目的 探讨丙型肝炎患者血清HCV RNA载量与基因型的关系及其对抗病毒治疗疗效的影响.方法 113例慢性丙型肝炎患者接受聚乙二醇干扰素联合利巴韦林抗病毒治疗.采用实时荧光定量PCR法检测血清HCV RNA载量,应用CE1区测序遗传树比对分析法检测HCV基因型.结果 113例患者分别感染1b、2a、3a、3b和6a共5种基因亚型,其HCV RNA载量(lgcopies/ml)分别为6.6973±1.19245、6.0824±1.68603、6.8393±1.03400、6.5533±1.29577和7.1503±1.16115,经单因素方差分析无明显统计学差异(P=0.166);治疗前高血清HCV RNA载量者(≥107copies/ml)与低HCV RNA载量者(＜107copies /ml)完成治疗后获得SVR的比例,无论在所有患者(76.4%对75.9%,P=0.950),还是在HCV1型(66.7%对60.0%,P=0.641)或非1型感染者(82.4%对87.9%,P=0.526)中均无统计学差异.结论 治疗前血清HCV RNA载量与HCV基因型无关,血清HCV RNA载量对聚乙二醇干扰素联合利巴韦林抗病毒的疗效无明显影响.%Objective To investigate whether the level of viremia differs in accordance with genotypes and responses to pegylated interferon and ribavirin treatment in patients with chronic hepatitis C. Methods 113 patients with chronic hepatitis C were treated with pegylated interferon and ribavirin. The level of serum HCV RNA was measured with real-time quantitative reverse-transcription polymerase chain reaction and HCV genotypes were determined by core-envelope1 region nucleotide sequencing followed by phylogenic analysis. Results There were five different subtypes of HCV in 113 patients,including 1b (40.7％), 2a (13.3％), 3a (9.7％), 3b (17.7％) and 6a (18.6％).The serum HCV RNA (lgcopies/ml) of them were 6.6973±1.19245,6.0824±1.68603,6.8393±1.03400, 6.5533±1.29577 and 7.1503±1.16115,respectively;There was no significant relationship between serum HCV RNA and genotypes (F=1.652,P=0.166) ;The rate of SVR in patients with higher serum HCV RNA(≥107copies/ml) was similar to that seen in patients with lower serum HCV RNA (＜107copies/ml),whether in the total patients (76.4％vs.75.9％,P=0.950),or in the HCV1b infections(66.7％ vs.60.0％,P=0.641)or in the non-HCV1 infected patients(82.4％vs.87.9％,P=0.526).Conclusions The levels of HCV RNA differ neither in different subtypes of HCV infection nor in different responses to pegylated interferon and ribavirin therapy.
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