Tran Huy A, Jones Tracey L, Ianna Elizabeth A, Gibson Robert A, Reeves Glenn E M
Hunter Area Pathology Service, John Hunter Hospital, Newcastle, Australia.
Hepat Mon. 2012 Aug;12(8):e6036. doi: 10.5812/hepatmon.6036. Epub 2012 Aug 30.
Single nucleotide polymorphism in the interleukin28B (IL28B) gene was recently shown to be associated with a significant increase in response to interferon-α and ribavirin treatment in patients with chronic hepatitis C. Similarly, thyroid disease (TD) occurring during treatment confer an improved sustained virologic response (SVR).
To determine the role of IL28B genotypes in a cohort of hepatitis C patients who develop TD during treatment and its relationship to SVR.
IL28B gene profiles including rs12979860, rs12980275 and rs 8099917 and their genotypes were determined in a cohort of 23 hepatitis C patients who developed TD during treatment and their relationship to SVR.
Out of 23 studies cases, 19 has one or more favorable genotypes, of which 15 (78.9%) achieved SVR. Eleven has all three unfavorable genotypes and yet achieved 72.7 % SVR. The presence of more than one favorable genotype only correctly predicts SVR vs. non- SVR in ~50 % of cases, i.e. by chance.
Despite the small number of subjects, the presence of one or more unfavorable IL28B genotype does not portend a poor SVR prognostic outcome. This suggests that TD in this clinical context may be a critical factor in the achievement of SVR, probably above that of the genetic predisposition.
白细胞介素28B(IL28B)基因中的单核苷酸多态性最近显示与慢性丙型肝炎患者对干扰素-α和利巴韦林治疗的反应显著增加有关。同样,治疗期间发生的甲状腺疾病(TD)可带来更好的持续病毒学应答(SVR)。
确定IL28B基因型在治疗期间发生TD的丙型肝炎患者队列中的作用及其与SVR的关系。
在23例治疗期间发生TD的丙型肝炎患者队列中确定包括rs12979860、rs12980275和rs8099917的IL28B基因谱及其基因型,并确定它们与SVR的关系。
在23例研究病例中,19例具有一种或多种有利基因型,其中15例(78.9%)实现了SVR。11例具有所有三种不利基因型,但仍实现了72.7%的SVR。存在一种以上有利基因型仅在约50%的病例中正确预测了SVR与非SVR,即只是偶然。
尽管受试者数量较少,但存在一种或多种不利的IL28B基因型并不预示SVR预后不良。这表明在这种临床情况下,TD可能是实现SVR的关键因素,可能高于遗传易感性。