丙型肝炎病毒基因型及其病毒RNA定量与干扰素疗效的关系

The Relationship Between HCV Genotypes,HCV RNA Quantities, and IFN Therapeutic Effectiveness

目的 :探讨丙型肝炎病毒 (hepatitis C virus,HCV)基因型及 HCV RNA量与干扰素 (interferon,IFN)疗效的关系。方法 :应用特异引物聚合酶链反应 (polym erase chain reaction,PCR)法并利用信号引物能量转移技术对2 0例慢性丙型肝炎患者进行 HCV基因分型及 IFN治疗前后血清 HCV RNA定量检测。结果 :HCV- 型患者对IFN治疗的完全应答率高于 HCV- 型 (P<0 .0 5 ) ;治疗前血清 HCV RNA低水平者 ,完全应答率高 ,且完全应答组血清 HCV RNA量明显低于部分应答及无应答组 (P<0 .0 1) ;治疗结束时 3组血清 HCV RNA量较治疗前均有明显下降 ,但停药后半年 ,部分应答及无应答组血清 HCV RNA量均回升至治疗前水平 ,仅完全应答组保持治疗结束时的低水平状态。结论 :治疗前血清 HCV RNA量及 HCV基因型可作为预测 IFN疗效的参考指标 ;治疗及观察过程中血清 HCV RNA量的变化对 IFN疗效评价有重要意义。

Objective: Our aim was to study the relationship between HCV genotypes, HCV RNA quantities, and interferon (IFN) therapeutic effectiveness. Methods: The HCV genotypes and HCV RNA quantities in 20 blood samples of patients with chronic hepatitis C before and after IFN therapy were detected with specific primer PCR assay and energy transference technique of signal primer. Results: Patients with HCV Ⅲ type had complete response much more than HCV Ⅱ type, (P<0.05); the patients who had low level HCV RNA before treatment had much more complete response to IFN. The serum HCV RNA quantities in complete response group were lower than HCV RNA quantities in part response group and in non response group before treatment (P<0.01). The serum HCV RNA quantities in three groups decreased much more when the treatment finished than HCV RNA quantities before treatment, but at the 6th month after treatment HCV RNA quantities returned to the level before treatment in part response and non response. Only in complete response, HCV RNA quantities kept low level at the end of treatment. Conclusion: The HCV RNA quantities and HCV genotypes before treatment might be used as predictive factors of IFN therapeutic effectiveness. The changes of HCV RNA quantities in treatment and follow up survey had important significance in therapeutic evaluation.