Kalantari Hamid, Tavakoli Tahmine, Bagherpour Bahram, Honarmand Shahram
Department of Gastroenterology, Isfahan Liver Disease Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Immunology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
J Res Med Sci. 2014 Nov;19(11):1062-7.
The success of treatment of chronic hepatitis C (CHC) with pegylated interferon-α (PEG-IFN-α) and ribavirin (RBV) is affected by several host, viral, and treatment factors. This study was designed to describe the association of interleukin (IL) 28B genotypes for rs12979860 with sustained virologic response (SVR) in patients with genotype 1 CHC infection treated with PEG-IFN α-2 and RBV.
Interleukin-28B genotype in 100 studied patients was detected by tagman real-time polymerase chain reaction. Before treatment blood samples were obtained, then patients were treated for 48-week with a combination therapy using of the PEG-IFN α-2 and RBV. SVR evaluated 6 months after stopping therapy, and was defined as undetectable plasma hepatitis C virus-RNA.
Among studied patients, 65% were IL-28B CT, 27% CC, and 8% TT. In all studied patients, SVR was 58.3%, relapse 15.6%, and null virological response 26.1%. SVR rates were 76.9% in IL-28B-CC, 56.4% in IL-28B-CT, and 12.5% in IL-28B-TT patients. Relapse rates were 7.7% in IL-28B-CC, 12.9% in IL-28B-CT, and 62.5% in IL-28B-TT patients. There was a significant difference between response to treatment in patients IL-28B-CC, CT, and TT (P = 0.003). IL-28B genotype CC, (odds ratio = 0.053, 95% confidence interval; 0.005-0.54, P = 0.03), was the independent predicting factor.
Interleukin-28B was an important predictor of CHC treatment outcome with Peg-IFN-α and RBV. IL-28B-CC seems to be more important than IL-28B-CT/TT in predicting positive treatment response.
聚乙二醇化干扰素-α(PEG-IFN-α)联合利巴韦林(RBV)治疗慢性丙型肝炎(CHC)的疗效受多种宿主、病毒及治疗因素影响。本研究旨在描述白细胞介素(IL)28B基因rs12979860基因型与接受PEG-IFN α-2联合RBV治疗的基因1型CHC感染患者持续病毒学应答(SVR)之间的关联。
采用TaqMan实时聚合酶链反应检测100例研究对象的白细胞介素-28B基因型。治疗前采集血样,随后患者接受PEG-IFN α-2联合RBV的联合治疗48周。停药6个月后评估SVR,定义为血浆丙型肝炎病毒RNA检测不到。
在研究对象中,65%为IL-28B CT型,27%为CC型,8%为TT型。在所有研究对象中,SVR为58.3%,复发率为15.6%,无病毒学应答率为26.1%。IL-28B-CC型患者的SVR率为76.9%,IL-28B-CT型为56.4%,IL-28B-TT型为12.5%。IL-28B-CC型患者的复发率为7.7%,IL-28B-CT型为12.9%,IL-28B-TT型为62.5%。IL-28B-CC型、CT型和TT型患者的治疗应答存在显著差异(P = 0.003)。IL-28B基因型CC型(优势比=0.053,95%置信区间:0.005-0.54,P = 0.03)是独立预测因素。
白细胞介素-28B是PEG-IFN-α联合RBV治疗CHC疗效的重要预测指标。在预测积极治疗应答方面,IL-28B-CC型似乎比IL-28B-CT/TT型更重要。