HLA-dp基因多态性和抗HCV治疗的免疫应答相关性研究(1)
【摘要】 目的：探析丙型肝炎患者HLA-DP基因多态性和抗病毒治疗的免疫应答相关性。方法：以2017年1月-2018年6月笔者所在医院诊治的100例丙型肝炎患者作为研究对象，均行抗病毒治疗，接受24周随访，测定HLA-DP基因多态性表现，通过Logistic回归模型分析丙型肝炎抗病毒治疗免疫应答相关影响因素。结果：本组患者中，HLA-DP基因rs3077、rs2395309位点基因型符合Hardy-Weinberg遗传平衡(P>0.05)。从治疗结局看，持续应答(SVR)75例，非持续应答(N-SVR)25例;通过单因素、多因素分析表明，rs3077位点CT与TT型、rs2395309位点GA和AA是影响抗HCV治疗免疫应答的相关因素(P<0.05)。结论：HLA-DP基因多态性和抗HCV治疗免疫应答相关，有重要临床意义。
【关键词】 丙型肝炎 HCV HLA-DP基因 基因多态性 抗病毒治疗 免疫应答
doi：10.14033/j.cnki.cfmr.2020.15.009 文献标识码 B 文章编号 1674-6805(2020)15-00-03
Study on the Relationship between HLA-DP Gene Polymorphism and Immune Response to Anti HCV Therapy/CHEN Huihua. //Chinese and Foreign Medical Research， 2020， 18(15)： -23
[Abstract] Objective： To explore the relationship between HLA-DP gene polymorphism and immune response to anti HCV in patients with hepatitis C. Method： From January 2017 to June 2018， 100 patients with hepatitis C in our hospital were treated with antiviral therapy. They were followed up for 24 weeks， and HLA-DP gene polymorphism was measured. Logistic regression model was used to analyze the related factors of immune response in antiviral therapy of hepatitis C. Result： In this group， the rs3077 and rs2395309 genotypes of HLA-DP genes were in line with the Hardy-Weinberg genetic balance (P>0.05). From the perspective of treatment outcome， there were 75 patients with sustained response (SVR) and 25 patients with non-sustained response (N-SVR). Univariate and multivariate analysis showed that CT， TT type at rs3077， GA and AA at rs2395309 were the relevant factors influencing the immune response to anti-HCV treatment (P<0.05). Conclusion： HLA-DP gene polymorphism is associated with the immune response to anti HCV therapy， which has important clinical significance.
[Key words] Hepatitis C HCV HLA-DP gene Gene polymorphism Antiviral therapy Immune response
First-author’s address： Quanzhou First Hospital Affiliated to Fujian Medical University， Quanzhou 362000， China
丙型肝炎一種丙型肝炎病毒(HCV)感染引起的病毒性肝炎，是肝硬化、肝细胞癌等主要病因。当前，临床以抗病毒治疗为主，聚乙二醇化干扰素α(PEGIFNα)联用利巴韦林是首选疗法。但因病毒基因、患者个体以及遗传等差异使得部分抗病毒治疗患者不能得到持续性的病毒免疫应答(SVR)。临床研究报道，携带特定基因型丙型肝炎患者行抗病毒治疗有着更高的病毒清除率，且可获得良好SVR。近年有研究报道，HLA-DP基因多态性和丙型肝炎的发生及转归有着密切关系[1]。基于此，本文对笔者所在医院收治的100例丙型肝炎患者抗病毒治疗进行研究，分析HLA-DP基因多态性和抗病毒治疗免疫应答相关性，现报告如下。
1 资料与方法
1.1 一般资料
