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目的 观察免疫活性细胞回输前后慢性丙型肝炎患者外周血丙型肝炎病毒 (HCV)滴度及C区和E2区CTL表位的变化情况。方法 定量PCR检测 4例接受免疫活性细胞回输的慢性丙型肝炎患者外周血HCV滴度 ,并利用分子克隆、基因测序和计算机辅助分析技术分析不同时间点不同分离株CTL表位的变化情况。结果 4例患者在接受免疫活性细胞回输前后血清ALT水平存在不同程度波动 ,其差值从第 2例患者的 5 8到第 1例患者的 198,同时HCV滴度也发生了较大变化 ,其变化倍数从第 3例患者的 2 5 .37倍到第 4例患者的 882 .35倍 ,其对数转换值的波动幅度在 1.4 0～ 2 .94之间。在免疫活性细胞回输后 4例患者外周血HCV滴度均出现了不同程度的一过性下降。在全部观察期内HCVC区和E2区的CTL表位编码区均未出现明确的变化。结论 机体免疫攻击状态发生改变时可引起患者体内丙型肝炎病毒滴度的变化 ,但不伴随目前观察的CTL表位编码基因的改变。
Objective To observe the changes of hepatitis C virus (HCV) titers and CTL epitopes in C and E2 regions of peripheral blood of patients with chronic hepatitis C before and after the delivery of immunocompetent cells. Methods Quantitative PCR was used to detect peripheral blood HCV titers in 4 patients with chronic hepatitis C receiving immunocompetent cells. Molecular cloning, gene sequencing and computer-aided analysis were used to analyze the CTL epitopes of different isolates at different time points. Results The serum ALT levels fluctuated to varying degrees in four patients before and after receiving immunocompetent cells. The difference ranged from 58 in the second patient to 198 in the first patient, with significant changes in HCV titer, The fold change from 25.37 times of the third patient to 882.35 times of the fourth patient fluctuated between 1.4 0-2.94. In the four immunosuppressed cells after transfusion, HCV titers showed different degrees of transient decline. No clear changes were observed in the CTL epitope coding regions in both HCVC and E2 regions during the entire observation period. Conclusion The change of the immune attack state may cause the change of hepatitis C virus titer in patients, but it is not accompanied by the change of the CTL epitope coding gene.