慢性丙型肝炎患者第一高变区抗体的交叉反应性与抗病毒治疗早期病毒应答的关系

High cross-reactivity of hypervariable region 1 antibody of hepatitis C virus is associated with early virological response in chronic hepatitis C patients undergoing antiviral therapy

目的探讨慢性丙型肝炎患者血清第一高变区（HVR1）抗体的交叉反应性与抗病毒治疗早期病毒应答（EVR）的关系。方法用ELISA丙型肝炎病毒（HCV）HVR1抗体交叉反应性矩阵试剂检测抗HCV高变区抗体差异性，16条高变区抗原与患者血清交叉反应性比较采用Fisher精确概率检验。同时对2009年1月至12月首都医科大学附属北京佑安医院46例慢性丙型肝炎患者抗病毒治疗前基线血清标本进行分析。用荧光定量逆转录（RT）．PCR检测46例患者在治疗前、聚乙二醇干扰素联合利巴韦林治疗12周、48周的血清HCVRNA水平，并进行基因分型。结果46例慢性丙型肝炎患者中，HCV2a型16例，1b型30例；治疗12周及结束时分别检测HCVRNA，其中，EVR组33例，非EVR组13例；2a型EVR发生率[93．8％（15／16）]高于1b型[60．0％（18／30），x2=4．316，P〈0．05]。HCV1b型慢性丙型肝炎患者中，EVR组平均多靶点HVR1抗原阳性反应数目为（12±4）个，明显高于非EVR组[（74-5）个，t=2．797，P〈0．01]。经Fisher精确概率法检验，HVR1抗原编号分别为001、003、009、013、016的5条抗原在EVR组患者基线血清的反应阳性率明显高于非EVR组（P均〈0．05）。结论HVR1抗体的交叉反应性可能是一项抗病毒治疗疗效的预测指标。

Objective To discuss the relationship between the cross-reactivity of antibody against the hypervariable region 1 （ HVR1 ） of hepatitis C virus and early viral response （ EVR ） in patients undergoing antiviral therapy. Methods By ELISA and HCV HVR1 antibody cross-reactivity matrix reagent, the differences of anti-HCV hypervariable region antibody were tested in baseline serum from 46 patients with chronic hepatitis C before antiviral therapy. HCV genotyping and HCV RNA were analyzed by RT-PCR method. The HCV RNA assay was done at three time points： before treatment, pegylated interferon in combination with ribavirin therapy for 12 and 48 weeks. Results In 46 cases of chronic hepatitis C patients, there were 16 cases with HCV 2a type, 30 cases with lb and 33 patients obtained EVR. The EVR incidence of type 2a [ 93.8% （15/16） ] was higher than that of type 1 b[60. 0% （18/30） ,X2 = 4. 316,P 〈 0. 05 ]. In the EVR group of type lb chronic hepatitis C patients, the positive number of average multi-target HVR1 antigen was （12 ± 4）, which was significantly higher than that in the Non-EVR patients [ （7 ± 5 ）, t = 2. 797, P 〈 0. 011- By the Fisher exact test, it was showed that patients＇semm response to HVR1 antigens numbered 001, 003, 009, 013, 016 were higher in EVR group than those in non-EVR group, with statistically significant （ P 〈 0. 05 ）. Conclusion The cross-reactivity of HVR1 antibody may play an important role in predicting the effectiveness of antiviral therapy. （Chin J Lab Med,2012,35：630-633）