论文部分内容阅读
目的 探讨丙型肝炎病毒 (HCV)因素及机体细胞免疫因素对干扰素疗效的影响。方法 对 4 0例慢性丙型肝炎患者进行干扰素治疗 ,分析HCV基因型、准种多样性、血清HCVRNA水平及肝组织HCV特异性细胞毒T淋巴细胞 (CTL)活性与干扰素应答的关系。结果 经过 6个月的干扰素治疗 ,2 1例获得治疗终点应答 ,其中 10例呈持续应答 ,19例无应答。HCV1型患者应答率( 4 3.3% )明显低于非 1型患者 ( 80 % ,P <0 .0 5 ) ;应答患者中治疗前血清HCV准种数目及HCVRNA水平明显低于无应答患者 (P <0 .0 5 ,P <0 .0 1) ,而其肝组织HCV特异性CTL活性阳性率则显著高于无应答者 (P <0 .0 5 )。结论 病毒因素和宿主因素均是影响慢性丙型肝炎干扰素治疗效果的重要因素 ,非 1型感染、低准种数目、低病毒血症水平及肝组织HCV特异性CTL活性阳性者预示对干扰素应答良好
Objective To investigate the effects of hepatitis C virus (HCV) and cellular immune factors on the efficacy of interferon. Methods Forty - four patients with chronic hepatitis C were treated with interferon. The relationship between HCV genotypes, quasispecies diversity, serum HCV RNA levels and HCV - specific cytotoxic T lymphocytes (CTL) activity and interferon response in liver tissue was analyzed. Results After 6 months of interferon treatment, 21 patients received response to the treatment end point, of which 10 patients continued response and 19 patients had no response. The response rate of HCV1 patients was significantly lower than that of non-type 1 patients (4.3% vs 80%, P <0.05). The number of HCV quasispecies and the level of HCVRNA in pre-treatment patients were significantly lower than those in non-responders <0.05, P <0.01), while the positive rate of HCV-specific CTL activity in liver tissues was significantly higher than that in non-responders (P <0.05). Conclusions Both viral factors and host factors are important factors influencing the therapeutic effect of interferon on chronic hepatitis C. The positive rate of non-type 1 infection, low quasispecies number, low viremia and liver-specific HCV-specific CTL activity predict that interferon Answer well