白细胞介素-28Brs12978960多态性与1b型慢性丙型肝炎复发者聚乙二醇干扰素联合利巴韦林再治疗疗效的相关性研究  

Correlation study of interleukin-28B rs12978960 genetic polymorphism and the retreatment efficacy of peginterferon/ribavirin in chronic hepatitis C genotype lb relapsers

作　　者：曾艳丽[1] 何佳[1] 宁会彬 魏君峰[1] 李威[1] 毛重山[1] 尚佳[1] 康谊[1] 

机构地区：[1]河南省人民医院感染性疾病科,郑州450003

出　　处：《中华传染病杂志》2015年第7期415-419,共5页Chinese Journal of Infectious Diseases

基　　金：国家自然科学基金青年科学基金资助项目(81401706)；河南省医学科技攻关项目(201303120)；河南省科技厅基础与前沿技术研究项目(142300410372)；河南省科技厅科技攻关项目

摘　　要：目的分析基因1b型慢性丙型肝炎（CHC）复发型的患者再次进行聚乙二醇干扰素（peg—IFN）联合利巴韦林（RBV）治疗时的病毒学应答情况，探讨IL-28Brs12978960基因多态性对再治疗患者病毒应答及疗效的影响。方法对河南省人民医院感染性疾病科2012年至2014年收治的CHC复发患者采用peg—IFN联合RBV治疗48周并随访24周，检测宿主IL-28Brs12978960基因的多态性，分析患者抗病毒治疗的病毒学应答情况，以及与持续病毒学应答（SVR）相关的预测因素。计量资料采用独立样本t检验，计数资料采用y。检验或Fisher确切概率法。结果61例患者完成peg—IFN联合RBV治疗48周并随访24周，平均年龄（46．7±12．4）岁，男37例（60．7％），rs12978960CC基因型49例（80．3％）。经过peg—IFN／RBV治疗48周并随访24周后，达到SVR者40例（65．6％）。年轻患者能获得较高的快速病毒学应答（RVR）率和SVR率，差异均有统计学意义（均P〈0．05）；IL28Brs12978960基因型对RVR和SVR有预测价值，获得RVR和SVR的患者CC基因型携带率更高（均P〈0．05）。CC基因型相对于CT／TT型的患者可获得较高的RVR（34．1％比0，x^2=10．625，P=0．006）、治疗结束时病毒学应答（84．1％比70．6％，x^2=5．563，P=0．039）和SVR（77．3％比35．3％，x^2=9．572，P=0．007），而延长快速病毒学应答（34．1％比29．4％，x^2=0．122，P=0．809）、早期病毒学应答（79．5％比82．3％，x^2=0．612，P=0．964）与CT／TT基因型患者之间差异无统计学意义。结论基因1b型CHC复发患者仍需再次抗病毒治疗。IL-28Brs12978960基因多态性与再治疗SVR率密切相关，尤其是对未获得RVR的患者更具预测价值，为CHC患者个体化抗病毒治疗和优化诊疗方案提供了有利依据。Objective To investigate the virological response in hepatitis C virus （HCV） genotype lb relapsers after 48 weeks of peginterferon/ribavirin （peg-IFN/RBV）combination retreatment, and to explore the predictive value of interleukin （IL）-28B rs12978960 genetic polymorphismon virological response. Methods From 2012 to 2014, genotype lb chronic hepatitis C（CHC）relapsers in He＇ nan Provincial People＇s Hospital were retreated with combined peg-IFN/RBV for 48 weeks and followed up for 24 weeks off-treatment. Host IL-28B genetic polymorphism was detected. Predictive factors associated with virological response and sustained virological response （SVR） were analyzed. Independent-samples t test was conducted in continuous variables, while x^2 test or Fisher exact probability test was conducted in counts data. Results A total of 61 patients finished 48 weeks of peg-IFN/RBV combination therapy and were further followed up for 24 weeks off-treatment. Mean age was （46.7±12.4） years. Thirty-seven patients （60.7%） were male and 49 were rs12978960 CC genotype. After 48 weeks of retreatment with peg-IFN/RBV and 24 weeks of off-treatment follow-up, 40 patients （65. 6%） achieved SVR. Rapid virological response （RVR） and SVR of younger patients were both significantly higher than those of older patients （100.0% vs67.4% and 85.0% vs 47.6%, respectively; both P=0.006）. IL-28B rs12978960 genotype was predictive to RVR and SVR. Patients with RVR and SVR had higher carriage rates of IL-28B rs12978960 CC genotype compared with those without RVR and SVR （both P〈0.05）. Patients with CC genotype had higher rates of RVR （34.1% vs 0 ;x^2= 10. 625, P = 0. 006）, end-of-treatment virological response （84. 1% vs 70. 6% x^2=5. 563, P=0. 039） and SVR （77. 3% vs 35. 3% x^2 9. 572, P=0. 007） than those with CT/TT genotype. However, there were no statistical differences of extendedRVR （34. 1% vs 29. 4~; x^2=0.122,P=0.809） and early virological response （79. 5% vs 82.3% x^2 =0. 612, P= 0.

关 键 词：IL28B基因 多态性 单核苷酸 再治疗 复发 肝炎 丙型 慢性 

分 类 号：R512.63[医药卫生—内科学]