IL-28B单核苷酸多态性对武汉地区慢性丙型肝炎抗病毒疗效的影响

Effects of IL-28B single nucleotide polymorphism on antiviral efficacy of chronic hepatitis C in Wuhan area

目的分析武汉地区慢性丙型病毒性肝炎患者的白细胞介素-28B(IL-28B)单核苷酸位点rs12979860多态性对抗病毒治疗的病毒学应答及持续病毒学应答的影响。方法对224例慢性丙型病毒性肝炎患者进行全程联合抗病毒治疗,基线水平进行了IL-28B rs12979860位点基因多态性检测,抗病毒治疗疗程为48周,治疗结束后随访24周,有179例患者完成了全部随访。结果 224例患者IL-28B rs12979860位点基因型以CC型为主占87.1%,CT型占12.9%,未发现TT型,对武汉地区224例慢性丙型肝炎患者予以PEG-IFNα-2a联合RBV治疗48周,治疗结束时病毒学应答(ETVR)率为91.9%(206例),持续病毒学应答率(SVR)为77.7%(174例),复发32例,反弹11例,无应答7例。CC型患者的SVR率明显高于CT型患者(81.0%vs.55.2%),差异有统计学意义(P<0.05)。结论我国武汉地区慢性丙型肝炎患者的IL-28B rs12979860位点基因型以CC型为主,C等位基因频率明显高于T等位基因频率,PEG-IFNα-2a联合RBV治疗慢性丙型肝炎疗效显著,其SVR率可达87.2%。IL-28B rs12979860位点CC型患者的SVR率明显高于CT型,因此宿主IL-28B位点多态性检测对抗病毒疗效的预测有一定价值,可作为丙型肝炎患者抗病毒治疗效果的预测因素之一。

Objective To analyse the effect of single nucleotide polymorphism rs12979860 of interleukin-28B （IL-28B） on virologic and sustained virological response to anti-virus therapy for chronic hepatitis C patients in Wuhan region. Methods A total of 224 patients with chronic hepatitis C were enrolled in this study. All of them received the whole process of combined antiviral therapy, and the baseline levels of IL-28B rs12979860 gene polymorphism were detected. When the 48-week antiviral therapy was finished, we did a 24-week followed up to the patients, and 179 patients completed the follow-up. Results The distribution oflL-28B rs12979860 genotype CC and CT were 87.1% and 12.9%, respectively; while the genotype CC was not detected in the 224 patients. After 48-week combined therapy of PEG-IFNα-2a and RBV, the rate of virological response （ETVR） was 91.9% （206 cases）, and the rate of sustained virological response （SVR） was 77.7% （174 cases）. In addition, we found 32 cases of recurrence, 11 cases of rebound, and 7 cases non-response. SVR rate in patients with the genotype CC was significantly higher than the patients with genotype CT （81.0% vs. 55.2%）, and the difference was statistically significant （P〈0.05）. Conclusion In Wuhan area of our country, the genotype of IL-28B rs12979860 is mainly CC genotype in patients with chronic hepatitis C, and the C allele frequency was significantly higher than that of T allele frequency. Combined therapy of PEG-IFNα-2a and RBV is effective to treat the chronic hepatitis C, the SVR rate of which is up to 87.2%. SVR was significantly higher in patients with genotype CC of IL-28B rs12979860 than that of CT genotype. To detect the single nucleotide polymorphism of IL-28B is valuable for the prediction on antiviral efficacy.