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目的探讨动态观测ＨＣＶ感染指标及序列变异的意义。方法ＥＬＩＳＡ方法检测抗ＨＣＶＩｇＧ、ＩｇＭ，ＲＴＰＣＲ方法检测ＨＣＶＲＮＡ，ＰＣＲ产物直接测序。结果６例感染ＨＣＶ的血透析患者抗ＨＣＶＩｇＧ的表现类型分为持续阴性及持续阳性两种；抗ＨＣＶＩｇＭ有四种表现：一过性阳性、间隙性阳性、持续阴性及持续阳性；ＨＣＶＲＮＡ检测多为间断阳性；同一患者不同时期感染的ＨＣＶ株Ｅ２／ＮＳ１区序列间存在差别，且ＨＶＲ１区基因变异与有无抗体生成有关。结论抗ＨＣＶＩｇＧ、ＩｇＭ、ＨＣＶＲＮＡ的动态检测对说明体内有无病毒存在，疾病有无慢性化倾向有重要的意义。ＨＣＶＥ２／ＮＳ１区基因变异对提示病毒逃避机体免疫清除，疾病向慢性化方向发展有指导意义。
Objective To explore the significance of dynamic observation of HCV infection index and sequence variation. Methods ELISA method was used to detect anti-HCV-IgG, IgM, RT-PCR method to detect HCVRNA, PCR products were sequenced directly. Results The expression of anti-HCV-IgG in 6 hemodialysis patients with HCV infection was divided into persistent negative and persistent positive. There were four manifestations of anti-HCV-IgM: transient positive, intermittent positive, persistent negative and persistent Positive; HCV RNA test mostly intermittent positive; the same patient infected with different stages of HCV strains E2 / NS1 sequence differences between the sequence, and HVR1 gene mutation with or without antibody production. Conclusion The dynamic detection of anti-HCV IgG, IgM and HCVRNA is of great significance to explain the existence of virus in vivo and the tendency of chronic disease. HCVE2 / NS1 gene mutation prompted the virus to evade immune clearance, the disease to the development of chronic Guidance.