摘要：
目的 探讨 IL28B单核苷酸多态性(SNPs)rs12979860 C/C型的慢性丙肝(CHC)患者在不同 HCV基因型中进行聚乙二醇干扰素(PEG-IFN)α-2a联合利巴韦林(RBV)抗病毒治疗的远期疗效.方法 采用前瞻性研究,观察兰州大学第一医院感染科2011 年3 月-2015 年9 月接受PEG-IFN联合RBV治疗48 周并停药后随访42 个月的CHC患者 38 例,以肝功能、脂代谢、持续病毒学应答(SVR)作为疗效的主要评价指标.结果 在纳入的 IL28B SNP rs12979860 C/C型的CHC 患者中,基因 1b 型的 SVR 率为 73.33%,基因 2a 型 SVR 率为 95.65%,两种基因型的SVR率可能无差异.抗病毒治疗后,两组肝功能指标 ALT、AST、TBIL、TC、TG、HDL 较治疗前均明显下降(P＜0.05);但两种基因型之间生化指标(转氨酶、GGT、胆红素、血脂)均无统计学差异(P＞0.05).结论 IL28BSNP rs12979860 C/C型的CHC患者在以IFN为基础的抗病毒治疗中具有较高的SVR率,以IFN为基础的抗病毒治疗后肝功能、脂代谢可得到明显改善,其远期疗效良好.%Objective To investigate the long-term efficacy of PEG-IFN alpha-2a (PEG-IFNα-2a)plus ribavirin (RBV)in treatment of chronic hepatitis C (CHC)patients with IL28B single nucleotide polymorphisms (SNPs)rs12979860 C/C type in different HCV genotypes.Methods A prospective study was conducted on 38 CHC patients from our hospital's Infection Department from March 2011 to September 2015.The patients were treated with PEG-IFNα-2a/RBV for 48 weeks.A 42-month follow-up of patients was performed after withdrawal of treatment.The main paramenters to value the efficacy were liver function,blood lipids,and sustained virological response (SVR).Results In the CHC patients with IL28B SNP rs12979860 C/C type,the rate of SVR in patients with antiviral therapy had no significant difference between groups 1b and 2a (73.33% and 95.65%,respectively, P＞0.05).After anti-HCV therapy,liver function indices such as ALT,AST,TBIL,TC,TG and HDL all significantly improved in the two groups (all P＜0.05).However,there was no difference in biochemical indices (ALT,GGT,bilirubin,blood lipids)between the two groups (all P＞0.05).Conclusion In CHC patients with IL28B SNP rs12979860 C/C type,the long-term efficacy of PEG-IFNα-2a/RBV is good.IFN-based antiviral therapy has a higher SVR rate,and liver function and lipid metabolism can be significantly improved.
