干扰素α治疗慢性丙型肝炎干扰素中和抗体的产生及其对抗病毒治疗疗效的影响  

Generation of neutralizing anti-interferon antibodies and its influence on the interferon-alpha (IFN-alpha) treatment for chronic hepatitis C

作　　者：张文杰 李朝霞 田淑菊 毛维武 龚晏萱 屈延 

机构地区：[1]甘肃省第二人民医院感染科,甘肃兰州730000

出　　处：《临床肝胆病杂志》2010年第1期27-30,共4页Journal of Clinical Hepatology

摘　　要：目的探讨干扰素中和抗体的产生与干扰素治疗慢性丙型肝炎临床疗效的关系。方法纳入92例初治慢性丙型肝炎患者,应用干扰素α-1b(IFNα-1b)、聚乙二醇化干扰素α-2a(PegIFNα-2a)开始(48-72)周的抗病毒治疗,用酶免疫法(EIA)检测治疗前及治疗不同时期血清中的干扰素总抗体,同时应用抗病毒中和生物鉴定法(ANB)检测干扰素中和抗体(NA)。结果92例患者中共有16例出现NA阳性,阳性率为17.39%,反弹组干扰素中和抗体的阳性率明显高于完全应答组(P<0.05),而难治性丙肝患者中和抗体阳性率亦明显高于完全应答组(P<0.05)。多元Logistic回归分析显示,治疗前HCVRNA水平为NA阳性的影响因素。结论临床应用干扰素治疗慢性丙型肝炎患者出现反弹与NA阳性率显著相关。干扰素中和抗体的产生可能是导致难治性丙肝产生的因素之一。Objective The aim of this study was to evaluate the relationship between neutralizing antibodies to interferonalpha and its effect on the interferon antiviral treatment in patients with chronic hepatitis C.Methods The total anti-IFN Ab and neutralizing antibodies（NA） were detected by enzyme immunoassay（EIA） and antiviral neutralizing bioassay（ANB）,respectively.The antibodies were measured in the serum of 92 patients with chronic hepatitis C before treatment and in different periods during the treatment with IFN-α1b or PegIFNα-2a.Results Of the 92 patients,16 were positive for NA during the treatment course,resulting in an overall NA occurrence rate of 17.39% .The positive rates of NA were significantly higher in group of responders with breakthrough than the group with sustained virological response（SVR）（P〈 0.05）;meanwhile,the NA incidence rate was significantly higher in difficult-to-treat population in Hepatitis C than the group of SVR（P〈 0.05）.Multinomial logistic regression analysis showed a positive correlation between the positive rates of NA and pretreatment HCV RNA level.Conclusion The phenomenon of break through during antiviral therapy with IFN-α seems to be an obvious consequence of anti-IFN neutralizing antibody.The development of NA may be one of the factors for difficult-to-treat population in Hepatitis C.

关 键 词：慢性丙型肝炎 聚乙二醇化干扰素 干扰素中和抗体 难治性丙肝 

分 类 号：R512.63[医药卫生—内科学]