难治性慢性丙型肝炎患者抗病毒疗效与血清趋化因子IP-10水平的相关分析

Association between the response to antiviral therapy and serum level of chemokine IP-10 in patients with refractory chronic hepatitis C

目的探讨难治性慢性丙型肝炎(chronic hepatitis C,CHC)患者抗病毒疗效与血清趋化因子干扰素γ诱生蛋白-10(interferon-γinducible protein-10,IP-10)水平的关系。方法入组的难治性CHC患者,给予聚乙二醇干扰素联合利巴韦林治疗,评估抗病毒疗效。用Luminex技术检测基线、治疗4周和治疗12周血清趋化因子IP-10水平。结果 75例难治性CHC患者中,2例治疗至24周脱落,其余患者均完成48周治疗,随访24周,持续病毒学应答(sustained virologic response,SVR)率为68.49%(50/73)。75例难治性CHC组患者基线血清IP-10水平高于11例正常对照,差异均有统计学意义(P<0.01)。获得快速病毒学应答(rapid virologic response,RVR)者、完全早期病毒学应答(complete early virological response,cEVR)者和持续病毒学应答者基线IP-10水平显著低于未获得应答者(P=0.020,0.003,0.002)。另外比较SVR者基线、治疗4周和治疗12周IP-10水平,发现抗病毒治疗过程中,IP-10水平逐渐减低。其中治疗12周时IP-10水平明显低于基线、治疗4周,差异有统计学意义(P=0.001,0.016)。结论基线IP-10低水平有利于获得病毒学应答。获得SVR者抗病毒治疗过程中,IP-10水平显著减低。

Objective To investigate the correlation with antiviral efficacy and serum chemokine IP-10 level in refractory chronic hepatitis C （CHC） patients. Methods We enrolled refractory chronic hepatitis C patients who received Peg-IFNa-2a plus ribavirin, to evaluate antiviral efficacy. We used Luminex to test the serum lev- el of IP-10 at baseline, 4 weeks and 12 weeks. Results A total of 75 CHC patients were enrolled, in which two patients were drop-out for 24 weeks, which of 50 finish treatment for 48 weeks and 24 weeks following- up, the rate of sustained virologic response （SVR） was 68.49% （50/73） . Comparison of CHC patients and normal controls at baseline, the results showed that IP-10 level in CHC patients higher than normal controls, had statistic significant （P〈0.01） . The level of IP-10 in rapid virologic response （RVR） complete early vir- ological response （cEVR） group and SVR group at baseline were lower than non-responder patients, and had statistic significance （P=0. 020, 0. 003, 0. 002） . The level of IP-10 in SVR group gradually reduce at base- line, 4 weeks and 12 weeks. The level of IP-10 at 12 weeks was lower than baseline and 4 weeks, and had sta- tistic significance （P=0. 001, 0. 016）. Conclusions The low baseline level of IP-10 was in favor of virologi- cal response. During antiviral treatment in SVR group, the level of IP-IO reduced significantly.