Kitson Matthew T, George Jacob, Dore Gregory J, Leung Reynold, Button Peter, McCaughan Geoffrey W, Grawford Darrell H G, Siebert William, Weltman Martin D, Cheng Wendy S C, Roberts Stuart K
J Gastroenterol Hepatol. 2014;29(7):1458-62. doi: 10.1111/jgh.12544.
Background and Aim: While genetic polymorphisms upstream of the interleukin-28B(IL28B) gene are associated with necroinflammatory activity grade in chronic hepatitis C virus genotype 1 (HCV-1) infection, any association with fibrosis is less definitive. Pretreatment liver biopsies in a cohort of treatment-naïve patients with HCV-1 were analyzed to evaluate associations between liver histology, and the rs12979860 and rs8099917 IL28B single nucleotide polymorphisms.Methods: Two hundred sixty-six patients with HCV-1 infection and pretreatment liver biopsy were tested for the rs12979860 and rs8099917 single nucleotide polymorphisms.Predictors of advanced fibrosis (METAVIR F3/4) and high activity grade (A2/3) were identified using multivariable logistic regression analysis.Results: Forty-four patients (16.5%) had advanced fibrosis and 141 patients (53.0%) high activity grade. Prevalence of rs12979860 IL28B genotype was: CC 45.7%, CT 42.7%, and TT 11.6%. Prevalence of advanced fibrosis was lower in those with IL28B CC genotype compared with those without (11.0% vs 21.3%; P = 0.03), with an increasing number of Talleles associated with a higher frequency of advanced fibrosis: CC 11.0%, CT 18.0%, TT33.3% (P = 0.01). Predictors of advanced fibrosis on multivariate analysis were platelet count (odds ratio [OR] 0.98, 95% confidence interval [CI] 0.97–0.99; P < 0.0001), high activity grade (OR 5.68, 95% CI% 1.86–17.32; P = 0.002), IL28B rs12979860 CC genotype(OR 0.36, 95% CI 0.14–0.93; P = 0.03), and aspartate aminotransferase (OR 1.02,95% CI 1.00–1.03; P = 0.046). No association was found between rs8099917 IL28B genotype and liver histology.Conclusions: IL28B rs12979860 CC genotype appears to be independently associated with a lower prevalence of advanced fibrosis stage in HCV-1 infection. This association warrants further evaluation.
虽然白细胞介素-28B(IL28B)基因上游的基因多态性与慢性丙型肝炎病毒1型(HCV-1)感染中的坏死性炎症活动分级相关,但与肝纤维化的任何关联尚不确定。对一组未经治疗的HCV-1患者的治疗前肝活检进行分析,以评估肝组织学与rs12979860和rs8099917 IL28B单核苷酸多态性之间的关联。
对266例HCV-1感染且有治疗前肝活检的患者进行rs12979860和rs8099917单核苷酸多态性检测。使用多变量逻辑回归分析确定高级别肝纤维化(METAVIR F3/4)和高活动分级(A2/3)的预测因素。
44例患者(16.5%)有高级别肝纤维化,141例患者(53.0%)有高活动分级。rs12979860 IL28B基因型的患病率为:CC 45.7%,CT 42.7%,TT 11.6%。与无IL28B CC基因型的患者相比,有该基因型的患者高级别肝纤维化的患病率较低(11.0%对21.3%;P = 0.03),T等位基因数量增加与高级别肝纤维化的频率升高相关:CC 11.0%,CT 18.0%,TT 33.3%(P = 0.01)。多变量分析中高级别肝纤维化的预测因素为血小板计数(比值比[OR] 0.98,95%置信区间[CI] 0.97–0.99;P < 0.0001)、高活动分级(OR 5.68,95% CI% 1.86–17.32;P = 0.002)、IL28B rs12979860 CC基因型(OR 0.36,95% CI 0.14–0.93;P = 0.03)和天冬氨酸转氨酶(OR 1.02,95% CI 1.00–1.03;P = 0.046)。未发现rs8099917 IL28B基因型与肝组织学之间存在关联。
IL28B rs12979860 CC基因型似乎与HCV-1感染中高级别肝纤维化阶段的较低患病率独立相关。这种关联值得进一步评估。