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目的探讨受体白介素28B(interleukin-28B,IL-28B)基因多态性对肝移植术后丙型肝炎复发抗病毒治疗及预后的影响。方法对33例肝移植术后丙型肝炎复发患者进行干扰素联合利巴韦林抗病毒治疗,并通过肝组织进行受体IL-28B rs12979860位点的基因多态性检测,观察病毒学应答及预后情况。结果 33例患者获得治疗结束时病毒学应答(end of treatment virologic response,ETVR)24例(72.7%),其中获得持续性病毒学应答(sustained virologic response,SVR)12例(36.4%)。受体的基因型分布:CC型25例(75.8%)、非CC型8例(24.2%)。CC型与非CC型患者中ETVR率分别为84.0%、37.5%,SVR率分别为44.0%、12.5%,二者比较,CC型获得ETVR率较高(P<0.05),SVR率差异无统计学意义(P>0.05);CC型及非CC型患者中抗病毒治疗后移植肝硬化率分别为8.0%、50.0%,二者比较,CC型患者移植肝硬化率较低(P<0.05)。结论受体IL-28B rs12979860位点CC基因型可能对移植术后丙型肝炎复发患者抗病毒治疗效果及预后存在有利影响。
Objective To investigate the effect of interleukin-28B (IL-28B) gene polymorphism on recurrent and anti-HCV therapy and prognosis in patients with liver transplantation after liver transplantation. Methods 33 patients with recurrent hepatitis C after liver transplantation were treated with interferon plus ribavirin, and the genetic polymorphism of IL-28B rs12979860 at the receptor was detected by liver tissue. The virological response and Prognosis. Results Totally 24 patients (72.7%) received end-treatment virologic response (ETVR) at the end of treatment. Among them, 12 patients (36.4%) had sustained virologic response (SVR). The genotype distribution of the receptor: CC type 25 cases (75.8%), non-CC type in 8 cases (24.2%). The ETVR rates in CC and non-CC patients were 84.0% and 37.5% respectively, and the SVR rates were 44.0% and 12.5% respectively. There was no significant difference in the SVR rates between CC and CC patients (P <0.05) (P> 0.05). The rates of liver cirrhosis after antiviral therapy in CC and non-CC patients were 8.0% and 50.0%, respectively. There was a lower rate of liver cirrhosis in CC patients (P <0.05) . Conclusion The genotype CC of rs12979860 locus in IL-28B receptor may have beneficial effects on the anti-viral treatment and prognosis of hepatitis C recurrence patients after transplantation.