丙型肝炎病毒基因分型及其与干扰素治疗应答的关系

Genotypic analysis of hepatitis C viruses and its significance in interferon treatment

目的为了解山西省丙型肝炎病毒的基因型和基因型对干扰素疗效的预示价值。方法用ＨＣＶ５’ＮＣ区酶切分型方法对９４例丙型肝炎病人进行基因分型，并观察其中４５例患者对干扰素α１ｂ治疗的应答。结果显示ＨＣＶⅠ组（Ⅰ、Ⅱ型）感染８０例（８５１％），ＨＣＶⅡ组（Ⅲ、Ⅳ型）感染１２例（１２８％），ＨＣＶⅠ／Ⅱ组混合感染２例（２１％）。在接受干扰素治疗的病例中，ＨＣＶⅠ组感染（３５例）的应答率为３７１％，持续应答率为１７１％，而Ⅱ组感染（１０例）的应答率为８０％，持续应答率为６０％，两组相比，有显著性差异（Ｐ＜００５，Ｐ＜００２５）。结论表明山西省以ＨＣＶⅠ组感染为主，干扰素对ＨＣＶⅡ组感染的疗效优于ＨＣＶⅠ组感染，ＨＣＶ基因型有预测干扰素疗效的意义。

To study the genotypes of HCV infection in Shanxi Province and the response of HCV genotypes to interferon therapy, the genotypes of HCV were analysed by restriction fragment length polymorphism in 94 chronic hepatitis C patients who were positive for HCV RNA (RT-PCR). It was shown that 80 patients (851%) were group Ⅰ infection, 12 (128%) were group Ⅱ infection and 2 (21%) were group Ⅰ/Ⅱ co-infection. 45 chronic hepatitis C patients with different genotypes (35 with HCV group Ⅰ, 10 with group Ⅱ) receirved rIFN α1b 3MU three times a week for 6 months and were followed up to 12-34months. The responsive rate was significantly higher in patients with group Ⅱ infection (80%) than that in patients infected with group Ⅰ (371%) (P<005). Sustained response was observed in 60% for group Ⅱ and in 171% for group Ⅰ(P<0025). The date indicated that HCV group Ⅰ is the major type of HCV infection in Shanxi Province the and HCV genotype seems to be an important factor in determining the response rate to IFN treatment in patients with chronic hepatitis C.