Changes in peripheral blood during the antiviral treatment with Peg-IFNα-2 a and ribavirin for patients with chronic hepatitis C and the relationship between the changes and effect / 中华实验和临床病毒学杂志

Objective@#To observe the changes of peripheral blood image of chronic hepatitis C (CHC) patients treated with pegylated interferon (Peg-IFN) and ribavirin, and explore the relationship between the changes and serum virological respose (SVR).@*Methods@#Patients with CHC treated with Peg-IFN α-2 a and ribavirin in the Second Division of Liver Disease in Beijing Ditan Hospital were monitored for peripheral blood cells routine examination and Liver function, kidney function, thyroid function at baseline and week 2, 4, 8, 12, 24, 36, 48, and week 12, 24, 48 after the end of treatment for chronic hepatitis C, and HCV RNA.@*Results@#The decrease of peripheral blood cell counts began to appear at week 2 of treatment. For CHC patients without cirrhosis, white blood cells, lymphocyte, hemoglobin and platelets at week 2, while minimum values were seen at week 36, and the neutrophils reached the minimum value to at week 24. Significant recovery of the peripheral blood changes was seen at the end of treatment (48 weeks), and reached pre-treatment levels at week 48 after the end of treatment. For CHC patients with cirrhosis, white blood cells, lymphocytes, hemoglobin and platelets significantly decreased at week 2, while neutrophils reached a minimum value at 2 weeks. And hemoglobin and platelets reached a minimum value at 24 weeks, and the white blood cells reached the minimum value at weeks 24-36 besides lymphocyte reached the minimum value at week 36. Significant recovery was seen at the end of treatment (48 weeks), and the blood cell counts reached pre-treatment levels at 48 weeks after the end of treatment. For patients with CHC, hemoglobin decreased by more than 27.47% at week 4, which means that the patient would have a predictive significance for SVR, as well as the of PLT reduction by more than 36.96% at week 8.@*Conclusions@#During the treatment with Peg-interferon and ribavirin, the variation of blood picture has some predicting effect, which predicts the result of antiviral treatment.

Comparison of hepatitis C virus RNA and antibody detection method in population screening and its application / 国际检验医学杂志

Objective To investigate the application of hepatitis C virus RNA and antibody detection method in population screening.Methods The colloidal gold rapid test method and the enzyme-linked immunosorbent assay (ELISA)were adopted to detect hepatitis C virus (HCV)antibodies,and the real-time quantitative PCR (RT-PCR)was adopted to detect HCV-RNA viral load.Results (1)Among 539 samples,266 cases were antibody negative and 263 cases were antibody positive.(2)Among 67 cases in the HCV-RNA viral load 0.05).Conclusion In order to reduce the missed diagnosis rate and diagnose hepatitis C as early as possible,the above laboratory detection methods should be jointly applied and the comprehensive analysis should be conducted in population screening.

Predictive Role of Acute Phase Reactants in the Response to Therapy in Patients with Chronic Hepatitis C Virus Infection

BACKGROUND/AIMS: Biochemical parameters and acute-phase proteins (APPs) may provide complementary data in patients with chronic hepatitis C (CHC). We aimed to evaluate the predictive role of APPs in the response to antiviral therapy. METHODS: Forty-five patients underwent antiviral therapy. Serum ferritin, C-reactive protein (CRP), transferrin, albumin, alpha-1 acid glycoprotein (A1AG), and alpha-2 macroglobulin (A2MG) levels were examined at the initial evaluation and at the 4th, 12th, and 48th weeks. HCV RNA levels were examined at the initial evaluation and at the 12th and 48th weeks. RESULTS: Ferritin, transferrin, A1AG, and A2MG levels were significantly higher in the patient group (p<0.05). CRP, ferritin, A1AG, and A2MG levels were significantly increased from baseline to the 4th week (p<0.05). The responders and nonresponders to antiviral therapy had insignificantly but remarkably different levels of CRP, ferritin, transferrin, A1AG, A2MG, and alanine aminotransferase (ALT) both at the initial evaluation and at the 12th week. CONCLUSIONS: Variations in ferritin, A1AG, A2MG, albumin, CRP, and transferrin levels are not alternatives to virological and biochemical parameters for predicting an early response to therapy in patients with CHC. However, the investigation of ALT levels and hepatitis C virus RNA in combination with acute-phase reactants may provide supplementary data for evaluating responses to antiviral therapy.

Quantitation of Hepatitis C Virus RNA by Competitive RT-PCR and DNA-ELISA Method / 대한간학회지

BACKGROUND/AIMS: Quantitation of Hepatitis C Virus (HCV) RNA in serum is important for monitoring the response to interferon-alpha therapy in patients with chronic hepatitis C. Several commercial assays are recently available, but they are expensive and cannot be used as a gold standard. METHODS: An in-house competitive reverse transcription-polymerase chain reaction (cRT-PCR) was developed and validated. The procedure involves the construction of a mutant and wild type HCV RNA internal standard (IS), cRT-PCR, and colorimetric detection with DNA-ELISA. A standard curve was obtained and used for final HCV RNA quantitation. RESULTS: The standard curve was linear over the range of 1x104 to 5x107 copies/mL of the HCV RNA standard (r=0.976). This in-house cRT-PCR was comparable with the branched DNA (bDNA) assay (Quantiplex HCV 2.0, Chiron, USA) with positive correlation between the two tests (r=0.735). CONCLUSION: The quantitation of HCV RNA by in-house cRT-PCR and DNA ELISA was more sensitive and had wider range of detection compared to bDNA assay. This assay is useful for follow-up of HCV RNA concentration after interferon-alpha therapy.

Detection of hepatitis C virus RNA by polymerase chain reaction: Design of amplification primers.

New sets of primers for amplification of hepatitis C virus (HCV) RNA were designed from the conserved regions of American and Japanese isolates of HCV. Primers set A amplified parts of the 5’-untranslated and core gene regions, whereas set B amplified parts of the core and envelope gene regions. PCR amplification were carried out from HCV RNA isolated from sera of 13 Thai patients with antibody to HCV, using these newly developed primers. HCV RNA was detectable in 8 patients (61.5%). Of those PCR positive samples, only 4 patients (50%) were positive with primer set A, whereas 7 patients (87.5%) were positive with primer set B. Interestingly, 4 patients were tested positive with only set B, 3 patients with both sets A and B, and just one patient with set A only. This result suggests that PCR assay as a diagnostic tool for HCV may need to be carried out with more than one primer set. The relatively low percentage of PCR positivity of the HCV from Thai patients using primer set A, which was previously identified as the most conserved region of the HCV genome, also indicates that the sequence of the Thai isolates of the virus may be different from those of the American and Japanese strains.