Correlation of HLA- DRBl * 15 allele with short term antiviral effect of adefovir dipivoxil

目的 探讨人类白细胞相关抗原DRB1*15(HLA-DRB1*15)等位基因位点与阿德福韦酯治疗慢性乙型肝炎(CHB)6个月时疗效的相关性.方法 以阿德福韦酯治疗的CHB患者6个月时有效及无效病例(分别为52 和42例)作为研究对象,采用序列特异性引物聚合酶链反应技术( PCR - SSP)对两组研究对象中HLA - DRBI* 15基因位点进行检测并对此等位基因位点的频率进行比较分析.结果 HLA - DRBI* 15等位基因位点在CHB及相同抗病毒疗效中分布与HBeAg无统计学差异,HLA - DRBI*15等位基因位点在治疗有效组和无效组中的频率分布差异存在统计学意义(x2=5,050,P= 0.025,OR=3.176,95％ CI:1.127～8.951).结论 HIA - DRB1* 15在CHB及相同抗病毒疗效中的分布与HBeAg无相关性,HLA - DRBl* 15可能是阿德福韦酯抗HBV有效的预测指标.     

贵州侗族HLA-DRB1基因多态性与拉米夫定抗病毒近期疗效的相关性

目的初步探讨贵州侗族人类白细胞抗原(HLA)-DRB1基因多态性与拉米夫定抗乙型肝炎病毒近期疗效的相关性。方法选取贵州省侗族慢性乙型肝炎患者90例,予口服拉米夫定每日100mg,疗程24周;分别于基线、12周、24周检测HBV DNA及ALT,据治疗24周后HBV DNA及ALT变化将患者分为有效组(完全应答及部分应答)和无效组(无应答);测定两组受试人群的HLA-DRB1基因型;统计学处理HLA-DRB1基因型在两组之间是否存在差异。结果 HLA-D刘琴RB1*07、*14基因频率在拉米夫定治疗无效组明显高于有效组(HLA-DRB1*07:12.5%VS2.31%,χ2=10.097,P0.05,OR=0.300;HLA-DRB1*14:18.75%VS 9.23%,χ2=7.049,P0.05 OR=0.149),其他等位基因频率在两组间差异无显著性。结论推测拉米夫定抗病毒疗效与HLA-DRB1存在一定相关性,携带HLA-DRB1*07、*14基因患者预示拉米夫定抗病毒疗效不佳。     

HLA-DRB1*09/12/15与广西HBV相关性肝病的关系

目的:探讨HLA-DRB1*09/12/15等位基因频率与广西乙型肝炎病毒(hepatitis B virus,HBV)相关性肝病病情的关系.方法:应用聚合酶链反应-序列特异性引物(polymerase chain reaction-sequence specific primer,PCR-SSP)技术对64例慢性无症状HBV携带者(asymptomatic chronic hepatitis B,ASC)组、80例慢性乙型肝炎(chronic hepatitis B,CHB)组、65例乙肝肝硬化(liver cirrhosis,LC)组、56例乙肝肝细胞癌(hepatocellular carcinoma,HCC)组以及75例正常对照(NC)组的HLA-DRB1*09/12/15等位基因进行检测,分析其表达频率与慢乙肝病情的相关性.结果:乙肝肝硬化组HLA-DRB1*15等位基因的携带率(10.8%),较NC组(34.7%)、ASC组(39.1%)、HCC组(33.9%)、CHB组(33.8%)明显减低,差异具有统计学意义(P<0.01),其余各组两两比较均无统计学差异;HLA-DRB1*09/12在各组间的分布均无统计学差异.结论:HLA-DRB1*15等位基因携带者感染HBV后可能降低乙肝肝硬化发生的风险,HLA-DRB1*15可能是广西乙肝肝硬化的抵抗基因.     

