만성 C형 간질환에서 C형 간염바이러스 항원에 대한 항체 발현양상의 임상적 의의 = Patterns of Antibodies to Hepatitis C Virus in Patients with Type C Chronic Liver Disease and Their Relationship to Disease Acivity and Viral Replication만성 C형 간질환에서 C형 간염바이러스 항원에 대한 항체 발현양상의 임상적 의의

다국어 초록 (Multilingual Abstract)

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다국어 초록 (Multilingual Abstract)

Hepatitis C virus(HCV) infection induces host antibody response to different structural and non structural viral proteins. Immunoblot assays with recombinant viral proteins or synthetic peptides are available to identify specific antibodies. However, little is known about the rela- tionship of antibody patterns to viral replication and disease activity. To investigate the clinical significance of different patterns of antibodies to HCV defined by line immunoassay(LIA) in chronic HCV infection, we compared the results of LIA assay with disease activity and HCV RNA positivity in 133 cases including 8 healthy carriers, 62 chronic hepatitis, 44 liver cirrhosis and 19 hepatocellular carcinoma, Among 133 cases, 128(96%) were antibody positive for C2 antigen, whereas positive rates of antibody for NS4 and NS5 antigens were 66% and 58%, respectively. Four patterns of antibody reactivity were observed ; pattern A[core(+), NS4(+), NS5(+)], pattern B[core(+), NS4(+), NS5( )], pattern C[core(+), .JS4( ), NS5(+)] and pattern D[core(+), NS4( ), NS5( )]. Pattern A was most frequently observed, and found in 55 cases(41% ). Past history of blood transfusion was frequently noted in pattern A and D. Pattern D showed lower ant HCV O.D./cut off and HCV RNA positivity than other patterns, but it was not statistically significant. In chronic hepatitis, serum ALT level was highest in pattern C and lowest in pattern D, although statisti- cally not significant. Serum anti HCV O.D./cut off, ALT level in chronic hepatitis and HCV RNA positivity were higher in NS antigen reactive group than non reactive group. Pattern D was more frequent in healthy carriers. In contrast to healthy carriers, NS reactivity was more than 80% in chronic hepatitis, liver cirrhosis and hepatocellular carcinoma. Pattern A was most cornmon in chronic hepatit,is and hepatocellular carcinoma, whereas pattern B was more frequent than pattern A in liver cirrhosis. It is suggested that the presence of antibodies to NS epitopes of HCV might be related to viral replication and activity of liver disease.(Korean J Gastroenterol 1994; 26: 833 841)