苏州地区不同HCV基因型感染者对抗病毒治疗的敏感性分析  

Analysis of the sensitivity of antiviral therapy in different genotypes of HCV infection in Soochow

作　　者：朱晓燕[1] 高媛媛 时翠林[1] 徐俊驰[1] 宋华峰[1] 朱捷 胥萍[1] ZHU Xiaoyan GAO Yuanyuan SHI Cuilin XU Junchi SONG Huafeng ZHU Jie XU Ping(Department of Clinical Laboratory, the Fifth People＇ s Hospital of Suzhou, Soochow 215007 Medical College of Soochow University, China)

机构地区：[1]苏州市第五人民医院检验中心,江苏苏州215007 [2]苏州大学医学部

出　　处：《胃肠病学和肝病学杂志》2017年第9期1026-1029,共4页Chinese Journal of Gastroenterology and Hepatology

基　　金：苏州科技计划项目(SYS201433);苏州市感染免疫重点实验室(SZS201006)

摘　　要：目的调查丙型病毒性肝炎(hepatitis C virus,HCV)各基因型在苏州地区的流行性,探讨不同基因型HCV-RNA载量之间的差异,以及苏州地区各基因型对于INF-2b联合口服利巴韦林抗病毒治疗的敏感性差异。方法收集144例HCV确诊患者,采用聚合酶链反应(polymerase chain reaction,PCR)法检测患者HCV-RNA的载量;使用自动生化分析仪测定AST及ALT;采用直接测序法分析HCV的各基因型及其亚型;根据用药后HCV-RNA载量转阴(或低于检测限)所需的时间来判定治疗的敏感性。结果 144例HCV患者中,1b亚型占多数(70.14%),2a亚型(20.14%)及3a亚型(9.72%)所占比例较低;不同基因型HCV患者性别、年龄、ALT及AST比较,差异无统计学意义(P>0.05);HCV-RNA载量1b亚型与2a亚型比较,2a亚型与3a亚型比较,差异无统计学意义(P>0.05),而1b亚型载量明显高于3a亚型,差异有统计学意义(P<0.05);1b型快速病毒学应答(rapid virological response,RVR)比例较低,早期病毒学应答(early virological response,EVR)、持续病毒学应答(sustained virological response,SVR)及无应答(no response,NR)的比例较高;而2a亚型及3a亚型对药物应答的敏感性则相反,RVR比例较高,EVR、SVR及NR的比例较低。结论目前1b亚型是苏州地区丙型肝炎的主要基因亚型,紧随其后的是2a亚型和3a亚型,另外还有极少数的其他基因型。对HCV基因分型的了解有助于预估疗程的长短和患者对药物的敏感性,是评估患者治疗的一项重要因素。Objective To investigate the epidemicity of different hepatitis C virus （HCV） genotypes in Soochow, and to expose the difference of HCV-RNA load among different genotypes, and to analyze the difference of the sensitivity of polyethylene glycol interferon （INF-2b） and ribavirin combination antiretroviral treatment among different HCV genotypes in Soochow. Methods One hundred and forty-four patients diagnosed as HCV were collected, the HCV-RNA load was detected by the method of polymerase chain reaction （PCR） , the ALT and AST were detected by automatic bio- chemical analyzer, the HCV genotype and subgenotype were analyzed by direct gene sequencing method. The sensetivity was classified according to the time spending in waiting HCV-RNA load to become negative （or below the limit of detection sensitivity） during antiviral therapy. Results In the 144 patients, the majority was subgenotype lb （70. 14% ）, subgenotype 2a （20. 14% ） and subgenotype 3a （9.72%） shared low proportion. Among different HCV genotypes, there were no significant differences in many aspects, such as ALT, AST, sex and age. Neither the subgenotype lb and

关 键 词：丙型病毒性肝炎 基因分型 抗病毒治疗 敏感性 

分 类 号：R512.63[医药卫生—内科学]