苦参素联合胸腺因子α1应用于阿德福韦酯治疗后HBV DNA阴性HBeAg阳性慢性乙型肝炎的临床研究

目的:探讨苦参素联合胸腺因子α1应用于阿德福韦酯治疗后HBV DNA阴性HBeAg阳性慢性乙型肝炎(CHB)的临床疗效.方法:选择150例CHB患者,均首次选用阿德福韦酯抗病毒治疗,在治疗48周、96周、144周时检测患者肝功能、HBV DNA、乙型肝炎病毒标志物(HBV-M)、甲胎蛋白(AFP)、肝胆脾超声,并记录患者症状变化.在治疗144周后,我们选取HBV DNA阴性而HBeAg阳性的CHB 37例,随机分为两组,治疗组19例,在继续服用阿德福韦酯的基础上,加用苦参素和胸腺因子α1;对照组18例,继续单独服用阿德福韦酯,疗程均为6个月.观察患者症状、肝功能、HBV-M、肝纤维化指标、肝胆脾超声等.结果:150例患者在治疗48周、96周、144周时,HBV DNA阴转率分别为36.00％、60.67％、82.00％;ALT复常率分别为61.33％、76.00％、89.33％;HBeAg阴转率分别为34.00％、52.00％、72.00％,与治疗前相比,差异均有显著性意义(P＜0.05).选取的19例HBV DNA阴性而HBeAg阳性的CHB患者,在治疗6个月后HBeAg阴转率高于对照组(P＜0.05),肝纤维化指标改善明显(P＜0.05).结论:阿德福韦酯治疗CHB,可以有效地降低病毒载量、改善患者肝功能、促进HBeAg阴转.阿德福韦酯治疗后HBV DNA阴性而HBeAg阳性的CHB者,加用苦参素和胸腺因子α1治疗可取得比单用阿德福韦酯更好的疗效.     

六味五灵片联合阿德福韦酯治疗慢性乙型肝炎疗效观察

目的观察六味五灵片联合阿德福韦酯治疗慢性乙型肝炎(CHB)的效果。方法将82例CHB患者随机分成六味五灵片联合阿德福韦酯组(治疗组)44例和阿德福韦酯组(对照组)38例,疗程均为24周,观察临床症状、体征、生物化学、病毒复制指标的变化。结果治疗24周后,治疗组患者综合疗效、肝功能复常率、HBeAg、HBVDNA低于检测下限的比率均优于对照组,差异有统计学意义(P<0.05)。结论六味五灵片联合阿德福韦酯治疗慢性乙型肝炎在改善患者症状、恢复肝功能和抗病毒等方面均有很好疗效。     

HLA-DRB1*03/04等位基因与广西原发性肝癌家族聚集性的相关性

目的:探讨HLA-DRB1*03/04等位基因与广西原发性肝癌家族聚集性的相关性,为寻找原发性肝癌的遗传易感基因或抗病基因提供线索.方法:采取性别、年龄±5岁配对方法,在广西肝癌高发区选取肝癌高发家族成员、肝癌单发家族成员和无癌家族成员各150例作为研究对象,采集研究对象外周全血提取DNA,应用PCR-SSP方法对HLA-DRB1*03/04等位基因进行检测.结果:HLA-DRB1*03在肝癌高发家族组的表达频率(16.7%)稍高于肝癌单发家族组(12.7%)及无癌家族组(16.0%),该等位基因在3组间的分布无显著性差异(?2=1.074,P=0.584);HLA-DRB1*04在肝癌高发家族组的表达频率(14.7%)稍高于肝癌单发家族组(5.3%)及无癌家族组(7.3%),其在3组间的分布有显著性差异(?2=8.748,P=0.013).结论:HLA-DRB1*04等位基因可能与广西肝癌高发区原发性肝癌的家族聚集性存在相关性;而HLA-DRB1*03等位基因则与之无明显相关.     

