HCV感染者个体化基因检测与疗效评估  

Individualized genetic testing and outcome of patients infected with HCV

作　　者：李艳华[1] 王娟[1] 李宏伟[1] 杨柳[1] 郝晓柯[1] 马越云[1] 

机构地区：[1]第四军医大学西京医院检验科,西安710032

出　　处：《免疫学杂志》2015年第10期888-892,共5页Immunological Journal

基　　金：陕西省科技计划项目(2013K12-05-10)

摘　　要：目的检测丙型肝炎患者IL-28B基因型与HCV亚型,探索IL-28B基因变异与慢性丙型肝炎（CHC）型别和抗病毒疗效的相关性。方法收集诊疗的51例慢性丙型肝炎（CHC）患者资料,对48例CHC患者进行聚乙二醇干扰素联合利巴韦林（PEGIFN/RBV）治疗24~48周,评估抗病毒疗效。焦磷酸测序的高通量基因组测序系统检测分析IL-28B基因多态性和HCV的亚型。结果48例CHC样本的HCV基因分型检测结果显示,2个基因型感染率较高：1b（60.43%）、2a（27.08%）;其获得SVR的比率分别是41.38%（12/29）和76.92%（10/13）,（χ2=25.68,P〈0.05）。患者IL-28B rs8099917 TT型、12979860 CC型、12980275 AA型获得SVR的比例分别（25/27,92.41%）、（26/28,92.86%）、（24/27,88.89%）（P〈0.001）。同时,无论HCV 2a还是1b型感染者中,IL-28B野生型（12979860 CC型）均更易获得SVR,但2a型HCV比率更高。结论 IL-28B SNP与HCV基因型对于慢性丙型肝炎患者接受PEGIFN/RBV治疗方案预后具有很高的预测和评估价值。This study aimed to explore the correlation of IL-28 B gene mutation and the type of chronic hepatitis C（CHC） with antiviral efficacy by analyzing of IL-28 B SNP and HCV genotype of hepatitis C patients.Data of diagnosis and treatment of 51 cases of CHC patient were collected at first. Then we evaluated the antiviral efficacy of the 48 cases of CHC which were treated with pegylated interferon plus ribavirin（PEG-IFN/RBV） for 24-48 weeks. IL-28 B gene polymorphism and HCV subtype were detected and analyzed with high-throughput genome sequencing system using pyrosequencing method. Data shown that, in the 48 CHC samples, two genotypes of HCV had higher possibility of getting infection： 1b（60.43%）, 2a（27.08%）. Sequential virus response（SVR） rates of 1b and2 a subtype were 41.38%（12/29） and 76.92%（10/13）, respectively. And there was significant difference between them（χ2=25.68, P 0.01）. The IL-28 B SNP rates of patients obtained SVR were IL-28 B rs8099917 TT（25/27,92.41%）, IL-28 B rs12979860 CC（26/28, 92.86%） and IL-28 B rs12979860 AA type（24/27, 88.89%）. In both of the HCV 2a and 1b infected patients, wild type of IL-28b（rs12979860 CC） was more likely to obtain SVR. Taken together, IL-28 B SNP and HCV genotype have very high prediction and clinical application value for PEG-IFN/RBV therapy and prognostic evaluation of CHC patients.

关 键 词：慢性丙型肝炎 白细胞介素28 单核苷酸多态性 HCV亚型 个体化 

分 类 号：R512.63[医药卫生—内科学] R440[医药卫生—临床医学]