慢性丙型肝炎患者病毒因素及宿主细胞免疫对干扰素治疗应答的影响  

Effect of viral factors and host cellular immunity on the response to interferon in the patients with chronic hepatitis C

作　　者：唐小平[1] 钱可平[2] 许毅玲 袁小珍[1] 

机构地区：[1]广州市第八人民医院传染病研究所,510060 [2]美国佛罗里达大学医学院肝病研究所

出　　处：《中华传染病杂志》2002年第5期290-293,共4页Chinese Journal of Infectious Diseases

基　　金：广东省自然科学基金资助项目 ( 2 0 0 0 14 63 ) ;广东省重点科技攻关项目 ( 2km0 5 3 0 3s) ;广东省医学科研基金(A2 0 0 0 5 91) ;广州市重点科技攻关项目 ( 2 0 0 0 Z 10 7 0 4)

摘　　要：目的　探讨丙型肝炎病毒 (HCV)因素及机体细胞免疫因素对干扰素疗效的影响。方法　对 4 0例慢性丙型肝炎患者进行干扰素治疗 ,分析HCV基因型、准种多样性、血清HCVRNA水平及肝组织HCV特异性细胞毒T淋巴细胞 (CTL)活性与干扰素应答的关系。结果　经过 6个月的干扰素治疗 ,2 1例获得治疗终点应答 ,其中 10例呈持续应答 ,19例无应答。HCV1型患者应答率( 4 3.3% )明显低于非 1型患者 ( 80 % ,P <0 .0 5 ) ;应答患者中治疗前血清HCV准种数目及HCVRNA水平明显低于无应答患者 (P <0 .0 5 ,P <0 .0 1) ,而其肝组织HCV特异性CTL活性阳性率则显著高于无应答者 (P <0 .0 5 )。结论　病毒因素和宿主因素均是影响慢性丙型肝炎干扰素治疗效果的重要因素 ,非 1型感染、低准种数目。Objective To determine the influence of viral factors and host cellular immunity on the response to interferon in the patients with chronic hepatitis C. Methods Forty patients with chronic hepatitis C were treated with interferon α. The relationships between response to interferon a and HCV genotype, quasispecies heterogeneity, HCV RNA level and HCV specific cytotoxic T lymphocyte (HCV CTL) activity in the liver were analyzed. Results After 6 months of therapy, 21 patients had obtained end of treatment response (ETR), 10 Patients of which had obtained sustained response (SR). The other 19 patients got no response (NR). ETR rate in patients with genotype HCV1 infection (43.3%, 13/30) was significantly lower than that in patients with non HIV1 infection (80%, 8/10) [ P <0.05]. Patients who obtained ETR had lower pre treatment quasispecies heterogeneity and HCV RNA level ( P< 0.05; P < 0.01 ), but higher HCV CTL activity in the liver ( P <0.05) compared to those who had no response. Conclusions Both viral factors and host immunity are important determinants affecting the response to interferon α therapy in the patients with chronic hepatitis C. Non HCV1 infection, lower quasispecies heterogeneity, lower viremia and positive HCV CTL activity in the liver predict a better subsequent response to interferon α.

关 键 词：丙型肝炎 基因型 准种 病毒血症 T淋巴细胞 细胞毒性 干扰素Α 治疗 

分 类 号：R512.63[医药卫生—内科学]