汉族老年慢性乙型肝炎患者HLA-DRB1基因多态性

目的探讨汉族老年慢性乙型肝炎患者HLA-DRB1基因多态性。方法选取汉族老年人群中的53例慢性乙型肝炎患者、100例正常健康老年人以及31例乙型肝炎表面抗原携带者作为研究对象,分别为病例组、抗原携带组和健康对照组,对三组研究对象的HLA-DRB1等位基因分型进行比较,并对HBV不同复制状态者HLA-DRB1等位基因分型进行分析。结果病例组的HLA-DRB1*03等位基因频率明显较健康对照组高,而HLA-DRB1*15等位基因频率明显低于健康对照组(P<0.05),抗原携带者与健康对照组比较,HLA-DRB1各等位基因的频率,无显著性差异(P>0.05)。HBV高复制状态组的DRB1*07基因位点明显较低复制状态组多见(P<0.05)。结论汉族老年慢性乙型肝炎患者与HLA-DRB1基因多态性之间存在比较强的相关性。     

细胞因子诱导性杀伤细胞联合阿德福韦酯治疗慢性乙型肝炎疗效观察

目的:探索细胞因子诱导性杀伤细胞(CIK)联合阿德福韦酯治疗慢性乙型肝炎(CHB)的临床疗效。方法:选取CHB患者50例,CIK联合阿德福韦酯组25例,单用阿德福韦酯组25例,治疗1、3、6个月后复查HBVDNA和HBV血清标志物。结果:治疗1、3、6个月后两组HBV DNA均明显下降,但相比差异有显著性意义(P<0.05),治疗1、3、6个月后,HBV DAN转阴率CIK联合阿德福韦酯组分别为20%、64%和80%,而单用阿德福韦酯组分别为0、36%和52%,两组相比均P<0.05;两组患者治疗1、3、6个月后HBeAg转阴率和HBeAg血清学转换率相比差异均有显著性意义(P<0.05)。结论:阿德福韦酯单用或与CIK联合治疗CHB 3～6个月后,能使CHB患者HBV DNA水平显著下降,在与CIK联合治疗后使HBV DNA水平下降更加显著,特别是提高了HBV DNA转阴率,显示核苷类似物阿德福韦酯与CIK联合治疗能增强抗乙型肝炎病毒的效率,有助于病毒的清除。     

HBV感染者人类白细胞Ⅰ,Ⅱ类抗原等位基因多态性分析

目的:分析HBV感染者体内病毒持续和清除与HLA-A,B,DRB1各位点等位基因分布频率的关系.方法:采用序列特异性引物-聚合酶链式反应(PCR-SSP)技术,对61例慢性乙型肝炎患者(CHB)、32例HBV感染后病毒清除者(感染恢复组)和40例骨髓移植供者(正常组)的外周血白细胞,进行人类白细胞抗原等位基因(HLA-A,B,DRB1)分型检测.结果:在慢性乙型肝炎组,HLA-DRB1*12等位基因分布频率较正常组(0.230vs0.075,P=0.004,OR=3.674,95%CI:1.445-9.338)和HBV感染恢复组(0.230vs0.063,P=0.004,OR=4.468,95%CI:1.492-13.377)均显著增高,HLA-B*35,DRB1*13则显著降低(0.066vs0.163,P=0.027,OR=0.362,95%CI:0.143-0.918;0.016vs0.008,P=0.017,OR=0.174,95%CI:0.035-0.859);HLA-A*69,B*56也显著降低(均0.000vs0.037,P=0.031).HLA-A*02等位基因分布频率在慢性肝炎组与HBV感染恢复组比较显著降低(P=0.044),HLA-B*51在感染恢复组与正常组比较显著增高(P=0.019).结论:机体对HBV易感性和病毒持续或清除与HLA等位基因多态性相关.HLA-DRB1*12可能既为易感性位点,又能促进病毒的持续感染;HLA-B*51,A*02可能为易感性位点,但感染后易清除病毒;HLA-DRB1*13可能是抗HBV感染的保护性基因;HLA-B*35,B*56和A*69在中国北方汉族人可能也为抗HBV感染的保护性基因.     

