摘要
目的 探讨不同基因型丙型肝炎病毒(HCV)及人类白细胞抗原(HLA)-DRB等位基因多态性对慢性丙型肝炎(简称丙肝)患者干扰素联合利巴韦林治疗应答率的影响。 方法 对113例接受干扰素联合利巴韦林治疗的丙肝患者进行基因型调查,采用基因芯片技术对其中25例患者的HLA-DRB基因型进行分析,探讨病毒基因型及宿主HLA等位基因对丙肝患者抗病毒治疗反应性的影响。 结果 不同基因型HCV感染对干扰素联合利巴韦林治疗的应答率不同,其中HCV-Ⅳ/2b型应答率最高,为57.7 8％,I/la型和Ⅲ/2a型次之,分别为46.15％和47.62％,Ⅱ/1 b型应答率最低,仅为11.76％。HLA-DRBl*07阳性者对干扰素联合利巴韦林治疗的应答率较高,而DRB1*04阳性者应答率较低。患者性别、HCV基因型、宿主HLA-DRB等位基因三种因素均与抗病毒疗效密切相关,女性、Ⅳ型HCV感染以及携带HLA-DRB1*07等位基因的患者多表现为完全应答,而男性、Ⅱ型HCV感染以及携带HLA-DRB1*04等位基因的患者多表现对干扰素联合利巴韦林治疗无应答。其中DRB1*07等位基因及Ⅳ型HCV感染对抗病毒疗效的影响最大。 结论 病毒与宿主在影响抗病毒治疗应答状况方面具有同等重要的地位,丙肝的治疗方案不应单纯只针对抗病毒一个方面.还应着眼于宿主本身,通过多种方式调节机体的免疫状态以增强宿?
Objective To study the effects of HCV genotypes and HLA-DRB alleles on the response of chronic hepatitis C patients to interferon alpha and libavilin. Methods Genotypes of HCV in 113 patients with HCV infection treated with interferon alpha and libavilin were investigated. Gene chips were used to analyze the frequency of HLA-DRB alleles in 25 patients of them. The response to interferon alpha and libavilin therapy were discussed. Results The response rates in the four HCV types were different, HCV- Ⅳ /2b the highest (57.78%), HCV- I /la and -Ⅲ /2a lower (46.15% and 47.62%), and HCV- Ⅱ /1b the lowest(11.76%).The response rate to IFN and libavilin therapy in patients with DRB1*07 positive was higher, while in patients with DRB1 *04 positive was lower. Sex, HCV genotypes and HLA-DRB alleles were all related to the response. Female, patients with HCV- IV /2b and HLA-DRB 1*07 presented almost complete response, but male, patients with HCV- Ⅱ /1b and HLA-DRB1*04 usually appeared non-response . DRB1*07 allele and HCV- Ⅳ / 2b were the closest factors related to the response. Conclusions Not only virus but also host playes an important role in the curative effect of anti-virus therapy. It is necessary to view from the angle of host, adjusting the host's immune status to accelerate the clearance of HCV.
出处
《中华肝脏病杂志》
CAS
CSCD
2003年第10期620-622,共3页
Chinese Journal of Hepatology
