Höhler T, Gerken G, Notghi A, Knolle P, Lubjuhn R, Taheri H, Schneider P M, Meyer zum Büschenfelde K H, Rittner C
Department of Internal Medicine, Johannes Gutenberg University Mainz, Germany.
J Hepatol. 1997 Aug;27(2):259-64. doi: 10.1016/s0168-8278(97)80169-9.
BACKGROUND/AIMS: Chronic hepatitis C develops in more than 70% of hepatitis C virus infected subjects. Viral factors influence the disease course, but little is known about the importance of host factors.
Frequencies of major histocompatibility complex (MHC) class I and class II antigens were analyzed in two groups of patients with chronic hepatitis C virus infection and in control subjects. MHC class I typing was done by standard microlymphocytotoxicity assays. DRB1 and DQA1 genotyping was done by PCR based typing methods.
DRB10301 was found in 26 of 75 patients with chronic hepatitis C virus infection (34.7%) and in 12 of 101 control subjects (11.9%) (relative risk 3.9; p < 0.001). Homozygosity for this allele appeared to confer a stronger risk. In contrast, DRB11301 was detected in three subjects with persistent infection (4.0%) compared to 21 control subjects (20.8%) (relative risk 0.2; p < 0.008). This allele was linked with DQA10103, which was found in 10 patients (13.3%) compared to 34 control subjects (33.7%) (relative risk 0.31; p < 0.003). An even stronger protective effect was provided by the presence of DRB11301 and DQA1*0103 (relative risk 0.08; p < 0.005). These findings were confirmed in a second group of chronic hepatitis C virus infected patients.
The MHC class II allele DRB10301 appears to predispose to progression to chronic active hepatitis C, whereas the class II alleles DRB11301 and DQA1*0103 appear to provide protection against chronic active infection with hepatitis C virus.
背景/目的:超过70%的丙型肝炎病毒感染患者会发展为慢性丙型肝炎。病毒因素会影响疾病进程,但宿主因素的重要性却知之甚少。
分析了两组慢性丙型肝炎病毒感染患者及对照组中主要组织相容性复合体(MHC)Ⅰ类和Ⅱ类抗原的频率。MHCⅠ类分型采用标准微量淋巴细胞毒性试验。DRB1和DQA1基因分型采用基于聚合酶链反应的分型方法。
在75例慢性丙型肝炎病毒感染患者中,26例(34.7%)检测到DRB10301,而在101例对照者中,12例(11.9%)检测到该基因(相对危险度3.9;P<0.001)。该等位基因的纯合性似乎会带来更强的风险。相比之下,在3例持续感染患者(4.0%)中检测到DRB11301,而在21例对照者(20.8%)中检测到该基因(相对危险度0.2;P<0.008)。该等位基因与DQA10103相关联,在10例患者(13.3%)中检测到DQA10103,而在34例对照者(33.7%)中检测到该基因(相对危险度0.31;P<0.003)。DRB11301和DQA10103同时存在时,保护作用更强(相对危险度0.08;P<0.005)。这些发现在另一组慢性丙型肝炎病毒感染患者中得到了证实。
MHCⅡ类等位基因DRB10301似乎易导致进展为慢性活动性丙型肝炎,而Ⅱ类等位基因DRB11301和DQA1*0103似乎能提供针对丙型肝炎病毒慢性活动性感染的保护作用。