兰州地区HCV1b基因型5'-NCR变异与自身抗体的关系研究

Relationship of HCV genotype 1b 5'-NCR variation and auto antibodies in Lanzhou region

目的探讨兰州地区丙型肝炎病毒(HCV)1b基因型5'非编码区(5'-NCR)变异与自身抗体的关系。方法应用限制性内切酶酶切分析法检测120例HCV基因1b型感染者5'-NCR变异,采用ELISA法检测抗线粒体抗体(AMA)、抗肝肾微量抗体(LKM)、抗可溶性肝抗原(SLA/LP)、抗去唾液酸糖蛋白受体抗体(ASG)和抗肝细胞膜抗原抗体(LMA),比较不同自身抗体在HCV1b型5'-NCR变异中的出现情况及其与SVR应答率之间的关系。结果 120例HCV 1b基因型感染者存在5种感染状态:有MboⅠ切点野生株72例(60.0%),无MboⅠ切点变异株15例(12.5%),有MboⅠ和无MboⅠ切点混合感染株21例(17.5%),有BamHⅠ切点变异株6例(5.0%),有MboⅠ双切点变异株6例(5.0%);共检出165项自身抗体阳性,有42例出现1项或1项以上自身抗体阳性,总检出率为35.0%;野生株与变异株比较,各项自身抗体检测结果差异均无统计学意义(χ2=21.8,P=0.147),72例野生株感染者抗病毒治疗12周、24周、48周较治疗初比较共有8项次、16项次、22项次自身抗体出现,而48例变异株分别有7项次、9项次、13项次自身抗体出现,变异株与野生株在治疗过程中自身抗体出现差异无统计学意义(χ2=6.25、7.46、10.24,P=0.13、0.17、0.21),抗病毒治疗结束后野生株有64例取得了SVR,应答率88.9%,与变异株相比,差异有统计学意义(χ2=17.25,P=0.027)。结论兰州地区丙型肝炎感染者血清中存在单一的MboⅠ切点的野生株感染占60.0%。HCV 1b型感染者抗病毒治疗过程中自身抗体的出现与5'-NCR基因变异无直接关系,存在5'-NCR变异者抗病毒治疗效果不佳。

Objective To investigate the relationship of hepatitis C virus （HCV） genotype lb 5＇-non coding region （5＇-NCR） mutation and the auto-antibodies in Lanzhou region. Methods Restriction enzymes analysis method was used to detect 120 patients with HCV genotype 1 b infection 5＇-NCR variation, ELISA method was used to detect anti-mi- toehondrial antibody （ AMA）, anti-liver-kidney miorosomes （ LKM）, anti-soluble liver antigen （ SLA/LP）, anti-：~.~ialo- glycoprotein receptor antibody （ASG） and anti-liver cell membrane antigen antibody （LMA） , the appearance of differ- ent auto-antibodies in HCV lb type 5＇-NCR variation and the relationship with the SVR response rates were compared. Results 120 patients with HCV genotype lb infection existed five kinds of states： infection with Mbo [ tangent point of wild strains of 72 cases （60.0%）, no Mbo I tangent point mutant 15 cases （12.5%）, with and without Mbo I tangent point of 21 cases （ 17.5% ） of mixed infection, with BamH I tangent point mutation strains 6 eases （5.0%） , 6 cases （5.0%） with Mbo I double tangent point mutant; 165 positive auto-antibodies were checked out, 42 cases had one or more than one＇ s own antibody positive, the detection rate was 35.0% , there was no statistically significant difference in the test results between wild strains and variant strains （X2 =21.8, P =0. 147）. There were 8 items, 16 items and 22 i- tems of auto-antibodies after antiviral therapy 12 weeks, 24 weeks, 48 weeks in 72 cases of infected wild strains and 7 i- tems, 9 items, 13 items of auto-antibodies after antiviral therapy 12 weeks, 24 weeks, 48 weeks in 48 cases of variant strains compared with the early treatment. There was no significant difference in the treatment process of auto-antibodiesbetween wild strains and variant strains （X2 =6.25, 7.46, 10.24; P=0.13, 0.17, 0.21）, plants with 64 cases of wild strains obtained the SVR after antiviral treatment, response rate was 88.9% , difference was statistically significant compared with variant strains （X2 = 17.25, P = 0. 027）. Conclusion HCV infection existed in serum in Lanzhou, single Mbo I tangent point of wild strains infection accounted for 60.0%. HCV type lb antiviral treatment process in the presence of auto-antibodies and 5＇-NCR has no direct relationship with the gene mutation.