丙型肝炎病毒课件.ppt

Result-3 HCV 抗体水平、核心抗原浓度与CD4计数 在HCV/HIV共感染组（HIVpos-CHC）内，HCV Abs与CD4计数（1000/μl）之间为显著正相关（r=0.3155, p=0.0033）； HCV核心抗原浓度与CD4计数（1000/μl）之间为显著负相关（r=-0.2847, p=0.0083）； HCV RNA载量与CD4计数之间没有相关性（r=-0.1657, p=0.1295）。 Conclusion 在HCV/HIV共感染患者中，HCV抗体的S/CO比值明显降低，该结果提示实际工作中判断HCV抗体阳性的标准要有别于HCV单感染者； 在HCV/HIV共感染患者中，血浆HCV核心抗原定量检测在判断HCV复制及其与宿主免疫状态之间的关联性上，具有一定优势，可作为HCV RNA载量好的替代指标； 依据我们的研究结果，抗-HCV检测在低CD4+的HCV/HIV人群中，存在漏检的可能性。 在免疫缺陷人群HCV 核心抗原是否可以做为HCV抗体检测的补充或替代？ * 谢谢 * * * * * * * * * * * * * * * * * * * * * * * * * * * Hepatitis C, 2003　丙型肝炎，2003 Prevalence of infection　感染的流行程度 * Anti-HCV detecting is useful for screen, and a primary assay to diagnose HCV infection as well. Anti-HCV can be detected by enzyme immunoassays (EIAs), enhanced chemiluminescence immunoassays (CIAs) or electrochemiluminescence assays (ECLIAs), either in the serum or in plasma. FIGURE: Since 1990, the anti-HCV assay has evolved from the first-generation assay to the third-generation one. The specificity of the approved anti-HCV EIAs is 99%. However, even a specificity of 99% does not provide the desired predictive value among the population with a low prevalence of infection. Among the immunocompetent populations with anti-HCV prevalences 10%, the proportion of false-positive results ranged from 15% to 60%. Therefore, samples negative in an approved EIA can be reported as anti-HCV negative and samples reactive in an approved single EIA can be reported as anti-HCV positive provided the signal-to-cut-off ratio is sufficiently high to be predictive of a true positive. However, it should be noted that individuals on hemodialysis or coinfected with HIV might be HCV RNA positive but anti-HCV negative. * * * * * * HCV receptors/entry factors Intracellular GAGs (Barth et al., 2003) (Pileri et al., 1998) CD81 (Scarcelli et al., 2002) SR-BI Linear polysaccharides on proteins of all human cell surfaces Tetraspanin superfamily member Expressed in all nucleated cells Part of B-cell receptor complex