乙型肝炎患者乙型肝炎病毒前C区变异及干扰素抗体对干扰素治疗的影响

Clinical study of HBV precore mutant infection and interferon antibody

目的 探讨干扰素治疗与乙型肝炎病毒 (HBV )前C区变异 (1896位点G→A点变异 )及干扰素抗体的关系。方法 分别以PCR及ELISA方法检测 86例慢性HBV感染患者血清中HBV前C区变异株及干扰素抗体。结果 ALT >10 0IU/L组变异株检出率 (40 .4% )显著高于ALT≤ 10 0IU /L组 (8.8% ) ,两组比较差异有显著性 (P <0 .0 0 5 ) ;CHB重度组检出率明显高于慢性携带者及CHB轻度组 (P <0 .0 0 5 ) ;3 8例CHB接受干扰素治疗 ,变异株组和野生株组对干扰素近期应答率相似 ,但变异株组复发率 (70 .0 % )显著高于野生株组 (2 3 .1% ) ;干扰素抗体阳性组的近期应答率 (3 8.5 % )显著低于阴性组 (72 .0 % )。结论 变异株感染与肝病严重程度有关 ,HBV前C区变异和干扰素抗体可影响干扰素的抗病毒疗效。

Objective To explore the influence of HBV pre-c mutant (1896 G A point mutantion)and interferon antibody upon IFN therapy.Methods 86 patients with chronic hepatitis B infection were investigated, the HBV pre-c mutant was detect by PCR, the interferon antibody was tested by ELISA.Results The detective rate of mutant in group with ALT>100 IU/L(40.4%) was significantly higher than that in group with ALT≤100IU/L(8.8%)(P<0.05).38 patients received IFN therapy,the short-term response rate to interferon treatment in mutant type group(58.8%) was similar to that in wild type group(P>0.05). But relapse rate after IFN therapy in mutant type group(70%) was significantly higher than that in wild type group(23.1%).The short-term response rate to interferon treatment in interferon antibody(+) group (38.5%)was significantly lower than that in interferon antibody(-) group (72.0%).Conclusion HBV pre-c mutant and interferon antibody may negate the antiviral effects of interferon α-2b.