目的：检测宿主白细胞介素-28B（IL-28B）基因rs12979860区域基因型，分析其与丙型肝炎抗病毒疗效的关系。方法选择2012年5月至2014年12月珠海市人民医院使用干扰素联合利巴韦林进行抗病毒治疗的丙型病毒性肝炎患者63例，使用基因诊断试剂盒检测IL-28B rs12979860基因型，通过治疗过程中HCV RNA定量等指标总结疗效，分析宿主IL-28B rs12979860基因型与丙型肝炎抗病毒疗效的关系。结果63例检测IL-28B rs12979860基因型的患者中有41例（65.1%）为C/C型，16例（25.4%）为C/T型，6例（9.5%）为T/T型。按抗病毒疗效标准判断，63例中37例（58.7%）达到RVR，49例（77.8%）达到SVR。其中IL-28B rs12979860为C/C型者41例中实现RVR 32例（78.0%），cEVR 36例（87.8%），SVR 37例（90.2%），NR 1例（2.4%），RR 2例（4.9%）。C/T型者16例中实现RVR 5例（31.2%），cEVR 8例（50.0%），SVR 11例（68.8%），NR 2例（12.5%），RR 3例（18.8%）。T/T型者6例中RVR者0例，cEVR 1例（16.7%）， SVR 1例（16.7%），NR 4例（66.7%），RR 1例（16.7%）。经统计学分析，不同基因型之间疗效有显著性差异（P＜0.01或P＜0.05）。结论 IL-28B rs12979860为C/C型患者经过干扰素联合利巴韦林治疗达到RVR率和SVR率均高于基因型为C/T型及T/T型患者。IL-28B rs12979860基因型检测对丙型肝炎抗病毒应答和病毒清除具有预测作用，可帮助临床制定个体化治疗方案。%ObjectiveTo analyze the relationship between genotypes of rs12979860 on IL-28B and the anti-virus effects in HCV infection patients.MethodsThe rs12979860 genotypes of 63 HCV infected patients who were admitted in Zhuhai People’s Hospital with IFN + RBV therapy were assayed and the anti-virus effects were also evaluated by HCV RNA quantitative real time PCR. The expression of rs12979860 genotype and anti-virus effects were analyzed in our study.Results The genotypes of these 63 cases were 41 (65.1%) for C/C, 16 (25.4%) for C/T, and 6 (9.5%) for T/T. After treatment, there were totality 37 cases (58.7%) had rapid viral response (RVR), and 49 cases (77.8%) had sustained viral response (SVR). In genotype C/C there were totality 32 cases (78.0%) had RVR, and 37 cases (90.2%) had SVR. In genotype C/T there were totality 5 cases (31.2%) had RVR, and 11 cases (68.8%) had SVR . In genotype T/T there were 0 case had RVR and 1 case (16.7%) had SVR. The efifcacy data showed statistically signiifcant differences(P< 0.01,P< 0.05).Conclusions In hepatitis C patients that use IFN + RBV to anti-virus therapy, the RVR and SVR of C/C genotypes of rs12979860 is signiifcantly better than C/T and T/T genotypes. Detect the genotypes of rs12979860 can predict the clearance of virus in anti-virus therapy and it is helpful to personality therapy for hepatitis C patients.
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