CAJ | 학술논문

目的探讨慢性丙型肝炎病毒（HCV）感染者病毒基因型对聚乙二醇化干扰素联合利巴韦林抗病毒治疗病毒学应答的影响。方法采用PCR产物直接测序法检测71例HCV感染者的HCV基因型。所有患者接受聚乙二醇化干扰素皮下注射，联合口服利巴韦林抗病毒治疗。分析HCV基因型对快速病毒学应答（RVR）、早期病毒学应答（EVR）、治疗结束时病毒学应答（ETVR）和持续病毒学应答（SVR）的影响。结果71例患者中，HCV基因1b型48例，占67.6%；2a型12例，占16.9%；3a型6例，占8.5%；3b型2例，占2.8%；6a型1例，占1.4%；未分型2例，占2.8%。治疗4周时，基因1型组和非1型组的RVR分别为27.1%和87.0%，差异具有统计学意义（χ2=22.4076，P=0.000002）。治疗12周时，基因1型组和非1型组的EVR分别为39.6%和13.0%，差异有统计学意义（χ2=5.1216，P=0.02363）。疗程结束时，基因1型组和非1型组的ETVR分别为68.8%和100%，差异无统计学意义（χ2=2.9520，P=0.08577）。已停药随访24周的患者出现SVR者，基因1型组、非1型组分别为62.22%和100%，差异具有统计学意义（χ2=8.3797，P=0.00379）。结论我国HCV感染者基因型以1b型和2a型为主。基因1型HCV感染者的RVR、EVR和SVR均低于非基因1型者。
목적탐토만성병형간염병독（HCV）감염자병독기인형대취을이순화간우소연합리파위림항병독치료병독학응답적영향。방법채용PCR산물직접측서법검측71례HCV감염자적HCV기인형。소유환자접수취을이순화간우소피하주사，연합구복리파위림항병독치료。분석HCV기인형대쾌속병독학응답（RVR）、조기병독학응답（EVR）、치료결속시병독학응답（ETVR）화지속병독학응답（SVR）적영향。결과71례환자중，HCV기인1b형48례，점67.6%；2a형12례，점16.9%；3a형6례，점8.5%；3b형2례，점2.8%；6a형1례，점1.4%；미분형2례，점2.8%。치료4주시，기인1형조화비1형조적RVR분별위27.1%화87.0%，차이구유통계학의의（χ2=22.4076，P=0.000002）。치료12주시，기인1형조화비1형조적EVR분별위39.6%화13.0%，차이유통계학의의（χ2=5.1216，P=0.02363）。료정결속시，기인1형조화비1형조적ETVR분별위68.8%화100%，차이무통계학의의（χ2=2.9520，P=0.08577）。이정약수방24주적환자출현SVR자，기인1형조、비1형조분별위62.22%화100%，차이구유통계학의의（χ2=8.3797，P=0.00379）。결론아국HCV감염자기인형이1b형화2a형위주。기인1형HCV감염자적RVR、EVR화SVR균저우비기인1형자。
Objective To investigate viral genotypes of patients with chronic hepatitis C and its effects on virologic response of the combination therapy with peg-interferon plus ribavirin. Methods HCV genotypes of 71 patients were detected by direct sequencing of PCR products. All patients were treated with peg-interferon plus ribavirin. The rapid virological response (RVR), early virological response (EVR), end-of-treatment virological response (ETVR) and sustained virological response (SVR) rates of patients in different genotypes were compared and analyzed, respectively. Results Among 71 patients who infected with HCV, 48 cases (67.6%) were genotype 1b, 12 cases (16.9%) genotype 2a, 6 cases (8.5%) genotype 3a, 2 cases (2.8%) genotype 3b, 1 case (1.4%) genotype 6a, 2 cases (2.8%) with undifferentiated genotype. At the 4 th week after treatment, RVR rates were 27.1%and 87.0%in genotype 1 and non-genotype 1 patients, respectively, with signiifcant difference (χ2= 22.4076, P= 0.000002). At the 12th week after the treatment, EVR rates were 39.6%and 13.0%in genotype 1 and non-genotype 1 patients, respectively, with signiifcant difference (χ2=5.1216, P= 0.02363). When the treatment was ifnished, ETVR rates were 68.8%and 100%in genotype 1 and non-genotype 1 patients, respectively, without significant difference (χ2= 2.9520, P=0.08577). For patients who had ifnished treatment and were followed-up for 24 weeks, the SVR rates were 62.22%and 100%in genotype 1 and non-genotype 1 patients, respectively, with signiifcant difference (χ2=8.3797, P=0.00379). Conclusions The most common genotypes in China are 1b and 2a. The RVR, EVR and SVR rates of genotype 1 were signiifcanty lower than those of non-genotype 1.