献血人群HCV感染者自然转归与HLA-Ⅱ类等位基因的关系  

The correlation between the natural outcomes of HCV infection and HLA polymorphism among voluntary blood donors

作　　者：付萍萍 黄杰庭[2] 宋丹丹[3] 黄珂[2] 许茹[2] 廖峭[2] 单振刚[2] 梁明月[2] 戎霞[2] 付涌水[2] 王敏[2] 

机构地区：[1]江西省抚州市中心血站献血服务科,344000 [2]广州血液中心临床输血研究所,广州510095 [3]南方医科大学生物技术学院,广州510515

出　　处：《广东医学》2016年第24期3738-3742,共5页Guangdong Medical Journal

基　　金：国家自然科学基金资助项目(编号:81273145)

摘　　要：目的 了解广州献血人群中丙型肝炎病毒（HCV）感染者自然转归与HLA多态性的相关性,为HCV治疗策略的制定、预后的评估及疫苗的研制提供科学依据。方法 选取广州献血人群中373例HCV感染者,分为两组：自发清除组（133例）和慢性感染者（240例）,利用HLA-SBT方法对373份感染者进行HLA-Ⅱ类等位基因分型,用2检验分析每个HLA等位基因频率在自发清除组和慢性感染组的分布是否存在差异,并应用多因素Logistic回归对可能影响HCV自然转归的多种因素进行分析。结果 自发清除组与慢性感染组相比年龄较小[（28.2±9.9）岁vs（31.3±9.0）岁,t=-2.998,P=0.003],HCV自发清除组女性比例较高（34.6%vs 17.9%,2=13.090,P〈0.01）。DQB1＊05：02（P=0.002,OR=0.411,95%CI=0.232~0.727）和DRB1＊14：54（P=0.027,OR=0.350,95%CI=0.132~0.926）在慢性感染组中更为多见,DRB1＊11：01在自发清除组较为常见（P=0.007,OR=2.169,95%CI=1.223~3.848）。多因素logistic回归分析发现,年龄（P〈0.01,OR=1.035,95%CI=1.018~1.053）、性别（P〈0.01,OR=0.423,95%CI=0.297~0.603）和DQB1＊05：02（P=0.016,OR=0.480,95%CI=0.264~0.873）、DRB1＊11：01（P=0.016,OR=2.072,95%CI=1.142~3.758）等位基因是HCV感染自然转归的独立相关因素。结论 女性、较年轻的HCV感染者比较容易发生自发清除,携带DQB1＊05：02等位基因的人群在感染HCV后更易发生慢性化,携带DRB1＊11：01基因则容易发生自发清除。Objective To evaluate the correlation between the natural outcomes of hepatitis C virus （HCV） infection and HLA polymorphism among Guangzhou blood donors, which could provide scientific data for treatment, prevention and vaccine development of HCV. Methods A total of 373 HCV infection blood donors, who donated in Guangzhou blood center, were recruited, including 133 blood donors with spontaneous HCV clearance and 240 with HCV persistent infection. Sequencing - based typing （SBT） methodology was used for detection of genotype HLA class Ⅱ alleles. The differences in allelic frequencies of HLA - DPB1, DQB1 and DRB1 between spontaneous clearance group and persistent infection group were analyzed using the χ^2 test. Multivariate logistic regression analysis was applied to identify independent factors associated with natural outcomes of HCV. Results The participants in spontaneous HCV clearance group were significantly younger （P = 0. 003 ） , and with significantly higher female/male ratio （34.6% vs. 17.9% , 2 = 13. 090, P 〈 0. 01 ） than those in HCV persistent infection group. HLA - DQB1 ＊ 05：02 （P = 0. 002, OR = 0. 411, 95% CI = 0. 232 - 0. 727） and DRB1 ＊ 14：54 （P=0. 027, OR=0. 350, 95%67=0. 132 -0. 926） were significantly more frequent in HCV persistent infection group, while the frequency of DRB1 ＊ 11：01 was significantly higher in spontaneous HCV clearance group （P = 0. 007, OR = 2. 169, 95 % CI = 1. 223 - 3. 848 ）. The following variables were found independently associated with HCV clearance, age （ P 〈 0.01, OR = 1. 035,95 % CI = 1. 018 - 1. 053 ） , gender （ P 〈 0.01, OR = 0. 423,95% CI = 0. 297 - 0. 603 ）, and HLA - DQB1 ＊ 05：02 （P = 0. 016, OR = 0. 480, 95 % CI = 0. 264 - 0. 873 ）, and HLA - DRB1 ＊ 11：01 （P =0. 016, OR = 2. 072, 95% CI = 1. 142 - 3. 758）. Conclusion Our results show that female and young subjects are more likely to have HCV spontaneous clearance. After HCV infection, subjects who carry DQB1 ＊ 05：02 are more likely t

关 键 词：丙型肝炎病毒 人类白细胞抗原 无偿献血者 自然转归 

分 类 号：R457[医药卫生—治疗学]