HBV基因型与干扰素抗病毒疗效的关系  

The Relationship between HBV Genotypes and Anti-virus Therapeutic Efficacy of Interferon

作　　者：陈进宇[1] 王鲁文 龚作炯[2] 

机构地区：[1]深圳市东湖医院,广东深圳518020 [2]武汉大学人民医院感染科,病毒学国家重点实验室

出　　处：《中西医结合肝病杂志》2005年第2期68-71,共4页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：武汉大学创新基金资助项目 (No 30 1 2 70 0 5 4 )

摘　　要：目的:探讨HBV不同基因型对α- 干扰素抗病毒疗效的影响。方法:选取应用α-干扰素进行抗病毒治疗的慢性乙型肝炎患者作为研究对象,观察其抗病毒疗效。患者的HBV基因型采用PCR微板核酸杂交 ELISA方法检测;血清HBVDNA复制水平采用荧光定量PCR检测;HBV前C区和BCP (基础核心启动子)区基因位点变异采用HBV基因多态性芯片进行检测。结果:94例慢性乙型肝炎患者的HBV基因型以C型、B型为主,未发现A、E、F基因型。HBVDNA高复制水平明显与C基因型及混合基因型有关。B基因型对α- 干扰素抗病毒治疗的应答明显优于C、D型,而混合基因型对α- 干扰素的应答最不敏感。仅B基因型对α- 干扰素治疗产生完全应答。部分应答及无应答时HBeAg的转阴与HBV前C区nt 1 896位点变异、以及BCP区nt 1 76 2、nt 1 76 4双位点变异有关。C基因型HBV前C区及BCP区基因变异发生率明显高于B型。结论:HBV基因型与HBVDNA复制水平、HBV基因变异以及α-干扰素抗病毒疗效均有一定的相关性,提示HBV基因分型有重要的临床意义。Objective:To study the effects of HBV genotypes on anti-virus therapeutic efficacy of α-Interferon(IFN)in chronic hepatitis B patients.Methods: The chronic hepatitis B patients, who were treated by α-IFN,were selected by expectation. The anti-virus therapeutic efficacies of these patients were observed. The HBV genotypes were detected by PCR microplate hybridization ELISA. The levels of serum HBV DNA replication were determined by fluorescent quantitative PCR. The HBV gene mutational sites of pre-C and BCP regions were assayed by using technology of gene chip. Results: The genotypes B and C were predominant in 94 chronic hepatitis B patients selected by expectation. The genotypes A,E and F were not found in these patients. The HBV DNA levels in genotype C and mixed genotype were significantly higher than in genotype B. The response to α-IFN in patients of genotype B were obviously excellent than genotype C and D,and complete response to α-IFN was only observed in genotype B. The response to α-IFN in mixed genotype was the most insensitive compared with other genotypes. The mutation rates of HBV pre-C and BCP region in genotype C were obviously higher than in genotype B. Conclusion:The results suggested that HBV genotype is correlate with the serum levels of HBV DNA,HBV gene mutations and therapeutic efficacy of α-IFN.The regular detection of HBV genotypes in clinic will benefit for identification of disease prognosis and adjustment of therapeutic strategy.

关 键 词：HBV基因型 抗病毒疗效 慢性乙型肝炎患者 荧光定量PCR检测 HBV前C区 α-干扰素 HBVDNA复制 ELISA方法 HBV基因变异 HBV基因分型 抗病毒治疗 微板核酸杂交 位点变异 C基因型 B基因型 BCP区 不同基因型 血清HBV 基因多态性 

分 类 号：R512.62[医药卫生—内科学] R978.7[医药卫生—临床医学]