HBeAg阳性慢性乙型肝炎患者血清学转换与OAS基因多态性的关联分析

目的探讨HBeAg阳性慢性乙型肝炎（CHB）患者经干扰素（IFN）α为基础的抗病毒治疗血清学转换与2＇,5＇寡腺苷酸合成酶（OAS）1、2、3及OASL基因单核苷酸多态性（SNP）的关系。方法 277例HBeAg阳性CHB患者给予IFNα及核苷酸类似物（NA）联合抗病毒治疗,依据HBsAg及HBeAg转换与否评价疗效,分为HBsAg转换组、HBeAg转换组及无应答组（NR）,同时纳入50例HBV自限性感染者作为对照。应用多聚酶链式反应（PCR）及限制性片段长度多态性（RFLP）检测宿主的抗病毒蛋白OAS1基因内含子区rs2285934（A/C）位点、OAS2基因外显子-2区rs2072138（C/G）位点、OAS3基因外显子-8区rs2072136（C/T）位点及OASL基因内含子区rs11849829（A/G）位点SNP,并分别比较OAS基因单位点、基因型及单体型与疗效的相关性。结果 277例患者中HBsAg转换组41例（14.80%）,HBeAg转换组102例（36.82%）,NR组134例（48.38%）。OAS3等位基因C/T在四组间分布频率差异有统计学意义（χ2=16.2,P=0.001）,携带CC＋CT基因型患者与TT基因型分布频率在HBsAg转换组及NR组间存在差异,统计学差异居于临界值（χ2=3.17,P=0.07）。单体型分析显示：单体型ACCG、CCTG在应答组与NR组的分布频率差异有统计学意义（χ2=4.39,P=0.04;χ2=4.89,P=0.03）。结论携带OAS3（rs2072136）C等位基因的HBeAg阳性CHB患者易于获得IFNα治疗HBsAg转换,其单体型可作为获得HBeAg转换的预测因素。     

Adefovir dipivoxil alone or in combination with lamivudine in patients with lamivudine-resistant chronic hepatitis B

BACKGROUND AND AIMS: Adefovir dipivoxil possesses potent in vitro and in vivo antiviral activity in wild-type hepatitis B. This study assessed the safety and efficacy of adefovir dipivoxil alone and in combination with lamivudine compared with ongoing lamivudine therapy in patients with chronic hepatitis B with compensated liver disease and lamivudine-resistant hepatitis B virus (HBV). METHODS: Fifty-nine hepatitis B e antigen (HBeAg)-positive patients with genotypic evidence of lamivudine-resistant HBV, serum alanine aminotransferase (ALT) level > or =1.2 times the upper limit of normal, and serum HBV DNA level > or =6 log(10) copies/mL despite ongoing treatment with lamivudine were randomized to adefovir dipivoxil 10 mg, lamivudine 100 mg, or addition of adefovir dipivoxil to ongoing lamivudine daily. The primary end point was the time-weighted average change from baseline in serum HBV DNA level (DAVG) up to week 16. RESULTS: Rapid reductions in serum HBV DNA level were seen by 4 weeks in all recipients of adefovir dipivoxil; DAVG(16) was -0.07 in the lamivudine group compared with -2.45 and -2.46 log(10) copies/mL in the adefovir dipivoxil/lamivudine and adefovir dipivoxil monotherapy groups, respectively (P < 0.001). Median change from baseline in serum HBV DNA level at week 48 was 0.0, -3.59, and -4.04 log(10) copies/mL in the lamivudine, adefovir dipivoxil/lamivudine, and adefovir dipivoxil groups, respectively. ALT level normalized in 10 of 19 (53%) and 9 of 18 (47%) recipients of adefovir dipivoxil/lamivudine and adefovir dipivoxil, respectively, compared with 1 of 19 (5%) recipients of lamivudine. Three patients receiving adefovir dipivoxil or adefovir dipivoxil/lamivudine and none receiving lamivudine monotherapy were HBeAg negative at week 48 and one became hepatitis B surface antigen negative. CONCLUSIONS: These data, limited to patients with compensated liver disease, indicate that adefovir dipivoxil alone or in combination with ongoing lamivudine therapy provides effective antiviral therapy in patients with lamivudine-resistant HBV.     

