초록
만성C형 간염환자 160예를 대상으로 immunoblot방법과 RT-PCR-hybridization법을 실시하여 임상검사의 유용성을 알아보았다. 양성 150예 중 133예만 RT-PCR-hybridization 법에서 양성을 나타내어 immunoblot법의 진양성율은 88.6%를 나타났으며 두 방법 간의 일치율은 89.3%를 나타났다. 한국인의 HCV 아형을 알기 위하여 혈청형과 유전형을 실시하였다. HCV혈청형 1형과 2형 그리고 1b와 2a유전형이 가장 많은 C형간염 감염원으로 나타났다. 49예를 혈청형과 유전형을 서로 비교한 결과, 혈청형 검사에서 28예(57.1%)가 1형, 21예(42.9%)가 2형으로 나타났으며 유전자형 검사에서 1b형이 25예(51.0%), 1b/2b를 나타낸 예가 1예(2.0%), 2a형이 17예(34.7%), 2a/2c를 나타낸 예가 4예(8.2%), 그리고 2b형이 2예(4.1%)로 나타났다. 본 연구에서는 HCV 간이검출법으로는 immunoblot방법이 유용하며, immunoblot방법 양성 확진검사로는 RT-PCR-hybridization법을 실시하였다. 혈청형이 C형간염의 치료 나 진행과정을 관찰하기 위해서는 유전형보다 유용하나 인터페론 치료효과는 1형과 2형 혈청형별에 따라 차이를 보이지 않았다.
To determine the clinical utility of an immunoblot test and RT-PCR-hybridization test, 160 samples from patients with a chronic HCV infection were analyzed by two tests. A total of 133 samples out of 150 positive samples were positive by RT-PCR-hybridization. The true positive rate of the immunoblot tests and the concordance rate of the two tests was 88.6% and 89.3%, respectively. Serotyping and genotyping were performed to evaluate the distribution of the HCV subtype in Korean isolates. HCV serotypes 1 and 2, and genotypes 1b and 2a were the most common sources of HCV infections in this group. In 49 cases studied with the serotypes and genotypes, serotypes 1 and 2 were 57.1% and 42.9%, respectively. Genotypes 1b, 1b/2b, 2a, 2a/2c, and 2b were 51.0%, 2.0%, 34.7%, 8.2%, and 4.1%, respectively. This study shows that immunoblot tests are more useful for screening HCV infections. The RT-PCR-hybridization test confirmed the HCV infection in patients with positive immunoblot test results. The serotype test is preferred over the genotype test for monitoring the progression or response to treatment. On the other hand, there were no significant differences in the response to an ${\alpha}$-interferon treatment of HCV infection with serotype type 1 or type 2 in Korea.
