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目的探讨丙型肝炎病毒（ＨＣＶ）基因型与血清ＨＣＶＲＮＡ含量的关系及其对干扰素应答的影响。方法应用定量荧光ＰＣＲ（Ａｍｐｌｉｓｅｎｓｏｒ－ＰＣＲ）技术检测了１３５例不同基因型ＨＣＶ感染的慢性丙型肝炎患者血清ＨＣＶＲＮＡ含量，另对其中７７例进行干扰素治疗并随访１２个月以上。结果ＨＣＶ－Ⅱ型感染血清ＨＣＶＲＮＡ水平（１０７．８±３．４拷贝／ｍｌ）显著高于ＨＣＶ－Ⅲ型感染（１０６．３±２．５拷贝／ｍｌ）（Ｐ＜０．０１），Ⅲ型感染的应答率（７／１３，５３．８％）显著高于Ⅱ型感染（２０／６４，３１．３％）（Ｐ＜０．０５）。应答组治疗前血清ＨＣＶＲＮＡ含量（１０６．８±２．７拷贝／ｍｌ）显著低于无应答组（１０８．３±３．２拷贝／ｍｌ）（Ｐ＜０．０１）。ＨＣＶＲＮＡ含量低于１０６．５拷贝／ｍｌ者，无论何种型别ＨＣＶ感染均应答较好，而ＨＣＶＲＮＡ高于１０８．０拷贝／ｍｌ者则应答极差。结论ＨＣＶ基因型及病毒血症水平是预测干扰素疗效的重要因素，且后者比前者意义更大。Ⅱ型感染病毒血症水平较高可能是影响其疗效的原因之一。
Objective To investigate the relationship between hepatitis C virus (HCV) genotypes and serum HCV RNA levels and its effect on interferon response. Methods Serum HCV RNA levels were measured in 135 patients with HCV genotypes of chronic hepatitis C using quantitative fluorescent PCR (Amplisensor-PCR). Another 77 patients were treated with interferon and followed up for more than 12 months. Results The level of HCV RNA in HCV-Ⅱ infection group (107.8 ± 3.4 copies / ml) was significantly higher than that in HCV-Ⅲ infection (106.3 ± 2.5 copies / ml) (P <0.01) (7/13, 53.8%) was significantly higher than that of type II infection (20/64, 31.3%) (P <0.05). Serum HCV RNA levels (106.8 ± 2.7 copies / ml) in the response group before treatment were significantly lower than those in the non-responder group (108.3 ± 3.2 copies / ml) (P <0.01). Patients with an HCVRNA level of less than 106.5 copies / ml responded better regardless of the type of HCV infection, while those with HCVRNA levels above 108.0 copies / ml had poor response. Conclusion HCV genotypes and viremia levels are important predictors of the efficacy of interferon, and the latter is of greater significance than the former. Type II infection viremia levels may be one of the reasons that affect its efficacy.