Association between HLA class Ⅱ gene and susceptibility or resistance to chronic hepatitis B

AIM: To investigate the association between the polymorphism of HLA-DRB1, -DQA1 and -DQB1 alleles and viral hepatitis B.METHODS: HLA-DRB1, -DQA1 and -DQB1 alleles in 54patients with chronic hepatitis B, 30 patients with acute hepatitis B and 106 normal control subjects were analyzed by using the polymerase chain reaction/sequence specific primer (PCR/SSP) technique.RESULTS: The allele frequency of HLA-DRB1*0301 in the chronic hepatitis B group was markedly higher than that in the normal control group (17.31% VS 5.67%), there was a significant correlation between them (χ2= 12.3068,Pc=0.0074, RR=4.15). The allele frequency of HLADQA1*0501 in the chronic hepatitis B group was significantly higher than that in the normal control group (25.96% VS 13.68%), there was a significant correlation between them (χ2=9.2002, PC＝0.0157, RR=2.87). The allele frequency of HLA-DQB1*0301 in the chronic hepatitis B group was notably higher than that in the normal control group (35.58%vs 18.87%), there was a significant correlation between them (χ2=15.5938, PC=0.0075, RR=4.07). The allele frequency of HLA-DRB1*1101/1104 in the chronic hepatitis B group was obviously lower than that in the normal control group (0.96% VS 13.33%), there was a significant correlation between them (χ2=11.9206, PC=0.0145, RR=18.55). The allele frequency of HLA-DQA1*0301 in the chronic hepatitis B group was remarkably lower than that in the normal control group (14.42% VS30%), there was a significant correlation between them (χ2=8.7396, Pc=0.0167, RR=0.35).CONCLUSION: HLA-DRB1*0301, HLA-DQA1*0501 and HLA-DQB1*0301 are closely related with susceptibility to chronic hepatitis B, and HLA-DRB1*1101/1104 and HLADQA1*0301 are closely related with resistance to chronic hepatitis B. These findings suggest that host HLA class Ⅱ gene is an important factor determining the outcome of HBV infection.     

Association between HLA class Ⅱ gene and susceptibility or resistance to chronic hepatitis B

AIM: To investigate the association between the polymorphism of HLA-DRB1, -DQA1 and -DQB1 alleles and viral hepatitis B. METHODS: HLA-DRB1, -DQA1 and -DQB1 alleles in 54 patients with chronic hepatitis B, 30 patients with acute hepatitis B and 106 normal control subjects were analyzed by using the polymerase chain reaction/sequence specific primer (PCR/SSP) technique. RESULTS: The allele frequency of HLA-DRB1*0301 in the chronic hepatitis B group was markedly higher than that in the normal control group (17.31% vs 5.67 %), there was a significant correlation between them (X^2= 12.3068,PC=0.0074, RR=4.15). The allele frequency of HLA-DQAI*0501 in the chronic hepatitis B group was significantly higher than that in the normal control group (25.96 % vs 13.68 %), there was a significant correlation between them (X^2=9.2002, PC=0.0157, RR=2.87). The allele frequency of HLA-DQBI*0301 in the chronic hepatitis B group was notably higher than that in the normal control group (35.58 % vs 18.87 %), there was a significant correlation between them (x^2=15.5938, PC=0.0075, RR=4.07). The allele frequency of HLA-DRB1*1101/1104 in the chronic hepatitis B group was obviously lower than that in the normal control group (0.96 % vs 13.33 %), there was a significant correlation between them (X^2=11.9206, PC=0.0145, RR=18.55). The allele frequency of HLA-DQAI*0301 in the chronic hepatitis B group was remarkably lower than that in the normal control group (14.42 % vs30 %), there was a significant correlation between them (X^2=8.7396, PC=0.0167, RR=0.35). CONCLUSION: HLA-DRBI*0301, HLA-DQAI*0501 and HLA-DQBI*0301 are closely related with susceptibility to chronic hepatitis B, and HLA-DRB1*1101/1104 and HLA-DQAI*0301 are closely related with resistance to chronic hepatitis B. These findings suggest that host HLA class Ⅱ gene is an important factor determining the outcome of HBV infection.     

