de Bitencorte Jóice Teixeira, Rech Tássia Flores, Lunge Vagner Ricardo, Dos Santos Deivid Cruz, Álvares-da-Silva Mário Reis, Simon Daniel
PPG Biologia Celular e Molecular Aplicada à Saúde, Universidade Luterana do Brasil, Canoas 92425-900, Rio Grande do Sul, Brazil.
Division of Gastroenterology, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, Rio Grande do Sul, Brazil.
World J Hepatol. 2021 Jan 27;13(1):109-119. doi: 10.4254/wjh.v13.i1.109.
Hepatitis C virus (HCV) infection is a public health concern worldwide. Several factors, including genetic polymorphisms, may be evolved in the progression of HCV infection to liver diseases. Interferon lambdas (IFNLs) modulate the immune response during viral infections. IFNLs induce antiviral activity, interfering in the viral replication by promoting the expression of several genes that regulate immunological functions. The interferon lambda-4 () rs12979860 polymorphism, which is characterized by a C to T transition in intron 1, is associated with spontaneous and treatment-induced clearance of HCV infection and may play a role in the development of HCV-associated liver diseases, including hepatocellular carcinoma (HCC).
To investigate the association of rs12979860 polymorphism with fibrosis, cirrhosis, and HCC in patients with chronic HCV infection.
This study was comprised of 305 chronic HCV-infected patients (53 fibrosis, 154 cirrhosis, and 98 HCC cases). The control group was comprised of 260 HCV-negative healthy individuals. The rs12979860 polymorphism was genotyped using the TaqMan assay. Fibrosis was diagnosed based on liver biopsy findings, while cirrhosis was diagnosed through clinical, laboratory, anatomopathological, and/or imaging data. HCC was diagnosed through imaging tests, tumor, and/or anatomopathological markers.
The T allele was observed in the three groups of patients (fibrosis, cirrhosis, and HCC) at a significantly higher frequency when compared with the control group ( = 0.047, < 0.001, and = 0.01, respectively). Also, genotype frequencies presented significant differences between the control group and cirrhosis patients ( < 0.001) as well as HCC patients ( = 0.002). The risk analysis was performed using the codominant and dominant T allele models. In the codominant model, it was observed that the CT genotype showed an increased risk of developing cirrhosis in comparison with the CC genotype [odds ratio (OR) = 2.53; 95% confidence interval (CI): 1.55-4.15; < 0.001] as well as with HCC (OR = 2.54; 95%CI: 1.44-4.56; = 0.001). A similar result was observed in the comparison of the TT CC genotype between the control group and cirrhosis group (OR = 2.88; 95%CI: 1.44-5.77; = 0.001) but not for HCC patients. In the dominant T allele model, the CT + TT genotypes were associated with an increased risk for progression to cirrhosis (OR = 2.60; 95%CI: 1.63-4.19; < 0.001) and HCC (OR = 2.45; 95%CI: 1.42-4.31; = 0.001).
These findings suggest that the T allele of rs12979860 polymorphism is associated with the development of cirrhosis and HCC in chronic HCV-infected patients.
丙型肝炎病毒(HCV)感染是全球公共卫生关注的问题。包括基因多态性在内的多种因素可能在HCV感染进展为肝脏疾病的过程中发挥作用。干扰素λ(IFNLs)在病毒感染期间调节免疫反应。IFNLs诱导抗病毒活性,通过促进多种调节免疫功能的基因表达来干扰病毒复制。干扰素λ-4(IFNL4)rs12979860多态性,其特征为内含子1中C到T的转变,与HCV感染的自发清除和治疗诱导清除相关,可能在包括肝细胞癌(HCC)在内的HCV相关肝脏疾病的发生中起作用。
研究rs12979860多态性与慢性HCV感染患者的纤维化、肝硬化和HCC的相关性。
本研究纳入305例慢性HCV感染患者(53例纤维化患者、154例肝硬化患者和98例HCC患者)。对照组由260例HCV阴性健康个体组成。采用TaqMan分析法对rs12979860多态性进行基因分型。根据肝活检结果诊断纤维化,通过临床、实验室、解剖病理学和/或影像学数据诊断肝硬化。通过影像学检查、肿瘤标志物和/或解剖病理学标志物诊断HCC。
与对照组相比,三组患者(纤维化、肝硬化和HCC)中T等位基因的频率显著更高(分别为P = 0.047、P < 0.001和P = 0.01)。此外,对照组与肝硬化患者(P < 0.001)以及HCC患者(P = 0.002)之间的基因型频率存在显著差异。使用共显性和显性T等位基因模型进行风险分析。在共显性模型中,观察到CT基因型与CC基因型相比,发生肝硬化的风险增加[比值比(OR)= 2.53;95%置信区间(CI):1.55 - 4.15;P < 0.001],与HCC相比也是如此(OR = 2.54;95%CI:1.44 - 4.56;P = 0.001)。对照组与肝硬化组之间TT与CC基因型比较也观察到类似结果(OR = 2.88;95%CI:1.44 - 5.77;P = 0.001),但HCC患者未观察到。在显性T等位基因模型中,CT + TT基因型与进展为肝硬化(OR = 2.60;95%CI:1.63 - 4.19;P < 0.001)和HCC(OR = 2.45;95%CI:1.42 - 4.31;P = 0.001)的风险增加相关。
这些发现表明,rs12979860多态性的T等位基因与慢性HCV感染患者肝硬化和HCC的发生相关。