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台湾南部慢性丙型肝炎患者人类白细胞抗原 I 类和 II 类等位基因对丙型肝炎病毒载量的影响。

Effect of human leukocyte antigen class I and II alleles on hepatitis C viral load among chronic hepatitis C patients in Southern Taiwan.

机构信息

Department of Internal Medicine, Buddhist Dalin Tzu Chi General Hospital, Chia-Yi, Taiwan; School of Medicine, Tzuchi University, Hualien, Taiwan.

出版信息

Hum Immunol. 2013 Aug;74(8):978-82. doi: 10.1016/j.humimm.2013.04.023. Epub 2013 Apr 27.

Abstract

The viral load of hepatitis C virus (HCV) in chronic hepatitis C patients affects clinical outcomes and response to interferon treatment. Various factors may be involved in determining the viral load, including host genetic factors. The aim of this study was to investigate the relationship between HCV viral load and human leukocyte antigen (HLA) class I and class II alleles. One hundred and six HCV RNA positive subjects were enrolled, and viral load was measured. HLA-A, -B, -C, -DR, and -DQ loci were determined by sequence-based genotyping. Univariate analysis indicated that HLA-B()40 and HLA-C()07 alleles had significantly higher HCV RNA levels (P<0.05). Patients with the HLA-C()15 allele exhibited a trend toward a lower HCV viral load (P=0.06). After controlling for confounding factors, multivariate analysis revealed that only HLA-C()15 allele was identified as a significant determinant for HCV-RNA level (slope=-0.91, 95% CI: -1.58, -0.24; Holm's P<0.01). Patients expressing the HLA-C()15 allele had significantly lower HCV RNA levels. HCV genotype 1 was significantly associated with high HCV RNA levels (P<0.05 by Mann-Whitney U test). In conclusion, HLA-C()15 is an important host immunogenetic factor with an inverse association to HCV viral load in CHC patients in Taiwan. HCV genotype 1 is the viral factor that associated with high viral load.

摘要

丙型肝炎病毒(HCV)慢性丙型肝炎患者的病毒载量影响临床结局和干扰素治疗反应。多种因素可能参与了病毒载量的确定,包括宿主遗传因素。本研究旨在探讨 HCV 病毒载量与人类白细胞抗原(HLA)I 类和 II 类等位基因之间的关系。我们纳入了 106 名 HCV RNA 阳性患者,测量了病毒载量。采用基于序列的基因分型方法确定了 HLA-A、-B、-C、-DR 和-DQ 基因座。单因素分析表明,HLA-B()40 和 HLA-C()07 等位基因的 HCV RNA 水平显著较高(P<0.05)。具有 HLA-C()15 等位基因的患者 HCV 病毒载量呈下降趋势(P=0.06)。在控制混杂因素后,多因素分析显示,只有 HLA-C()15 等位基因被确定为 HCV-RNA 水平的显著决定因素(斜率=-0.91,95%CI:-1.58,-0.24;Holm's P<0.01)。表达 HLA-C()15 等位基因的患者 HCV RNA 水平显著降低。HCV 基因型 1 与高 HCV RNA 水平显著相关(Mann-Whitney U 检验,P<0.05)。总之,HLA-C()15 是台湾慢性丙型肝炎患者 HCV 病毒载量的一个重要宿主免疫遗传因素,与 HCV 病毒载量呈负相关。HCV 基因型 1 是与高病毒载量相关的病毒因素。

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