献血人群HCV感染者自然转归与HLA－Ⅱ类等位基因的关系

目的：了解广州献血人群中丙型肝炎病毒（ HCV）感染者自然转归与HLA多态性的相关性，为HCV治疗策略的制定、预后的评估及疫苗的研制提供科学依据。方法选取广州献血人群中373例HCV感染者，分为两组：自发清除组（133例）和慢性感染者（240例），利用HLA－SBT方法对373份感染者进行HLA－Ⅱ类等位基因分型，用χ2检验分析每个HLA等位基因频率在自发清除组和慢性感染组的分布是否存在差异，并应用多因素Logistic回归对可能影响HCV自然转归的多种因素进行分析。结果自发清除组与慢性感染组相比年龄较小（28．2±9．9）岁vs（31．3±9．0）岁，t＝－2．998，P＝0．003]，HCV自发清除组女性比例较高（34．6％ vs 17．9％，χ2＝13．090，P＜0．01）。 DQB1*05：02（P＝0．002，OR＝0．411，95％CI＝0．232～0．727）和DRB1*14：54（P＝0．027， OR＝0．350，95％CI＝0．132～0．926）在慢性感染组中更为多见，DRB1*11：01在自发清除组较为常见（ P＝0．007， OR＝2．169，95％CI＝1．223～3．848）。多因素logistic回归分析发现，年龄（ P＜0．01，OR＝1．035，95％CI＝1．018～1．053）、性别（P＜0．01，OR＝0．423，95％CI＝0．297～0．603）和DQB1*05：02（P＝0．016，OR＝0．480，95％CI＝0．264～0．873）、DRB1*11：01（P＝0．016，OR＝2．072，95％CI＝1．142～3．758）等位基因是HCV感染自然转归的独立相关因素。结论女性、较年轻的HCV感染者比较容易发生自发清除，携带DQB1*05：02等位基因的人群在感染HCV后更易发生慢性化，携带DRB1*11：01基因则容易发生自发清除。

The correlation between the natural outcomes of HCV infection and HLA polymorphism among voluntary blood donors

Objective To evaluate the correlation between the natural outcomes of hepatitis C virus ( HCV) in-fection and HLA polymorphism among Guangzhou blood donors , which could provide scientific data for treatment , preven-tion and vaccine development of HCV .Methods A total of 373 HCV infection blood donors , who donated in Guangzhou blood center , were recruited , including 133 blood donors with spontaneous HCV clearance and 240 with HCV persistent infection.Sequencing-based typing (SBT) methodology was used for detection of genotype HLA class II alleles .The differences in allelic frequencies of HLA -DPB1, DQB1 and DRB1 between spontaneous clearance group and persistent infection group were analyzed using the χ2 test.Multivariate logistic regression analysis was applied to identify independent factors associated with natural outcomes of HCV .Results The participants in spontaneous HCV clearance group were sig-nificantly younger (P=0.003), and with significantly higher female/male ratio (34.6%vs.17.9%, 2=13.090, P<0.01) than those in HCV persistent infection group .HLA-DQB1*05:02 (P=0.002, OR=0.411, 95%CI=0.232-0.727) and DRB1*14:54 (P=0.027, OR=0.350, 95%CI=0.132-0.926) were significantly more frequent in HCV persistent infection group , while the frequency of DRB 1*11:01 was significantly higher in spontaneous HCV clearance group (P=0.007, OR=2.169, 95%CI=1.223-3.848).The following variables were found independently associated with HCV clearance, age (P<0.01, OR=1.035, 95%CI=1.018-1.053), gender (P<0.01, OR=0.423, 95%CI=0.297-0.603), and HLA-DQB1*05:02 (P=0.016, OR=0.480, 95%CI=0.264-0.873), and HLA-DRB1*11:01 (P=0.016, OR=2.072, 95% CI=1.142-3.758).Conclusion Our results show that female and young subjects are more likely to have HCV spontaneous clearance .After HCV infection, subjects who carry DQB1*05:02 are more likely to develop persistent infection , while DRB1*11:01 carriers are in favor of spontaneous clearance .