HLA-DRB1基因多态性与阿德福韦酯抗HBV病毒疗效的相关性  

Analysis of correlation between HLA-DRB1 gene polymorphism and efficacy of adefovir dipivoxil against HBV virus

作　　者：宋海宁 韩雪梅 吉爱萍 王纳 王永斌 SONG Hai-ning;HAN Xue-mei;JI Ai-ping;WANG Na;WANG Yong-bin(Qingdao Hospital of Traditional Chinese Medicine(Qingdao Hiser Hospital),Qingdao,Shandong 266000,China)

机构地区：[1]青岛市中医医院(青岛市海慈医院)消化科,山东青岛266000 [2]青岛市中医医院(青岛市海慈医院)呼吸与急危重症医学科,山东青岛266000 [3]青岛市中医医院(青岛市海慈医院)急诊科,山东青岛266000

出　　处：《中华医院感染学杂志》2022年第7期999-1003,共5页Chinese Journal of Nosocomiology

基　　金：山东省自然科学基金资助项目(201968763)。

摘　　要：目的 分析人类白细胞抗原(HLA)-DRB1基因多态性与阿德福韦酯抗乙肝病毒(HBV)疗效的相关性分析。方法 回顾性分析青岛市中医医院92例经阿德福韦酯治疗的慢性乙型肝炎(CHB)患者临床资料(CHB组),收集36例同期入院治疗的CHB后肝硬化患者(肝硬化组)资料,并纳入32例入院体检者作为健康对照组。比较三组基线资料及HLA-DRB1等位基因频率;根据CHB组临床疗效分为疗效良好组及疗效不良组,比较其HLA-DRB1等位基因频率。结果 肝硬化组丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)水平高于CHB组及健康对照组(P<0.05),CHB组高于健康对照组(P<0.05);CHB组乙肝病毒脱氧核糖核酸(HBV-DNA)水平高于肝硬化组(P<0.05)。CHB组及肝硬化组HLA-DRB1*3等位基因频率高于健康对照组(P<0.05),HLA-DRB1*4、HLA-DRB1*13等位基因频率低于健康对照组(P<0.05);肝硬化组HLA-DRB1*7、HLA-DRB1*12等位基因频率高于CHB组及健康对照组(P<0.05)。CHB患者均经阿德福韦酯抗病毒治疗24周,疗效不良组HLA-DRB1*3、HLA-DRB1*7等位基因频率高于疗效良好组(P<0.05,OR=3.261、3.692)。结论 HLA-DRB1基因多态性与本地区慢性HBV感染的易感性及抗病毒疗效相关,HLA-DRB1*3、HLA-DRB1*7阳性提示CHB阿德福韦酯抗病毒疗效欠佳。OBJECTIVE To analyze the correlation between human leukocyte antigen(HLA)-DRB1 gene polymorphism and efficacy of adefovir dipivoxil against hepatitis B virus(HBV). METHODS The clinical data of 92 patients with chronic hepatitis B(CHB) who treated with adefovir dipivoxil in Qingdao Hospital of Traditional Chinese Medicine(as the CHB group) were retrospectively analyzed. The data of 36 patients with liver cirrhosis after CHB who were admitted to the hospital for treatment during the same period(as the liver cirrhosis group) were collected. And 32 people who were admitted to the hospital under physical examination were included in the healthy control group. The baseline data and HLA-DRB1 alleles frequencies were compared among the three groups. The patients in the CHB group were divided into the good efficacy group and poor efficacy group according to the clinical efficacy of the treatment, and the HLA-DRB1 alleles frequencies were compared. RESULTS The levels of alanine aminotransferase(ALT) and aspartate aminotransferase(AST) in the liver cirrhosis group were significantly higher than those in the CHB group and healthy control group(P<0.05), and the levels in the CHB group were significantly higher than those in the healthy control group(P<0.05). The level of hepatitis B virus deoxyribonucleic acid(HBV-DNA) in the CHB group was significantly higher than that in the liver cirrhosis group(P<0.05). The HLA-DRB1*3 allele frequency in the CHB group and liver cirrhosis group was significantly higher than that in the healthy control group(P<0.05) while the frequencies of HLA-DRB1*4 and HLA-DRB1*13 alleles were significantly lower than those in the healthy control group(P<0.05). The frequencies of HLA-DRB1*7 and HLA-DRB1*12 alleles in the liver cirrhosis group were significantly higher than those in the CHB group and healthy control group(P<0.05). The patients with CHB were given the antiviral treatment by the oral administration of adefovir dipivoxil for 24 weeks. And the frequencies of HLA-DRB1*3 and HLA-DRB1*7 alleles

关 键 词：慢性乙型肝炎 乙肝病毒 阿德福韦酯 人类白细胞抗原 DRB1位点 等位基因 

分 类 号：R512.62[医药卫生—内科学]