Internal Medicine III, Department of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria.
Gastroenterology. 2012 Jan;142(1):78-85.e2. doi: 10.1053/j.gastro.2011.09.039. Epub 2011 Sep 24.
BACKGROUND & AIMS: Single nucleotide polymorphisms (SNPs) in IL28B and serum levels of interferon γ inducible protein 10 (IP-10) predict outcomes of antiviral therapy in patients with chronic hepatitis C. We associated IL28B SNPs rs12979860 and rs8099917, along with serum levels of IP-10, with outcomes of patients with acute hepatitis C (AHC).
We studied 120 patients with AHC (64 male; 37 ± 16 years old) and 96 healthy individuals (controls). The IL28B SNPs rs12979860 and rs8099917 were detected using real-time polymerase chain reaction; serum concentrations of IP-10 were measured by enzyme-linked immunosorbent assays of 62 patients with AHC.
Hepatitis C virus was cleared spontaneously from 59 patients (49.2%). The IL28B rs12979860 C/C genotype was more frequent among patients with AHC than controls (62.5% vs 39.6%; P < .001) and among patients with spontaneous clearance than those without (74.6% vs 51.7%; P = .02) (positive predictive value, 60.3%). Patients with IL28B rs12979860 C/C more frequently developed jaundice (53.2% vs 27.6%; P = .022) than carriers of the T allele. The median level of IP-10 was lower among patients with AHC and spontaneous clearance (764 [113-2470] pg/mL) than those without spontaneous clearance (1481 [141-4412] pg/mL; P = .006). Based on receiver operating characteristic analysis, 540 pg/mL IP-10 was set as the cutoff for patients most likely to have spontaneous clearance (positive predictive value, 71.4%; negative predictive value, 65.9%). Including data on IP-10 levels increased the ability of the IL28B rs12979860 C/C to identify patients most likely to have spontaneous clearance (83% of those who had an IP-10 level <540 pg/mL and 32% who had an IP-10 level >540 pg/mL) (P < .01).
The combination of serum level of IP-10 and SNPs in IL28B can identify patients with AHC who are most likely to undergo spontaneous clearance and those in need of early antiviral therapy.
白细胞介素 28B（IL28B）基因单核苷酸多态性（SNPs）和干扰素 γ诱导蛋白 10（IP-10）血清水平可预测慢性丙型肝炎（CHC）患者抗病毒治疗的结局。我们将 IL28B 基因 SNPs rs12979860 和 rs8099917 与 IP-10 血清水平与急性丙型肝炎（AHC）患者的结局相关联。
我们研究了 120 例 AHC 患者（64 例男性；37±16 岁）和 96 例健康个体（对照组）。采用实时聚合酶链反应检测 IL28B 基因 SNPs rs12979860 和 rs8099917；采用酶联免疫吸附试验检测 62 例 AHC 患者的 IP-10 血清浓度。
59 例患者（49.2%）自发清除丙型肝炎病毒。与对照组（39.6%）相比，AHC 患者中 IL28B rs12979860 C/C 基因型更为常见（62.5% vs 39.6%；P<0.001），且在自发清除的患者中更为常见（74.6% vs 51.7%；P=0.02）（阳性预测值为 60.3%）。与携带 T 等位基因的患者相比，IL28B rs12979860 C/C 基因型的患者更易出现黄疸（53.2% vs 27.6%；P=0.022）。与未自发清除的患者相比，AHC 患者和自发清除患者的 IP-10 中位数水平更低（764[113-2470]pg/mL vs 1481[141-4412]pg/mL；P=0.006）。基于受试者工作特征分析，将 540pg/mL 的 IP-10 设定为最有可能自发清除的患者的截止值（阳性预测值为 71.4%；阴性预测值为 65.9%）。包括 IP-10 水平的数据增加了 IL28B rs12979860 C/C 对最有可能自发清除的患者进行识别的能力（IP-10 水平<540pg/mL 的患者中为 83%，而 IP-10 水平>540pg/mL 的患者中为 32%）（P<0.01）。
IP-10 血清水平与 IL28B 基因中的 SNPs 联合可识别出最有可能自发清除的 AHC 患者和需要早期抗病毒治疗的患者。
