Prognostic effect of human leukocyte antigen class I and II alleles on chronic hepatitis C patients treated by pegylated interferon-alfa plus ribavirin in Taiwan.
Prognostic effect of human leukocyte antigen class I and II alleles on chronic hepatitis C patients treated by pegylated interferon-alfa plus ribavirin in Taiwan.
复制标题
人类白细胞抗原 I 类和 II 类等位基因对台湾聚乙二醇干扰素-α 加利巴韦林治疗的慢性丙型肝炎患者的预后影响。
作者：
K. Tseng;Chin;A. Chou;Y. Hsieh;Chang;N. Lai
背景/目标
目的探讨聚乙二醇化干扰素-α和利巴韦林联合治疗慢性丙型肝炎(CHC)患者人类白细胞抗原(HL A)I、II类等位基因对疗效的影响。
方法论
入选106例完成联合治疗的慢性丙型肝炎患者。67例患者获得持续病毒学应答(SVR)。用基于序列的基因分型方法确定基因座中的-A、-B、-C、-DR和-DQ。用Logistic回归分析病毒学变量和HLA等位基因对SVR的影响。
结果
单因素分析显示，SVR与治疗前丙型肝炎病毒核糖核酸水平低、丙型肝炎病毒非1型、治疗前丙氨酸氨基转移酶水平高、丙氨酸氨基转移酶水平从基线到第4周显著下降以及低体重指数显著相关。单因素分析显示，在HLAI、II类等位基因中，SVR的发生与缺乏HLAB60和存在HLAA33显著相关(OR分别为0.33；95%CI，0.14~0.77；p=0.01；OR，2.16；95%CI，0.86~5.45；p=0.30，有趋势)。多因素分析显示，在调整潜在混杂因素后，HLAA33显著有利于SVR(OR，7.86；95%CI，1.43~43.30；经Holm‘s手术后p值=0.03)。
结论
在接受聚乙二醇化干扰素-阿尔法和利巴韦林联合治疗的台湾慢性丙型肝炎患者中，人类白细胞抗原A33与SVR的实现有关。
BACKGROUND/AIMS
To investigate the influence of human leukocyte antigen (HLA) class I and II alleles on the response in chronic hepatitis C (CHC) patients receiving combination therapy with pegylated interferon-alfa and ribavirin.
METHODOLOGY
One hundred and six CHC patients who accomplished combination treatment were enrolled. Sixty-seven patients achieved sustained virologic response (SVR). HLA-A, -B, -C, -DR, and -DQ loci were determined by sequence-based genotyping. The effects of virologic variables and HLA alleles on SVR were evaluated by logistic regressions.
RESULTS
Univariate analyses showed that SVR was significantly associated with low pre-treatment HCV RNA levels, HCV genotype non-1, high pre-treatment ALT levels, a significant decline of ALT levels from baseline to week 4, and the low body mass index. Among HLA class I and II alleles, the occurrence of SVR was significantly associated with lack of HLA-B60 and existence of HLA-A33 in univariate analyses (OR, 0.33; 95% CI, 0.14-0.77; p = 0.01; OR, 2.16; 95% CI, 0.86-5.45; p = 0.30 with a trend, respectively). Multivariate analyses revealed that HLA-A33 significantly favored SVR after adjusted for potential confounders (OR, 7.86; 95% CI, 1.43-43.30; p value after Holm's procedure = 0.03).
CONCLUSIONS
HLA-A33 is associated with the achievement of SVR in Taiwanese CHC patients receiving combination therapy with pegylated interferon-alfa plus ribavirin.