聚乙二醇干扰素治疗IL28B rs12979860 C/C基因型慢性丙型肝炎的远期疗效评价
The long-term efficacy of PEG-IFN in treatment of chronic hepatitis C with IL28B rs12979860 C/C genotype

摘要：目的 探讨IL28B单核苷酸多态性(SNPs)rs12979860 C/C型的慢性丙肝(CHC)患者在不同HCV基因型中进行聚乙二醇干扰素(PEG-IFN)α-2a联合利巴韦林(RBV)抗病毒治疗的远期疗效。方法 采用前瞻性研究，观察兰州大学第一医院感染科2011年3月-2015年9月接受PEG-IFN联合RBV治疗48周并停药后随访42个月的CHC患者38例，以肝功能、脂代谢、持续病毒学应答(SVR)作为疗效的主要评价指标。结果 在纳入的IL28B SNP rs12979860 C/C型的CHC患者中，基因1b型的SVR率为73.33%，基因2a型SVR率为95.65%，两种基因型的SVR率可能无差异。抗病毒治疗后，两组肝功能指标ALT、AST、TBIL、TC、TG、HDL较治疗前均明显下降(P<0.05)；但两种基因型之间生化指标(转氨酶、GGT、胆红素、血脂)均无统计学差异(P>0.05)。结论 IL28BSNP rs12979860 C/C型的CHC患者在以IFN为基础的抗病毒治疗中具有较高的SVR率，以IFN为基础的抗病毒治疗后肝功能、脂代谢可得到明显改善，其远期疗效良好。
ABSTRACT: Objective To investigate the long-term efficacy of PEG-IFN alpha-2a (PEG-IFNα-2a)plus ribavirin (RBV) in treatment of chronic hepatitis C (CHC) patients with IL28B single nucleotide polymorphisms (SNPs) rs12979860 C/C type in different HCV genotypes. Methods A prospective study was conducted on 38 CHC patients from our hospital’s Infection Department from March 2011 to September 2015. The patients were treated with PEG-IFNα-2a/RBV for 48 weeks. A 42-month follow-up of patients was performed after withdrawal of treatment. The main paramenters to value the efficacy were liver function, blood lipids, and sustained virological response (SVR). Results In the CHC patients with IL28B SNP rs12979860 C/C type, the rate of SVR in patients with antiviral therapy had no significant difference between groups 1b and 2a (73.33% and 95.65%, respectively, P>0.05). After anti-HCV therapy, liver function indices such as ALT, AST, TBIL, TC, TG and HDL all significantly improved in the two groups (all P<0.05). However, there was no difference in biochemical indices (ALT, GGT, bilirubin, blood lipids) between the two groups (all P>0.05). Conclusion In CHC patients with IL28B SNP rs12979860 C/C type, the long-term efficacy of PEG-IFNα-2a/RBV is good. IFN-based antiviral therapy has a higher SVR rate, and liver function and lipid metabolism can be significantly improved