白细胞介素-28B基因多态性对慢性丙型肝炎患者抗病毒治疗应答的影响  

The effects of interleukin-28B gene polymorphisms on antiviral treatment response in patients with chronic hepatitis C

作　　者：周宇[1] 叶晓婷[1] 陈威[1] 洪亮[1] 蒋卫民[2] 

机构地区：[1]温州医科大学附属第三医院感染科,浙江省瑞安市325000 [2]上海复旦大学附属华山医院感染科

出　　处：《中华传染病杂志》2017年第4期218-222,共5页Chinese Journal of Infectious Diseases

基　　金：温州市2014年公益性科技计划项目（Y20140504）

摘　　要：目的 探讨IL-28B基因单核苷酸多态性位点rs12979860和rs8099917与中国慢性丙型肝炎患者抗病毒疗效的关系.方法 利用Taqman探针单核苷酸多态性基因分型方法检测入组的105例患者IL-28B基因多态性位点rs12979860（C/T）和rs8099917（T/G）的基因型,对患者进行标准剂量的聚乙二醇干扰素联合利巴韦林（PR）治疗并定期随访治疗应答及不良反应,分析IL-28B基因多态性与患者抗病毒疗效的关系.计数资料采用Pearson卡方检验或Fisher确切概率法.结果 105例慢性丙型肝炎患者中有2例因搬迁失访,剩余103例中81例（78.6%）rs12979860和rs8099917基因型为CC/TT（CC/TT组）,19例（18.4%）为CT/TG（CT/TG组）,3例（2.9%）为TT/TG（TT/TG组）,未检测到其他基因型,两处多态性位点表现为连锁不平衡（r2=0.11）.治疗4周后,CC/TT组35例（43.2%）,CT/TG组3例（15.8%）,TT/TG组0例达到快速病毒学应答（RVR）,3组间差异有统计学意义（χ2=6.77,P=0.033）.治疗12周时,CC/TT组45例（55.6%）达到早期病毒学应答（EVR）,CT/TG组6例（31.6%）,TT/TG组0例,3组间差异有统计学意义（χ2=6.57,P=0.025）.治疗结束时,CC/TT组68例（83.9%）达到治疗结束时病毒学应答（ETR）,CT/TG组10例（52.6%）,TT/TG组1例（33.3%）,3组间差异有统计学意义（χ2=10.86,P=0.003）.随访24周后,CC/TT组患者62例（76.5%）达到持续病毒学应答（SVR）,CT/TG组9例（47.4%）,TT/TG组1例（33.3%）,3组间差异有统计学意义（Fisher值7.939,P=0.014）.治疗过程中,CC/TT组101例次出现不良反应,19例次需临床处理,CT/TG组43例次出现不良反应,9例次需临床处理,TT/TG组7例次出现不良反应,1例次需临床处理,3组间差异无统计学意义（χ2=0.139,P〉0.05）.结论 IL-28B基因rs12979860和rs8099917基因型影响慢性丙型肝炎患者抗病毒治疗应答,CC/TT基因型更易达到RVR及SVR,为慢性丙型肝炎个体化抗感染治疗提供依据.Objective To investigate the relationship between interleukin （IL）-28B gene polymorphisms （rs12979860 and rs8099917） and treatment response in patients with chronic hepatitis C in China.Methods Taqman probes single nucleotide polymorphism genotyping methods were used to detect the genotypes of rs12979860 （C/T） and rs8099917 （T/G） located at IL-28B gene in 105 included patients.The patients were treated with standard doses of pegylated interferon plus ribavirin and were followed up regularly for therapeutic response and adverse reaction.The relationship between IL-28B gene polymorphism and antiviral treatment response of patients were analyzed.Categorical data were analyzed using Pearson chi-square test or Fisher exact test.Results Totally 105 cases were included in our study and 2 cases lost to follow-up because of moving away.Eight-one cases （78.6%） of the remaining 103 patients were CC/TT genotype （CC/TT group） at rs12979860 and rs8099917, 19 cases （18.4%） were CT/TG （CT/TG group） and 3 cases （2.9%）were TT/TG （TT/TG group）.No other genotypes were detected and linkage disequilibrium was discovered at the two polymorphism loci （r2=0.11）.After 4 weeks of treatment, 35 cases （43.2%） in CC/TT group, 3 cases （15.8%） in CT/TG group and non in TT/TG group achieved rapid virological response （RVR）.There were statistically significant differences among three groups （P=0.033）.After 12 weeks of treatment, 45 cases （55.6%） in CC/TT group, 6 cases （31.6%） in CT/TG group and none in TT/TG group achieved early virological response （EVR）.There were statistically significant differences among three groups （P=0.025）.At the end of the treatment, 68 cases （83.9%） in CC/TT group, 10 cases （52.6%） in CT/TG group and only 1 case （33.3%） in TT/TG group achieved end-of-treatment response （ETR）.There were significant statistical differences among the three groups （P=0.003）.After 24 weeks of follow-up, 62 cases （76.5%） in CC/TT group, 9 cas

关 键 词：肝炎 丙型 慢性 多态性 单核苷酸 抗病毒应答 

分 类 号：R512.63[医药卫生—内科学]