Diamantis I, Vafiadis I, Voskaridou E, Dellatetsima J, Jäggi N, Gyr K, Battegay M
Outpatient Department of Medicine, University Hospital Basle, Switzerland.
Eur J Gastroenterol Hepatol. 1998 Jan;10(1):75-9. doi: 10.1097/00042737-199801000-00014.
The aim of this study was to investigate the prevalence of HCV genotypes among Greek patients with chronic hepatitis C and to assess the influence of genotypes and quasi-species populations on efficacy of interferon therapy. Genotypes were determined in 65 patients (18 patients after kidney transplantation, 16 with thalassemia and 31 with no known risk factor) with elevated ALT for more than 6 months and histologically proven chronic hepatitis, using the Inno-Lipa strip assay. The quasi-species were determined using the fluorescence single-strand conformational polymorphism method. Most patients were infected with genotype 3a, namely 61% of patients with kidney transplants (n = 18), 50% of patients with thalassemia (n = 16) and 48% of patients without known risk factors (n = 31). Other genotypes were found including coinfection with different genotypes. In all patients with mixed infection, genotype 3a was present. Thirty-six patients from the last two groups received interferon (3Mio U 3x week) for 1 year. Biochemical and/or virological and histological responses were found in 11/19 patients with genotype 3a (58%), 3/5 with mixed infection, 2/4 with genotype 1b, 2/5 with genotype 2a, 1/4 with genotype 1a and 1/1 with genotype 4. The virus found in non-responders with genotype 3a was genetically more heterogeneous than in responders. These data indicate that (1) the genotype 3a is prevalent in Greek patients (68% of all patients), (2) there is no significant difference regarding genotypes among patients with different risk factors and (3) although based on a small number of patients, the genotype 3a seems to respond better to interferon therapy. Finally, the number of quasi-species may be a factor predictive of response.
本研究旨在调查希腊慢性丙型肝炎患者中HCV基因型的流行情况，并评估基因型和准种群体对干扰素治疗疗效的影响。采用Inno-Lipa条带分析法，对65例丙氨酸转氨酶（ALT）升高超过6个月且经组织学证实为慢性肝炎的患者（18例肾移植后患者、16例地中海贫血患者和31例无已知危险因素患者）进行基因型测定。使用荧光单链构象多态性方法测定准种。大多数患者感染的是3a基因型，即肾移植患者中的61%（n = 18）、地中海贫血患者中的50%（n = 16）和无已知危险因素患者中的48%（n = 31）。还发现了其他基因型，包括不同基因型的混合感染。在所有混合感染患者中，均存在3a基因型。后两组中的36例患者接受了为期1年的干扰素（300万单位，每周3次）治疗。在11/19例3a基因型患者（58%）、3/5例混合感染患者、2/4例1b基因型患者、2/5例2a基因型患者、1/4例1a基因型患者和1/1例4基因型患者中发现了生化和/或病毒学及组织学反应。3a基因型无反应者中发现的病毒在基因上比有反应者更具异质性。这些数据表明：（1）3a基因型在希腊患者中占主导（占所有患者的68%）；（2）不同危险因素患者的基因型之间无显著差异；（3）尽管基于少数患者，但3a基因型似乎对干扰素治疗反应更好。最后，准种数量可能是反应的预测因素。
