IFNL4和IL-28B基因多态性检测评估慢性乙型肝炎患者抗病毒治疗应答价值分析

Prediction of response to peginterferon alfa-2a by blood IFNL4 and IL-28B gene polymorphisms in patients with chronic hepatitis B

目的探讨检测血干扰素λ4(IFNL4)和白介素-28B(IL-28B)基因多态性对慢性乙型肝炎(CHB)患者抗病毒治疗后应答的评估价值。方法2015年3月~2017年3月收治的CHB患者140例,均接受聚乙二醇干扰素α-2a治疗12个月。应用市售试剂盒检测外周血IFNL4和IL-28B基因多态性。结果在治疗结束时,在140例CHB患者中,108例(77.1%)获得应答,32例(22.9%)无应答;应答组IL-28Brsrs8099917位点基因TT型占比为88.9%,显著高于无应答组的68.8%(P<0.05);应答组血清ALT、AST和HBV DNA水平分别为(35.4±3.2)U/L、(38.6±2.1)U/L和(3.8±2.1)lg copies/ml,均显著低于无应答组的(61.5±4.8)U/L、(73.5±3.0)U/L和(5.2±3.1)lg copies/ml(P<0.05);125例IFNL4 TT/TT型患者血清ALT、AST和HBV DNA水平分别为(47.1±2.5)U/L、(49.1±1.6)U/L和(4.5±1.2)lg copies/ml,与15例TT/△G型患者的(48.0±2.1)U/L、(59.4±1.5)U/L和(4.7±1.3)lg copies/ml比,无显著性差异(P>0.05);118例IL-28B TT型患者血清ALT、AST和HBV DNA水平分别为(36.4±2.1)U/L、(38.9±2.7)U/L和(4.0±1.7)lg copies/ml,显著低于22例TG型患者【分别为(59.0±1.4)U/L、(72.1±1.1)U/L和(6.0±2.1)lg copies/ml(P<0.05)。结论CHB患者IFNL4rs368234815位点基因以TT/TT型和IL-28Brs8099917位点基因以TT型居多,检测IFNL4基因多态性可能对预测抗病毒疗效无明显指导意义,而检测IL-28B基因多态性可能对抗病毒疗效有一定的预测价值。

Objective The aim of this study was to explore the prediction of response to peginterferon alfa-2a by blood interferon lambda 4(IFNL4)and interleukin-28B(IL-28B)gene polymorphisms in patients with chronic hepatitis B(CHB).Methods 140 patients with CHB were enrolled in our hospital between March 2015 and March 2017,and all the patients were given peginterferon alfa-2a for antiviral therapy for 12 months.The blood genetic polymorphisms of IFNL4 and IL-28B were assayed by PCR.Results At the end of discontinuation of the regimen,108 patients(77.1%)responded,and 32(22.9%)didn’t responded to the anti-viral therapy;the percentage of IL-28Brsrs8099917 type TT was 88.9%,significantly higher than 68.8%(P<0.05)in non-responders;serum ALT,AST and HBV DNA levels in responders were(35.4±3.2)U/L,(38.6±2.1)U/L and(3.8±2.1)lg copies/ml,significantly lower than(61.5±4.8)U/L,(73.5±3.0)U/L and(5.2±3.1)lg copies/ml(P<0.05)in nonresponders;serum ALT,AST and HBV DNA levels in 125 patients with IFNL4 type TT/TT were(47.1±2.5)U/L,(49.1±1.6)U/L and(4.5±1.2)lg copies/ml,not significantly different as compared to(48.0±2.1)U/L,(59.4±1.5)U/L and(4.7±1.3)lg copies/ml in 15 patients with type TT/△G(P>0.05);serum ALT,AST and HBV DNA levels in 118 patients with IL-28B type TT were(36.4±2.1)U/L,(38.9±2.7)U/L and(4.0±1.7)lg copies/ml,significantly lower than[(59.0±1.4)U/L,(72.1±1.1)U/L and(6.0±2.1)lg copies/ml,respectively,P<0.05]in 22 patients with type TG.Conclusion The majority of CHB patients have genotype TT/TT of IFNL4rs368234815 and genotype TT of IL-28Brs8099917,and the detection of IL-28B gene polymorphism might,and that of IFNL4 polymorphism might not predict the response to anti-viral therapy in patients with CHB,which needs further investigation.