CAJ | 학술논문

目的：分析武汉地区慢性丙型病毒性肝炎患者的白细胞介素-28B（IL-28B）单核苷酸位点rs12979860多态性对抗病毒治疗的病毒学应答及持续病毒学应答的影响。方法对224例慢性丙型病毒性肝炎患者进行全程联合抗病毒治疗，基线水平进行了IL-28B rs12979860位点基因多态性检测，抗病毒治疗疗程为48周，治疗结束后随访24周，有179例患者完成了全部随访。结果224例患者IL-28B rs12979860位点基因型以CC型为主占87.1%，CT型占12.9%，未发现TT型，对武汉地区224例慢性丙型肝炎患者予以 PEG-IFNα-2a 联合 RBV 治疗48周，治疗结束时病毒学应答（ETVR）率为91.9%（206例），持续病毒学应答率（SVR）为77.7%（174例），复发32例，反弹11例，无应答7例。CC型患者的SVR率明显高于CT型患者（81.0% vs.55.2%），差异有统计学意义（P＜0.05）。结论我国武汉地区慢性丙型肝炎患者的IL-28B rs12979860位点基因型以CC型为主，C等位基因频率明显高于T等位基因频率，PEG-IFNα-2a联合RBV治疗慢性丙型肝炎疗效显著，其SVR率可达87.2%。IL-28B rs12979860位点CC型患者的SVR率明显高于CT型，因此宿主IL-28B位点多态性检测对抗病毒疗效的预测有一定价值，可作为丙型肝炎患者抗病毒治疗效果的预测因素之一。
목적：분석무한지구만성병형병독성간염환자적백세포개소-28B（IL-28B）단핵감산위점rs12979860다태성대항병독치료적병독학응답급지속병독학응답적영향。방법대224례만성병형병독성간염환자진행전정연합항병독치료，기선수평진행료IL-28B rs12979860위점기인다태성검측，항병독치료료정위48주，치료결속후수방24주，유179례환자완성료전부수방。결과224례환자IL-28B rs12979860위점기인형이CC형위주점87.1%，CT형점12.9%，미발현TT형，대무한지구224례만성병형간염환자여이 PEG-IFNα-2a 연합 RBV 치료48주，치료결속시병독학응답（ETVR）솔위91.9%（206례），지속병독학응답솔（SVR）위77.7%（174례），복발32례，반탄11례，무응답7례。CC형환자적SVR솔명현고우CT형환자（81.0% vs.55.2%），차이유통계학의의（P＜0.05）。결론아국무한지구만성병형간염환자적IL-28B rs12979860위점기인형이CC형위주，C등위기인빈솔명현고우T등위기인빈솔，PEG-IFNα-2a연합RBV치료만성병형간염료효현저，기SVR솔가체87.2%。IL-28B rs12979860위점CC형환자적SVR솔명현고우CT형，인차숙주IL-28B위점다태성검측대항병독료효적예측유일정개치，가작위병형간염환자항병독치료효과적예측인소지일。
ObjectiveTo analyse the effect of single nucleotide polymorphism rs12979860 of interleukin-28B (IL-28B) on virologic and sustained virological response to anti-virus therapy for chronic hepatitis C patients in Wuhan region. MethodsA total of 224 patients with chronic hepatitis C were enrolled in this study. All of them received the whole process of combined antiviral therapy, and the baseline levels of IL-28B rs12979860 gene polymorphism were detected. When the 48-week antiviral therapy was finished, we did a 24-week followed up to the patients, and 179 patients completed the follow-up.ResultsThe distribution of IL-28B rs12979860 genotype CC and CT were 87.1% and 12.9%, respectively; while the genotype CC was not detected in the 224 patients. After 48-week combined therapy of PEG-IFNα-2a and RBV, the rate of virological response (ETVR) was 91.9% (206 cases), and the rate of sustained virological response (SVR) was 77.7% (174 cases). In addition, we found 32 cases of recurrence, 11 cases of rebound, and 7 cases non-response. SVR rate in patients with the genotype CC was significantly higher than the patients with genotype CT (81.0%vs. 55.2%), and the difference was statistically significant (P<0.05).ConclusionIn Wuhan area of our country, the genotype of IL-28B rs12979860 is mainly CC genotype in patients with chronic hepatitis C, and the C allele frequency was significantly higher than that of T allele frequency. Combined therapy of PEG-IFNα-2a and RBV is effective to treat the chronic hepatitis C, the SVR rate of which is up to 87.2%. SVR was significantly higher in patients with genotype CC of IL-28B rs12979860 than that of CT genotype. To detect the single nucleotide polymorphism of IL-28B is valuable for the prediction on antiviral efficacy.