Treatment of HBeAg-negative chronic hepatitis B

The goals of therapy in hepatitis B e antigen (HBeAg)-negative chronic hepatitis B (CHB) are to abolish or efficiently suppress viral replication, which represents the main determinant of underlying liver necroinflammation and fibrosis. Currently available agents include interferon-alfa (IFN-alpha), lamivudine, and soon adefovir dipivoxil. A > or = 12-month course of IFN-alpha treatment or retreatment achieves sustained biochemical responses in 15 to 25% of patients with eventual hepatitis B surface antigen (HBsAg) loss and anti-HBs development in a proportion of them. Lamivudine induces initial virologic and biochemical responses in 70 to 90%, but breakthroughs due to lamivudine-resistant mutants accumulate with continuation of therapy and thus only one third of patients may remain in remission after the third year of therapy. Adefovir dipivoxil also achieves on-therapy responses in the majority of cases. Adefovir dipivoxil and entecavir appear to be effective against lamivudine-resistant strains. Many other antiviral agents and immunomodulatory approaches are currently evaluated for CHB, but, besides IFN-alpha, none has yet been convincingly shown to induce sustained off-therapy responses.     

阿德福韦酯联合苦参素治疗慢性乙型肝炎的临床研究

目的观察阿德福韦酯联合苦参素治疗慢性乙型肝炎的疗效。方法146例慢性乙型肝炎患者被随机分为观察组70例,给予阿德福韦酯10mg/d,苦参素0.6g/d静脉滴注或肌肉注射;和对照组76例仅给予阿德福韦酯治疗。观察治疗24周时的应答反应情况。结果治疗24周时,观察组和对照组HBVDNA阴转率、ALT复常率、HBeAg阴转率和完全应答率分别为67.1%和50.0%、78.6%和58.9%、30.4%和11.5%及27.1%和13.2%,各指标均有显著性差异（P分别为0.0359、0.0076、0.0205及0.0344）。两组不良反应发生率相近。结论联合苦参素治疗慢性乙型肝炎能显著提高阿德福韦酯抗病毒治疗的早期疗效。     

lnfluence of HLA-DRB1 alleles and HBV genotypes on interferon-α therapy for chronic hepatitis B

AIM: To investigate the influence of HLA-DRB(1) alleles and HBV genotypes on interferon-alpha therapy for chronic hepatitis B. METHODS: HLA-DRB1*03, *07, *09, *12, *15 alleles were determined using polymerase chain reaction/sequence specific primer (PCR/SSP) technique in 126 patients with chronic hepatitis B and 76 normal control subjects in Shandong Province, and HBV genotypes were determined by nested-PCR analysis using type-specific primers in 126 patients. RESULTS: The positivity of HLA-DRB1*07 allele in chronic hepatitis B group was significantly higher than that in normal control group (chi(2) = 6.33, P<0.025, RR = 2.37). Among the 126 patients, genotype B was found in 38 (30.2%), genotype C in 69 (54.8%), and mixed genotype (B+C) in 19 (15.0%), genotypes D-F were not found. Among the 46 DRB1*07(+) patients, 7 were responders and 39 were non-responders among them (chi(2) = 6.71, P<0.05). The positivity of HLA-DRB1*07 and prevalence of HBV genotype C were significantly higher in non-responders than in responders. CONCLUSION: High positivities of HLA-DRB1 *07 allele and HBV genotype C are closely associated with the lower response to interferon-alpha therapy for chronic hepatitis B.     

