IL28B基因多态性对聚乙二醇干扰素α治疗HBeAg阳性慢性乙型肝炎患者疗效的影响

doi:10.3969/j.issn.1672-5069.2019.02.008

实用肝脏病杂志 ›› 2019, Vol. 22 ›› Issue (2): 184-187.doi: 10.3969/j.issn.1672-5069.2019.02.008

IL28B基因多态性对聚乙二醇干扰素α治疗HBeAg阳性慢性乙型肝炎患者疗效的影响

袁春晖,李春雨,李红丽,赵红娜,王文红,孟庆旭,张中学

071000 河北省保定市解放军第252医院感染病科（袁春晖,李春雨）;
保定市传染病医院肝病科（李红丽,赵红娜,王文红）;
保定市第一医院重症医学科（张中学）;
河北大学附属医院普外科（孟庆旭）

收稿日期:2018-06-12 出版日期:2019-03-10 发布日期:2019-03-19
通讯作者: 张中学,E-mail: 349660779@qq.com
作者简介:袁春晖,女,36岁,大学本科,主治医师。E-mail:349660779@qq.com

Impact of blood IL28B gene polymorphism on viralogic response in patients with HBeAg positive chronic hepatitis B receiving peginterferon alfa therapy

Yuan Chunhui, Li Chunyu, Li Hongli, Zhao Hongna, Wen Wenhong, Meng Qingxu, Zhang Zhongxue

Department of Infectious Diseases,252nd Hospital,Baoding 071000,Hebei Province,China

Received:2018-06-12 Online:2019-03-10 Published:2019-03-19

摘要/Abstract

摘要： 目的探讨IL28B基因单核甘酸多态性（SNP）对聚乙二醇干扰素α（Peg-IFNα）治疗的HBeAg阳性慢性乙型肝炎（CHB）患者疗效的影响。方法 2014年8月~2016年10月我院收治的HBeAg阳性CHB患者143例,给予Peg-IFNα治疗24~144 w,随访52 w。采集外周血,提取DNA,检测IL28B 基因SNP位点rsl2979860、rs8099917和rsl2980275多态性分布。应用二分类多变量Logistic回归分析IL28B 基因SNP位点对病毒学应答率的影响。结果在治疗和随访结束时,应答58例（40.6%）,无应答者85例;在143例CHB患者中,rsl2979860位点CT型占9.1%,TT型占0.7%,CC型占90.21%, rs8099917位点GT型占9.1%,TT型占90.9%,rsl2980275位点AG型占10.5%,AA型占89.51%;应答者rsl2979860 CC基因型为94.8%,显著高于未应答者的87.1% （P<0.05）,rs8099917 TT基因型为96.6%,显著高于未应答者的87.1% （P<0.05）,rsl2980275 AA基因型为94.8%,显著高于未应答者的85.9%（P<0.05）; 校正基线资料后,经二分类多变量Logistic回归分析显示,L28B基因rsl2979860位点为病毒学应答的独立影响因子（P<0.05）。结论 IL28B基因的SNP位点与Peg-IFNα治疗HBeAg阳性的CHB患者病毒学应答密切相关,临床医生在决定给予抗病毒治疗前,可以根据检测的血IL28B基因多态性分布情况,预测Peg-IFNα的最终治疗效果,而作出合理的治疗方案。

关键词: 慢性乙型肝炎, HbeAg阳性, 聚乙二醇干扰素α, 应答, IL28B基因多态性

Abstract: Objective To investigate the impact of blood IL28B gene polymorphism on viralogic response in patients with HBeAg positive chronic hepatitis B（CHB） receiving peginterferon alfa （Peg-IFNα） therapy. Methods 143 patients with serum HBeAg positive CHB were recruited in this study between August 2014 and October 2016. All patients received Peg-IFN alpha therapy for 24 to 144 weeks, and were followed-up for 52 weeks. Blood were obtained and DNA was extracted to detect single nucleotide polymorphism（SNP） of IL28B gene. The impact of SNP locus of IL28B gene on virological response was analyzed by the two classification multivariable Logistic regression. Results At the end of followed-up,58 patients（40.6%） responded and 85 patients failed to the regimen;out of the 143 patients with CHB,the type CT was 9.1%,type TT accounted for 0.7% and type CC accounted for 90.21% in rsl2979860 site,the type GT accounted for 9.1%,and type TT was 90.9% in rs8099917 site,and type AG accounted for 10.5%,and type AA accounted for 89.51% in rsl2980275 site;the genotype CC of rsl2979860 was 94.8% in responded patients,much higher than 87.1% （P<0.05）,the genotype TT of rs8099917 was 96.6%,much higher than 87.1%（P<0.05）,and genotype AA of rsl2980275 was 94.8%,much higher than 85.9% in non-responders（P<0.05）;two classification multivariable Logistic regression analysis with correction of baseline data showed that the rsl2979860 locus of the IL28B gene was the independent factor affecting the virology response（P<0.05）. Conclusion s The SNP locus of blood IL28B gene is closely related to the virologic response to Peg-IFNα therapy in patients with serum HBeAg positive CHB. The SNP detection of IL28B gene before antiviral therapy might help the clinicians make a reliable choice and get an optimal efficacy.

Key words: Hepatitis B, HBeAg positive, Peginterferonα, Virologic response, IL28B gene, Polymorphism

袁春晖,李春雨,李红丽,赵红娜,王文红,孟庆旭,张中学. IL28B基因多态性对聚乙二醇干扰素α治疗HBeAg阳性慢性乙型肝炎患者疗效的影响[J]. 实用肝脏病杂志, 2019, 22(2): 184-187.

Yuan Chunhui, Li Chunyu, Li Hongli, Zhao Hongna, Wen Wenhong, Meng Qingxu, Zhang Zhongxue. Impact of blood IL28B gene polymorphism on viralogic response in patients with HBeAg positive chronic hepatitis B receiving peginterferon alfa therapy[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2019, 22(2): 184-187.

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IL28B基因多态性对聚乙二醇干扰素α治疗HBeAg阳性慢性乙型肝炎患者疗效的影响

Impact of blood IL28B gene polymorphism on viralogic response in patients with HBeAg positive chronic hepatitis B receiving peginterferon alfa therapy

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