慢性丙型肝炎患者年龄和感染方式对抗病毒治疗应答的影响

doi:10.3969/j.issn.1672-5069.2012.04.008

摘要/Abstract

摘要： 目的探讨患者年龄和感染方式与慢性丙型肝炎患者抗病毒疗效的关系。方法应用聚乙二醇干扰素联合利巴韦林治疗113例慢性丙型肝炎患者。采用实时荧光PCR法检测血清HCV RNA定量;采用CE1区测序遗传树比对分析法检测HCV基因型。结果在20例有静脉吸毒史的患者,获得持续病毒学应答率（95.0%）明显高于54例医源性感染患者（75.9%,P<0.05）和39例既无静脉吸毒史又无明显医源性感染患者（69.2%,P<0.05）;在年龄≤40岁的患者,获得持续病毒学应答率（82.9%）明显高于年龄>40岁的患者（65.1%,P<0.05）;有静脉吸毒史的患者主要感染HCV3型（45%）和6型（50%）,而医源性感染组和其他组感染HCV1b型的比例分别为51.9%和43.6%;在无静脉吸毒史的患者中,年龄≤40岁组患者感染非HCV1型（2型、3型和6型）的比例达64.7%,而年龄>40岁组患者感染HCV1型的比例达64.3%。结论慢性丙型肝炎患者年龄及感染方式可作为判断感染病毒基因型的参考指标,对抗病毒治疗的疗程确定和疗效预测有一定的意义。

关键词: 慢性丙型肝炎, 静脉吸毒, 医源性感染, HCV基因型, 聚乙二醇干扰素

Abstract: Objective To investigate the impact of infection route and age on responses to antiviral therapy in patients with chronic hepatitis C. Methods 113 patients with chronic hepatitis C were treated with pegylated interferon and ribavirin. The level of serum HCV RNA was measured with real-time quantitative reverse-transcription polymerase chain reaction and HCV genotypes were determined by core-envelope 1 region nucleotide sequencing followed by phylogenic analysis. Results The rate of sustained virological response （95.0%） in 20 patients with intravenous drug use was significantly higher than that in 54 patients with iatrogenic infection （75.9%,P<0.05） and 39 with unknown infection route（69.2%,P<0.05）;the rate of sustained virological response （82.9%） in patients under 40 years old was significantly higher than that in patients older than 40 years （65.1%, P<0.05）;the patients with intravenous drug use was mainly infected with HCV genotype 3（45%） and genotype 6（50.0%）,and the proportion of HCV genotype 1b in patients with iatrogenic infection and those with unknown infection route were 51.9% and 43.6%,respectively;64.7% of patients younger than 40 and without drug use were infected by HCV genotypes non- 1（2,3-and 6-type）,while 64.3 % of patients older than 40 were infected by HCV genotype 1（P<0.05）. Conclusions The patient's age and infection route could be important factors for predicting response to antiviral therapy.

Key words: Hepatitis C, Infection route, Hepatitis C viral genotypes, Pegylated interferon

周友乾, 尹凤鸣, 冯经华. 慢性丙型肝炎患者年龄和感染方式对抗病毒治疗应答的影响[J]. 实用肝脏病杂志, 2012, 15(5): 394-396.

Zhou Youqian, Yin Fengming, Feng Jinghua.. The impact of infection route and age on responses to antiviral therapy in patients with chronic hepatitis C[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2012, 15(5): 394-396.

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