不同HCV基因型感染的慢性丙型肝炎和肝硬化患者对重组人干扰素α-2a治疗应答的影响

doi:10.3969/j.issn.1672-5069.2021.06.033

Abstract

Abstract: Objective The aim of this clinical trial was to investigate the impact of HCV genotypes on the treatment response of recombinant human interferon α-2a (IFN-α-2a) in patients with chronic hepatitis C (CHC) and hepatitis C liver cirrhosis. Methods A total of 198 patients with CHC and 200 patients with hepatitis C-induced liver cirrhosis were enrolled in our hospital between January 2015 and April 2020, and all received liver biopsies and IFN-α-2a treatment for 24 weeks and followed-up for 24 weeks. Serum HCV RNA loads were detected by Roche's lightcycle real-time fluorescent quantitative PCR and the HCV genotypes were detected by gene sequencing. The liver injuries were evaluated by Knodell histological activity index scoring systems. The factors impacting response to IFN-α-2a therapy was analyzed by univariate or multivariate regression analysis. Results The percentage of HCV 1b genotype in patients with liver cirrhosis was 31.0%, significantly higher than 15.1% in 86 CHC patients with less than S1 liver fibrosis or 18.8%(P<0.05) in 112 CHC patients with S2-3 liver fibrosis; the percentage of HCV 1b genotype in 212 patients without response to IFN-α-2a therapy was significantly higher than(29.7% vs. 17.7%), and the percentage of genotype 1a was significantly lower than (17.9% vs. 28.0%, P<0.05) in 186 responders; the early virological response rate in responders was 60.8%, significantly higher than 18.9%(P<0.05), and high serum HCV RNA loads was 37.1%, significantly lower than 47.6%(P<0.05) in non-responders; the HCV 1b genotype (OR:0.553, 95%CI:0.316-0.969) was the independent risk factor, while the early response (OR:1.704, 95%CI:1.008-2.881) was the protective factor for response to IFN-α-2a therapy. Conclusion The detection of HCV genotype could predict the response to IFN-α-2a therapy in patients with CHC and CHC-induced liver cirrhosis, which might guide the selection of antiviral therapy strategy and the treatment period.

Key words: Liver cirrhosis, Hepatitis C, Hepatitis C virus genotypes, Interferon-α-2a, Response

Shu Qinghua, Zhang Nannan, Ge Yongsheng. Impact of HCV genotypes on the treatment response of recombinant human interferon α-2a in patients with chronic hepatitis C and hepatitis C liver cirrhosis[J]. Journal of Practical Hepatology, 2021, 24(6): 899-902.

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Impact of HCV genotypes on the treatment response of recombinant human interferon α-2a in patients with chronic hepatitis C and hepatitis C liver cirrhosis

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