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【摘要】：丙型肝炎病毒（HCV）感染的检测包括血清学检测和核酸检测（NAT），前者包括HCV抗体（抗-HCV）、核心抗原检测，后者包括定性/定量RNA检测和基因型/亚型检测。抗-HCV检测是应用最广的HCV感染筛查试验，操作简便、耗时短、成本低，但其缺点是窗口期较长，不能判别是活动性感染还是病毒已被清除，不适用于免疫缺陷人群。HCV RNA是病毒感染的直接证据，既往定性RNA检测灵敏度较高，但随着实时定量PCR技术的成熟，定量检测灵敏度不断提高，线性范围不断拓宽，适用于临床抗病毒治疗应答的监测，也正逐步取代定性检测用于血液制品的筛查。近年HCV抗原检测和抗原抗体联合检测试剂盒已用于HCV感染的筛查及治疗监测，但其灵敏度尚不及NAT。目前主流的HCV基因分型试剂检测基因型有较高的符合率，而检测亚型的结果存在较大差异，需要方法学上的改进。
【Abstract】：Diagnosis and treatment of hepatitis C virus (HCV) infection relies heavily on laboratory assays such as serological tests, which include the detection of anti-HCV antibody and coreantigen, and nucleic acid tests (NAT), which include the detection of qualitative/quantitative HCV RNA and genotypes/subgenotypes. Anti-HCV testing is simple, rapid and cheap for the screening of HCV infection. But it has a longer window period and not applicable in the immunosuppressed population. NAT provides direct evidence for the presence of HCV. Qualitative HCV RNA test has been used for blood screening due to its high sensitivity. Meanwhile quantitative HCV RNA testing has been widely used to monitor the antiviral response to treatment. With the development of real-time quantitative PCR the qualitative RNA assays are being replaced by the quantitative ones. Recently HCV core antigen assay and the combination antigen-antibody assay have been introduced for the early diagnosis of HCV, whereas they still remain less sensitive than NAT. Assays for the determination of HCV genotype based on sequencing, reverse hybridization or real-time PCR are highly consistent in determining genotypes. Whereas they are not very consistent in determining subtypes and need to be improved.
【关键字】：肝炎病毒属；肝炎，丙型
【Key words】：hepacivirus; hepatitis C
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