatitis C virus RNA in peripheral blood mononuclear cells of patients with chronic hepatitis C

目的 探讨外周血单个核细胞（ＰＢＭＣｓ） 在丙型肝炎病毒（ＨＣＶ） 感染中的作用。方法 对２２ 例慢性丙型肝炎患者、２１ 例抗ＨＣＶ（ ＋ ） 血液透析患者及１２ 例健康献血员的ＰＢＭＣｓ 分别进行ＨＣＶＲＮＡ，ＨＣＶ抗原检测及电镜观察。结果 （１）２２ 例慢性丙型肝炎患者ＰＢＭＣｓ 中有７７－３％ （１７／２２）ＨＣＶＲＮＡ 阳性；（２） 感染ＨＣＶ的ＰＢＭＣｓ 中电镜下发现复制的ＨＣＶ颗粒；（３） ＨＣＶ 颗粒阳性者的血清和ＰＢＭＣｓ 中ＨＣＶＲＮＡ 均阳性，与ＨＣＶ抗原和Ｆａｓ 抗原表达有明显相关，出现ＰＢＭＣｓ 胞浆内ＨＣＶ的表达和ＰＢＭＣｓ 凋亡性改变。结论 （１）ＨＣＶ可感染ＰＢＭＣｓ 并在其中复制；（２） ＰＢＭＣｓ 中的ＨＣＶ感染可能成为ＨＣＶ再感染的来源，从而导致感染的持续或复发。

Objective To determine the role of peripheral blood mononuclear cells (PBMCs) in hepatitis C virus (HCV) infection. Methods HCV RNA, HCV antigen and Fas antigen were detected in PBMCs of 22 patients with chronic hepatitis C, 21 renal dialysis patients with anti HCV positive and 12 health blood donors as normal controls. All specimens were studied by electronic microscope (EM). Results (1) The positive rate of HCV RNA in PBMCs of 22 patients with hepatitis C was 77 3%(17/22). (2) EM showed that HCV particles replicated in PBMCs of the patients with HCV infection , but not in the serum of patients with negative HCV RNA and healthy controls. (3) HCV RNA were positive both in the serum and PBMCs of 8 patients with HCV particles positive and had a close relationship with HCV antigen and Fas antigen. The expression of HCV and apoptosis were found in the cytoplasm of PBMCs in these 8 patients. Conclusion (1) Hepatitis C virus could replicate in PBMCs and produce infectoius HCV particles. (2) HCV in PBMCs may act as the source of reinfection for HCV and lead to persistent infection and recurrence.