宿主IL28B基因型联合病毒基因型对慢性丙型肝炎抗病毒疗效的预测

目的综合分析宿主IL28B基因型和丙型肝炎病毒（HCV）基因型对慢性丙型肝炎患者聚乙二醇干扰素联合利巴韦林抗病毒治疗疗效的影响。方法对120例慢性丙型肝炎患者进行全程联合治疗,其中92例患者完成了治疗后24周随访,同时分析HCV基因型及宿主IL28B基因型对治疗结束时应答（ETR）及持续病毒学应答（SVR）的影响。结果 IL28B基因CC型在这组慢性丙型肝炎患者中占89%。在HCV基因1b型患者中,IL28B基因CC型患者可以获得比非CC（N-CC）型更高的ETR率（P=0.001 4）和SVR率（P=0.000 7）,但在HCV基因非1b（N-1b）型患者中,CC型与N-CC型患者间的抗病毒疗效差异无统计学意义;在IL28B基因N-CC型患者中,HCV基因N-1b可以获得比1b型更高的ETR率（P=0.035 0）和SVR率（P=0.022 2）,但在CC型患者中,HCV基因N-1b与1b型间的疗效差异无统计学意义。结论 HCV基因型及宿主IL28B基因型对我国慢性丙型肝炎患者聚乙二醇干扰素联合利巴韦林抗病毒治疗疗效具有重要影响。联合检测宿主IL28B基因型和病毒基因型可以更加科学、准确地预测抗病毒疗效,为真正实现个体化治疗提供依据。

Host IL28B and viral genotype differences in responses to antiviral therapy efficacy in chronic hepatitis C

Objective To investigate host IL28B and viral genotype differences in responses to antiviral therapy efficiency in chronic HCV patients.Methods The study had 120 patients,who were able to complete the full course of combination therapy with pegylated interferon-α and ribavirin.Ninety-two patients were followed for 24 weeks after the cessation of treatment.The treatment efficiency was evaluated with end-of-treatment response（ETR） and sustained virological response（SVR）.A logistic regression model was applied to analyze the association of treatment efficacy with host IL28B and viral genotypes.Results The higher rates of ETR（P= 0.001 4） and SVR（P= 0.000 7） were observed in HCV genotype 1b infected patients with IL28B genotype CC than the rates in HCV genotype 1b infected patients with IL28B genotype N-CC.However,there was no significant difference in treatment efficiency between HCV genotype N-1b infected patients with IL28B genotype CC and HCV genotype N-1b infected patients with IL28B genotype N-CC.In the participants with IL28B genotype N-CC,the HCV genotype N-1b infected patients had higher rates of ETR（P=0.035 0） and SVR（P=0.022 2） than HCV genotype 1b infected patients did.However,there was no significant difference in treatment efficiency between IL28B genotype CC patients infected with HCV genotype 1b infection and IL28B genotype CC patients infected with N-1b.Conclusions HCV and host IL28B genotypes were associated with outcomes of patients treated with pegylated interferon-α and ribavirin.The determination of host IL28B and HCV genotypes could provide a reliable basis for individual therapy and predicting treatment efficacy.