丙型肝炎患者白细胞介素28B基因多态性和丙型肝炎病毒分型与干扰素疗效的相关性研究

Study on the correlation between interleukin- 28B gene polymorphism,genotypes distribution of hepatitis C virus and its antiviral efficacy in patients with chronic hepatitis C

目的研究丙型肝炎患者白细胞介素28B(IL-28B)基因多态性分布和HCV基因型的不同,对干扰素治疗效果的影响。方法选择接受聚乙二醇干扰素联合利巴韦林治疗(PR)的436例慢性丙型肝炎患者为研究对象,采用双色荧光MGB探针检测IL-28B rs12979860多态性位点基因型,采用Taq Man探针检测HCV基因型。结果 436例CHC患者中,IL-28B rs12979860的CC型、CT型和TT型检出频率分别为82.80%、15.60%和1.61%;HCV基因1b、2a与3b亚型的检出频率分别为73.39%、24.77%和1.83%;CC型、CT型、TT型患者在应答良好组和无应答组的分布差异有统计学意义(P<0.01);组间两两比较,差异均有统计学意义(P<0.01)。HCV分型为1b、2a、3b亚型的患者中,在应答良好组和无应答组差异无统计学意义(P>0.05)。结论患者IL-28B rs12979860基因型与PR治疗的CHC患者病毒持续应答关系密切,CC基因型分布频率明显高于CT、TT基因型,TT型几乎无应答。不同HCV基因型与治疗效果无关。

Objective To study the correlation of 28B（ IL- 28B） gene distribution polymorphism with hepatitis C（ HCV） genotype in patients with HCV,and to explore its effect on interferon therapy. Methods 436 cases of chronic HCV patients with pegylated interferon plus ribavirin treatment were enrolled in this study. IL- 28 B rs12979860 polymorphism genotype was detected by two- color fluorescent MGB assay; HCV genotypes were genotyped by Taq Man technology. Results The detection frequencies of CC,CT and TT of IL- 28 B rs12979860 were respectively 82. 80%,15. 60% and 1. 61% in 436 patients with chronic hepatitis C; that of 1b,2a and 3b were respectively 73. 39%,24. 77% and 1. 83% of HCV gene subtypes. The distribution differences of CC,CT,TT patients between in the group of good response and in the non- response group were statistically significant（ P〈0. 01）. However,the distribution differences of HCV genotyping 1b,2a,3b between in the group of good response and the non- response group were not statistically significant（ P〉0. 05）. Conclusion The sustained response rate of PR treatment of CHC is closely related to genotype of IL- 28 B rs12979860. The distribution frequency of CC is significantly higher than that of CT and TT. There is almost no response in TT patients. However,different HCV genotypes has no correlation with the therapeutic effect.