α-2b干扰素治疗不同基因型丙肝疗效与免疫指标的关系

EFFECTS OF THERAPY WITH α 2b INTERFERON ON HUMORAL IMMUNITY AND CELLULAR IMMUNITY IN PATIENTS WITH DIFFERENT HEPATITIS C VIRUS GENOTYPES

根据Ｏｋａｍｏｔｏ基因分型法对２８例丙肝患者的病毒基因进行了分型，１８例为ＨＣＶ－Ⅱ型，１０例为ＨＣＶ－Ⅲ型。重点研究了α－２ｂＩＦＮ治疗ＨＣＶ－Ⅱ型患者和ＨＣＶ－Ⅲ型患者免疫功能的不同改变：在α－２ｂＩＦＮ治疗前，ＨＣＶ－Ⅱ型患者和ＨＣＶ－Ⅲ型患者之间ＩｇＧ、ＩｇＭ、ＩｇＡ、ＣＤ４百分比、ＣＤ８百分比及ＣＤ４／ＣＤ８比值６项指标无明显差别。α－２ｂＩＦＮ治疗８ｗ时，ＨＣＶ－Ⅲ型患者ＣＤ４／ＣＤ８比值明显高于ＨＣＶ－Ⅱ型患者ＣＤ４／ＣＤ８比值。α－２ｂＩＦＮ治疗１个疗程（１２ｗ）时，ＨＣＶ－Ⅲ型患者ＣＤ４百分比，ＣＤ４／ＣＤ８比值明显高于ＨＣＶ－Ⅱ型患者。α－２ｂＩＦＮ治疗１个疗程后第４周（１６ｗ）时，ＨＣＶ－Ⅲ型患者ＣＤ４百分比，ＣＤ４／ＣＤ８比值仍明显高于ＨＣＶ－Ⅱ型患者，但在整个治疗过程中，ＨＣＶ－Ⅲ型和Ⅱ型患者ＩｇＧ、ＩｇＭ、ＩｇＡ和ＣＤ８百分比４项指标改变无显著差异。α－２ｂＩＦＮ治疗ＨＣＶ－Ⅲ型患者，其ＣＤ４百分比，ＣＤ４／ＣＤ８比值改变明显高于ＨＣＶ－Ⅱ型患者。这可能是α－２ｂＩＦＮ治疗ＨＣＶ－Ⅲ型患者疗效明显好于ＨＣＶ－Ⅱ型患者重要原因之一。

According to Okamotos method,assayed the hepatitis C virus genotypes of 28 patients with hepatitis C by PCR,18 patients genotypes were HCV RNA Ⅱ genotype,10 patients genotypes were HCV RNA Ⅲ genotype.Especially studied the effects of therapy with α 2b IFN on humoral immunity and cellular immunity in patients with HCV RNA Ⅱ genotype or with HCV RNA Ⅲ genotype.The results showed that,before treatment,no strong evidence for a difference in humoral immunity:IgG,IgM and IgA,or in cellular immunity:percentage of CD4 + T subsets,percentage of CD8 + T subsets,CD4/CD8 ratio was observed between patients with HCV RNA Ⅱ genotype and patients with HCV RNA Ⅲ genotype(P>0.05).CD4/CD8 ratio of patients with HCV RNA Ⅲ genotype was higher than that of patients with HCV RNA Ⅱ genotype at the 8th week of interferon therapy(P<0.05).Both percentage of CD4 + T subsets and CD4/CD8 ratio of patients with HCV RNA Ⅲ genotype were significantly higher than that of patients with HCV RNA Ⅱ genotype at the 12th week of interferon therapy(P<0.01).At the 4th week after interferon therapy,percentage of CD4 + T subsets and CD4/CD8 ratio of patients with HCV RNA Ⅲ genotype were also significantly higher than that of patients with HCV RNA Ⅱ genotype(P<0.01).During and after interferon therapy,the humoral immunity:IgG,IgM,IgA and percentage of CD8 + T subsets of patients with HCV RNA Ⅱ genotype or with HCV Ⅲ genotype had some differences,but the differences were not satistically significant(P>0.05).The results indicated that,during and after interferon therapy,patients with HCV RNA Ⅲ genotype tended to have higher percentage of CD4 + T subsets and higher CD4/CD8 ratio than patients with HCV RNA Ⅱ genotype,this may be one of causes why the effects of therapy with interferon in patients with HCV RNA Ⅲ genotype were better than in patients with HCV RNA Ⅱ genotype.