青岛地区宿主IL-28B基因多态性及HCV基因型对慢性丙型肝炎抗病毒疗效的影响  

Effect of IL-28B gene polymorphism and HCV genotype on treatment of chronic hepatitis C in Qingdao District

作　　者：史昌河 宋秀云 魏阳[2] 周永 

机构地区：[1]山东省青岛市第六人民医院五病区,青岛市266033 [2]山东省枣庄市立医院,枣庄市277000

出　　处：《中华实验和临床感染病杂志（电子版）》2017年第1期45-50,共6页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：青岛市医疗卫生优秀人才培养项目(No.2010-WSZD081)

摘　　要：目的了解青岛市HCV基因型和宿主IL-28B基因多态性以及二者对CHC患者抗病毒治疗应答的影响,为慢性丙型肝炎患者个体化治疗提供一定指导。方法纳入40例慢性丙型肝炎初治患者,治疗前检测其HCV基因型、病毒载量以及人IL-28B基因型等指标,采用长效干扰素联合利巴韦林抗病毒治疗并定期随访患者的疗效。结果 HCV基因1a、1b、2a、3a型感染者例数分别为1、28、10和1例。宿主IL-28B基因SNP rs12979860 CC型28例,CT型12例;SNPrs8099917 GT型8例,TT型32例。治疗结束后随访24周共29例患者获得持续病毒应答率(SVR)。治疗2周时获得病毒学应答组与非应答组患者比较,两组获得的RVR(χ~2=11.25、P=0.001)和SVR(χ~2=15.09、P<0.001)患者例数差异均有统计学意义。双变量相关分析结果显示,HCV非1b型,IL-28B SNPrs12979860 CC型和SNP rs8099917 TT型均与抗病毒治疗2周时应答率、RVR、SVR显著相关(P均<0.05)。结论青岛地区CHC患者HCV基因型以基因1b型为主;青岛地区CHC患者IL-28B SNP位点以rs12979860 CC型和rs8099917 TT型为主;HCV基因型、IL-28B单核苷酸多态性可作为预测抗病毒疗效的指标,可用于指导慢性丙型肝炎的个体化治疗。Objective To investigate the genotype of HCV and host IL-28 B genotype polymorphism in Qingdao Distinct,and their influence on antiviral treatment of chronic hepatitis C（CHC）,so as to provide individualized treatment guidances to patients.Methods Total of 40 patients with CHC were enrolled,HCV genotypes,viral load and IL-28 B genotypes of those patients were detected before treatment;those cases were given antiviral therapy of long-term interferon combined with ribavirin,and regular follow-up were carried out.Results There were 1,28,10 and 1 cases of HCV genotype la,lb,2a and 3a groups,respectively.The patients with host IL-28 B gene SNP CC type and CT type were 12 and 28 cases;the SNPrs8099917 type Gt and type TT were 8 and 32 cases.Total of 29 patients got sustained viral response（SVR） at the end of treatment for total 24 weeks followed.Compared with the patients in non-response group after 2 weeks of treatment,there were significant difference of cases who got RVR（x^2 = 11.25,P = 0.001） and SVR（x^2 =15.09,P〈0.001） in virological response group.On the basis of Bivariate correlation analysis,there were significant correlation between the HCV non-lb type,IL-28 B SNPrsl2979860 type CC,SNP rs8099917 TT and the antiviral treatment response rate,RVR,SVR after 2 weeks of treatment（all P〈0.05）.Conclusions HCV genotype lb was the main genotype in Qingdao Distinct;rs 12979860 CC and rs8099917 TT were the chief types of IL-28 B SNP loci in patients with CHC.HCV genotype,IL-28 B single nucleotide polymorphism could be used in individualized treatment of CHC as predictive index of antiviral efficacy.

关 键 词：慢性丙型肝炎 白细胞介素-28B基因 单核苷酸多态性 基因分型 抗病毒治疗 

分 类 号：R512.63[医药卫生—内科学]