IL-28B基因突变与慢性丙型肝炎治疗应答的相关性研究

目的 探讨白介素28B(IL-28B)基因型与慢性丙型肝炎(CHC)患者抗病毒治疗反应的相关性.方法 220例CHC患者均接受聚乙二醇干扰素(peg-IFN)联合利巴韦林(RBV)治疗48周,随访至停药后24周.检测IL-28B(rs8099917)位点,比较IL-28B基因型与抗病毒疗效的关系,评估IL-28B单核苷酸多态性(SNP)在CHC患者治疗应答中的作用.结果 TT、TG和GG基因型在持续应答组(SVR)中的比例分别是71.4％、25.0％和3.6％；在无应答组(NR)分别是15.8％、60.5％和23.7％；在复发组(RP)分别是38.1％、52.3％和9.6％；三组之间比较差异具有统计学意义(P＜0.001).NR与SVR组内基因型比较,TG vsTT的OR为7.67(P＜0.001,95％ CI:2.91～20.56),差异有统计学意义.RP与SVR组内基因型比较,TG vsTT的OR为3.10(P＜0.01,95％ CI:1.41～6.36),差异有统计学意义.结论 IL-28B(rs8099917)基因型与慢丙肝患者抗病毒应答密切相关,可作为治疗前的一个重要的预测因子.

Genetic variation of IL-28B is associated with treatment response of patients with chronic hepatitis C

Objective To explore the effect of IL-28B variation on the response of patients with chronic hepatitis C virus （HCV） infection to therapy. Methods A total of 220 patients with chronic hepatitis C （CHC） were prospectively treated with pegilated interferon （peg-IFN） in combination with ribavirin （RBV） for 48 weeks. After completing the therapy, the patients were followed-up for 24 weeks and the therapeutic effectiveness was evaluated. The rs8099917 was identified from each cohort. The IL28B genotype was compared in hepatitis C patients to assess the effect of single nucleotide polymorphism （SNP） on different treatment response. Result The proportion of the rs8099917 TY, TG, and GG genotypes was 71.4% , 25.0% , and 3.6% in sustained viral response （SVR） group; 15.8% , 60. 5% ,23.7% in null response （NR） group; 38.1% ,52.3% ,9.6% in relapse （RP） group. There was a statistically significant difference in the genotype among SVR, NR and RP groups （P 〈 0. 001, Chi-square test）. NR vs. SVR （TG vs. TT： OR=7.67,95% CI： 2.91-20.56, P〈0.001）. RPvs. SVR （TGvs. TT： OR=3.10, 95% CI： 1.14-6.36, P 〈 0. 01 ）. Conclusions The genotypes of IL-28 B （rs8099917） is closely related to the effectiveness of peg-IFN-α/RBV therapy, and it is an important predictive factor before treatment in patients with chronic hepatitis C.