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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．
Objective To understand the anti-HVR1 production in patients with hepatitis C and to explore its relationship with the progression of disease and its prognosis. Methods Anti-HVR1 in sera of 45 patients with acute and chronic hepatitis were tested by ELISA with synthetic peptides containing HVR1 sequence and HCV RNA was detected in all sera. Results The positive rate of anti-HVR1 in serum of patients with acute hepatitis C was 70-6%, which was significantly different from that of early-stage hepatitis C patients (12-5%) (P <0-05) The difference in antibody titers was also significant (4-2 ± 0-6 vs 2-8 ± 0-7, P <0-01). The positive rate of serum anti-HVR1 in patients with chronic hepatitis C is 72-7%, and the positive rate of HCVRNA in anti-HVR1-positive serum is also high (75-0%). Conclusion The production of anti-HVR1 and the titer of anti-HVR1 in early stage of HCV infection may be related to the prognosis of disease. The anti-HVR1 in vivo may reflect the immune evasion caused by HVR1 mutation.