HCV NS5b 1b与1b混合感染指标在干扰素治疗中的应用

目的 :探讨丙型肝炎病毒 (HCV)感染的基因型及其与干扰素应答效果的关系。方法 :应用逆转录—聚合酶链反应 (RT PGR)技术对 2 69例肝炎病人血清进行HCVNS5b区基因片段扩增 ,并对 5 6例阳性PCR产物进行酶切分型 ,同时观察干扰素α 2b对其中 48例慢性丙型肝炎的疗效。结果 :HCV单纯 1b型感染、1b与 1b混合感染及 2a型感染对干扰素的应答率分别为 70 % (14 /2 0 )、9 5 % (2 /2 1)、71 4% (5 /7) ;其中完全应答分别为 45 % (9/2 0 )、4 8% (1/2 1)、5 7 1% (4 /7) ;部分应答分别为 2 5 % (5 /2 0 )、4 8% (1/2 1)、14 3 % (1/7)。 1b与 1b混合感染组同单纯 1b型及 2a型感染组比较有显著性差异 (P <0 0 1) ,而单纯 1b型感染组与 2a型感染组比较无明显差异 (P >0 0 5 )。结论 :HCV单纯 1b型感染或 2a型感染者对干扰素敏感 ,而 1b与 1b混合感染者干扰素治疗效果极差 ,可作为预测干扰素疗效的一项新的重要指标

Typing of hepatitis C virus (HCV) genome with restriction endonuclease and its predictive value on the response to interferon therapy

Objective: To investigate the genotypes of HCV infection in Beijing areas and the relationship between HCV genotypes and the effectiveness of interferon(IFN) therapy.Methods: Reverse transcription polymerase chain reaction(RT PCR) for NS5b region was used to detect HCV RNA in 269 cases.56 positive PCR products were typed by restriction endonuclease.Results: 48 chronic hepatitis C patients with different genotypes(20 with type 1b,21 with type 1b/1b,7 with type 2a) were treated with recombinant interferon α 2b (IFN α 2b) for 24 weeks.The response rate of HCV genotype 1b infection was 70% (14/20),1b/1b co infection was 9 5%(2/21),2a infection was 71 4% (5/7).Conclusion: The response rate of HCV 1b/1b infection was significantly lower than that of HCV 16 or 2a infection( P <0 01)