将笔者所在医院感染科2017年1月-2018年6月接治的100例丙型肝炎患者纳入研究中，均经症状、病毒学、影像学等检查，符合HCV相关诊断标准[2]。纳入标准：(1)确诊为HCV，且民族均是汉族;(2)接受抗病毒治疗;(3)临床资料完整。排除标准：(1)合并乙肝病毒、HIV及其他病毒感染;(2)心肺肾功能不全;(3)失代偿肝硬化、自身免疫病症及精神系病变;(4)妊娠期或哺乳期妇女;(5)其他严重疾病;(6)不配合随访。其中，男53例，女47例;年龄35～61岁，平均(47.6±3.2)岁;体质量指数(BMI)21.4～27.5 kg/m2，平均(23.4±1.3)kg/m2。本研究得到医院伦理委员会批准，且患者对研究知情并签署知情同意书。, 百拇医药(陈辉华)
【关键词】 丙型肝炎 HCV HLA-DP基因 基因多态性 抗病毒治疗 免疫应答
doi：10.14033/j.cnki.cfmr.2020.15.009 文献标识码 B 文章编号 1674-6805(2020)15-00-03
Study on the Relationship between HLA-DP Gene Polymorphism and Immune Response to Anti HCV Therapy/CHEN Huihua. //Chinese and Foreign Medical Research， 2020， 18(15)： -23
[Abstract] Objective： To explore the relationship between HLA-DP gene polymorphism and immune response to anti HCV in patients with hepatitis C. Method： From January 2017 to June 2018， 100 patients with hepatitis C in our hospital were treated with antiviral therapy. They were followed up for 24 weeks， and HLA-DP gene polymorphism was measured. Logistic regression model was used to analyze the related factors of immune response in antiviral therapy of hepatitis C. Result： In this group， the rs3077 and rs2395309 genotypes of HLA-DP genes were in line with the Hardy-Weinberg genetic balance (P>0.05). From the perspective of treatment outcome， there were 75 patients with sustained response (SVR) and 25 patients with non-sustained response (N-SVR). Univariate and multivariate analysis showed that CT， TT type at rs3077， GA and AA at rs2395309 were the relevant factors influencing the immune response to anti-HCV treatment (P<0.05). Conclusion： HLA-DP gene polymorphism is associated with the immune response to anti HCV therapy， which has important clinical significance.
[Key words] Hepatitis C HCV HLA-DP gene Gene polymorphism Antiviral therapy Immune response
First-author’s address： Quanzhou First Hospital Affiliated to Fujian Medical University， Quanzhou 362000， China
丙型肝炎一種丙型肝炎病毒(HCV)感染引起的病毒性肝炎，是肝硬化、肝细胞癌等主要病因。当前，临床以抗病毒治疗为主，聚乙二醇化干扰素α(PEGIFNα)联用利巴韦林是首选疗法。但因病毒基因、患者个体以及遗传等差异使得部分抗病毒治疗患者不能得到持续性的病毒免疫应答(SVR)。临床研究报道，携带特定基因型丙型肝炎患者行抗病毒治疗有着更高的病毒清除率，且可获得良好SVR。近年有研究报道，HLA-DP基因多态性和丙型肝炎的发生及转归有着密切关系[1]。基于此，本文对笔者所在医院收治的100例丙型肝炎患者抗病毒治疗进行研究，分析HLA-DP基因多态性和抗病毒治疗免疫应答相关性，现报告如下。
1 资料与方法
1.1 一般资料
将笔者所在医院感染科2017年1月-2018年6月接治的100例丙型肝炎患者纳入研究中，均经症状、病毒学、影像学等检查，符合HCV相关诊断标准[2]。纳入标准：(1)确诊为HCV，且民族均是汉族;(2)接受抗病毒治疗;(3)临床资料完整。排除标准：(1)合并乙肝病毒、HIV及其他病毒感染;(2)心肺肾功能不全;(3)失代偿肝硬化、自身免疫病症及精神系病变;(4)妊娠期或哺乳期妇女;(5)其他严重疾病;(6)不配合随访。其中，男53例，女47例;年龄35～61岁，平均(47.6±3.2)岁;体质量指数(BMI)21.4～27.5 kg/m2，平均(23.4±1.3)kg/m2。本研究得到医院伦理委员会批准，且患者对研究知情并签署知情同意书。, 百拇医药(陈辉华)