CAJ | 학술논문

目的探讨干扰素治疗慢性丙型肝炎合并艾滋病毒感染( HCV/HIV)患者早期疗效与干扰素( INF)诱导的粘病毒抵抗蛋白A(MxA)基因的单核苷酸多态性(SNP)和HCV基因型之间的关系.方法 151例HCV/HIV患者用INFα -2b联合Rib治疗24周,评价早期疗效,根据疗效将其分为早期应答与非应答组.应用PCR及限制片段长度多态性的分析方法,检测患者HCV-RNA基因分型、MxA-88及-123位点的SNP,并分析SNP与INF的早期疗效关系,HCV基因1型与非1型患者MxA基因型之间INF的早期疗效.结果 151例HCV/HIV患者除去12例HCV基因分型无记录者,139例患者中52例为HCV基因1型(34.4％),非1型87例( 57.7％)；HCV基因非1型早期应答率(85.1％)高于基因1型(55.8％),差异有统计学意义(x2=14.547,P＜0.001)；MxA启动子-88位点,GT型与GG、TT型患者疗效比较,各型间应答率GT型(79.7％)好于GG型(67.7％)及TT型(70.0％),但三者之间差异无统计学意义(x2=2.711,P＞ 0.05).MxA-123位点,CA型、CC型及AA型三者INF疗效应答率分别为78.0％、72.6％及75.0％,差异无统计学意义(x2=0.453,P＞0.05).HCV基因Ⅰ型与非1型患者MxA基因型之间INF的早期应答率比较,HCV基因非1型患者G/T、T/T型(91.5％)好于GG型(77.5％),但差异无统计学意义(x2=3.327,P=0.068),HCV基因1型患者MxA各基因型间应答率差异也无统计学意义.但是,HCV基因非1型患者与Ⅰ型患者间比较,前者G/T、T/T型(91.5％)应答率高于后者G/T、T/T型(62.5％),差异有统计学意义(P＜0.05).结论 HCV基因非1型患者MxA启动子-88、-123各基因型对INF应答率好于HCV基因1型患者,MxA-88位点为GT型的HCV/HIV患者的INF疗效较好,可为INF治疗的预后及个性化治疗提供参考依据.
목적 탐토간우소치료만성병형간염합병애자병독감염( HCV/HIV)환자조기료효여간우소( INF)유도적점병독저항단백A(MxA)기인적단핵감산다태성(SNP)화HCV기인형지간적관계.방법 151례HCV/HIV환자용INFα -2b연합Rib치료24주,평개조기료효,근거료효장기분위조기응답여비응답조.응용PCR급한제편단장도다태성적분석방법,검측환자HCV-RNA기인분형、MxA-88급-123위점적SNP,병분석SNP여INF적조기료효관계,HCV기인1형여비1형환자MxA기인형지간INF적조기료효.결과 151례HCV/HIV환자제거12례HCV기인분형무기록자,139례환자중52례위HCV기인1형(34.4％),비1형87례( 57.7％)；HCV기인비1형조기응답솔(85.1％)고우기인1형(55.8％),차이유통계학의의(x2=14.547,P＜0.001)；MxA계동자-88위점,GT형여GG、TT형환자료효비교,각형간응답솔GT형(79.7％)호우GG형(67.7％)급TT형(70.0％),단삼자지간차이무통계학의의(x2=2.711,P＞ 0.05).MxA-123위점,CA형、CC형급AA형삼자INF료효응답솔분별위78.0％、72.6％급75.0％,차이무통계학의의(x2=0.453,P＞0.05).HCV기인Ⅰ형여비1형환자MxA기인형지간INF적조기응답솔비교,HCV기인비1형환자G/T、T/T형(91.5％)호우GG형(77.5％),단차이무통계학의의(x2=3.327,P=0.068),HCV기인1형환자MxA각기인형간응답솔차이야무통계학의의.단시,HCV기인비1형환자여Ⅰ형환자간비교,전자G/T、T/T형(91.5％)응답솔고우후자G/T、T/T형(62.5％),차이유통계학의의(P＜0.05).결론 HCV기인비1형환자MxA계동자-88、-123각기인형대INF응답솔호우HCV기인1형환자,MxA-88위점위GT형적HCV/HIV환자적INF료효교호,가위INF치료적예후급개성화치료제공삼고의거.
Objective To explore the relationship of host single nucleotide polymorphisms( SNP )of the MxA gene and HCV genotype with early virological response ( EVR ) )to interferon for HIV/HCV coinfected patients.Methods 151 HIV/HCV co-infected patients were treated with interferon-2b ( INF-2b ) plus ribavirin( RBV ) for 24 weeks,then were divided into EVR group and non EVR ( NEVR )group.HCV genotype and SNP of the MxA promoter-88 site and -123 site were examined by polymerase chain reaction-restriction fragment length polymorphism ( PCR-RFLP ) and the relationship of SNP of MxA and HCV genotype with EVR to IFN-2b were analysed.Results 12 cases were excluded because of no record of HCV genotype.Among the 139 patients,52 cases ( 34.4％ ) were genotype 1,87 cases ( 57.7％ ) were non-1 genotype.The rate of EVR in was higher in genotype 1 than in non-1 genotype ( x2=14.547,P ＜ 0.001 ); GT genotype at MxA promoter-88 responded better to INF treatment than GG and TT genotype,but the difference was not significant( x2=2.711,P ＞ 0.05 ).AT MxA promoter-123 site,the responses among CC,CA and AA genotype were not significantly different ( x2=0.453,P ＞ 0.05 ).In HCV non-1 genotype patients,the rate of EVR was higher in GT and TT genotype ( 91.5％ ) than in GG genotype ( 77.5％ ),but the difference was not significant ( x2=3.327,P=0.068 ).The rates of EVR in GT,GG and TT genotype of HCV genotype 1 patients were not significantly different.The rate of EVR in GT and TT genotype( 91.5％ )was higher in HCV genotype 1 patients than in non-1 genotype patients( 62.5％ ),and the difference was significant ( P ＜ 0.05 ).Conclusions Among HIV/HCV co-infected patients,those HCV non-1 genotype patients have a higher rate of EVR to INF than those genotype 1 ones,and those with GT genotype at MxA promoter-88 responds better to IFN treatment.It can be helpful in assessing the outcome and prognosis of IFN treatment.