Tnfluence of HLA-DRB1 alleles and HBV genotypes on interferon-α therapy for chronic hepatitis B

AIM: To investigate the influence of HLA-DRB1 alleles and HBV genotypes on interferon-α therapy for chronic hepatitis B.METHODS: HLA-DRB1*03, *07, *09, *12, *15 alleles were determined using polymerase chain reaction/sequence specific primer (PCR/SSP) technique in 126 patients with chronic hepatitis B and 76 normal control subjects in Shandong Province, and HBV genotypes were determined by nested-PCR analysis using type-specific primers in 126 patients.RESULTS: The positivity of HLA-DRB1*07 allele in chronic hepatitis B group was significantly higher than that in normal control group (x2 = 6.33, P<0.025, RR = 2.37). Among the 126 patients, genotype B was found in 38 (30.2%), genotype C in 69 (54.8%), and mixed genotype (B+C) in 19 (15.0%),genotypes D-F were not found. Among the 46 DRB1*07(+)patients, 7 were responders and 39 were non-responders among them (x2 = 6.71, P<0.05). The positivity of HLADRB1*07 and prevalence of HBV genotype C were significantly higher in non-responders than in responders.CONCLUSION: High positivities of HLA-DRB1 *07 allele and HBV genotype C are closely associated with the lower response to interferon-α therapy for chronic hepatitis B.     

Tnfluence of HLA-DRB1 alleles and HBV genotypes on interferon-α therapy for chronic hepatitis B

AIM: To investigate the influence of HLA-DRB1 alleles and HBV genotypes on interferon-α therapy for chronic hepatitis B.METHODS: HLA-DRB1*03, *07, *09, *12, *15 alleles were determined using polymerase chain reaction/sequence specific primer (PCR/SSP) technique in 126 patients with chronic hepatitis B and 76 normal control subjects in Shandong Province, and HBV genotypes were determined by nested-PCR analysis using type-specific primers in 126 patients.RESULTS: The positivity of HLA-DRB1*07 allele in chronic hepatitis B group was significantly higher than that in normal control group (x2 = 6.33, P<0.025, RR = 2.37). Among the 126 patients, genotype B was found in 38 (30.2%), genotype C in 69 (54.8%), and mixed genotype (B+C) in 19 (15.0%),genotypes D-F were not found. Among the 46 DRB1*07(+)patients, 7 were responders and 39 were non-responders among them (x2 = 6.71, P<0.05). The positivity of HLADRB1*07 and prevalence of HBV genotype C were significantly higher in non-responders than in responders.CONCLUSION: High positivities of HLA-DRB1 *07 allele and HBV genotype C are closely associated with the lower response to interferon-α therapy for chronic hepatitis B.     

六味五灵片联合阿德福韦酯治疗慢性乙型肝炎肝硬化疗效分析

目的：观察六味五灵片联合阿德福韦酯治疗慢性乙型肝炎（CHB）肝硬化的临床效果.方法：将55例CHB肝硬化患者随机分成两组,治疗组28例,口服六味五灵片和阿德福韦酯;对照组27例,单纯口服阿德福韦酯;均治疗48W,观察治疗前后两组患者临床症状、肝功能、HBV DNA、肝纤维化指标的变化.结果：治疗组患者治疗48W ALT的复常率为95％,HBV DNA转阴率为78.9％,肝纤维化指标明显降低,主要临床症状明显改善,优于对照组,治疗组总有效率为88.5％,对照组总有效率为61.3％.结论：六味五灵片联合阿德福韦酯治疗CHB肝硬化能够降低患者血清肝纤维化指标,提高临床疗效.