Pegylated interferon monotherapy in patients with chronic hepatitis C with low viremia and its relationship to mutations in the NS5A region and the single nucleotide polymorphism of interleukin-28B.
Pegylated interferon monotherapy in patients with chronic hepatitis C with low viremia and its relationship to mutations in the NS5A region and the single nucleotide polymorphism of interleukin-28B.
复制标题
聚乙二醇干扰素单药治疗低病毒血症慢性丙型肝炎患者及其与 NS5A 区突变和白细胞介素 28B 单核苷酸多态性的关系。
作者：
Hayashi K;Katano Y;Masuda H;Ishizu I;Kuzuya T;Honda T;Ishigami M;Itoh A;Hirooka Y;Nakano I;Ishikawa T;Urano F;Yoshioka K;Toyoda H;Kumada T;Goto H.
先前的研究表明，低预处理丙型肝炎病毒（HCV）水平的慢性丙型肝炎患者具有高的持续病毒学应答（SVR）率，并且可能存在单独使用聚乙二醇化干扰素（PEG IFN）根除HCV而不降低SVR的患者亚群。然而，PEG - IFN单药治疗低HCV RNA水平患者的疗效尚不清楚。一些研究报道干扰素敏感性决定区（ISDR）和白细胞介素28B （IL - 28B）的单核苷酸多态性（SNP）有助于IFN应答，但这些关系存在争议。本研究的目的是确定低HCV水平患者ISDR中IL - 28B (rs8099917) SNP和氨基酸替换是否影响PEG - IFN单药治疗的反应。方法对104例低水平HCV感染患者进行分析。低HCV水平定义为100 KIU/mL或更低。结果94例患者（92.2%）达到ssvr。单变量分析显示，HCV水平（≤50 KIU/mL）和ISDR（≥2个突变）与SVR相关。IL - 28B基因型TT、TG和GG患者SVR率分别为94.5%、77.8%和100%。G等位基因倾向于与IFN治疗不良反应相关（P= 0.0623）。多因素分析显示，ISDR是SVR的预测因子（P= 0.004）。结论ISDR与低HCV水平患者对PEG - IFN单药治疗的良好反应显著相关。
AimPrevious studies have suggested that patients with chronic hepatitis C with a low pretreatment hepatitis C virus (HCV) level have a high sustained virological response (SVR) rate, and that there would be a subpopulation of patients in which HCV can be eradicated with pegylated interferon (PEG IFN) alone without a decrease in SVR. However, the efficacy of PEG IFN monotherapy in patients with low HCV RNA levels is unclear. Several studies have reported that interferon sensitivity‐determining region (ISDR) and the single‐nucleotide polymorphism (SNP) of interleukin‐28B (IL‐28B) contribute to IFN response, but these relationships are controversial. The aim of this study was to determine whether the SNP of IL‐28B (rs8099917) and amino acid substitutions in the ISDR among patients with low HCV levels affect the response to PEG IFN monotherapy.MethodsOne hundred and four patients with low‐level HCV infection were studied. Low HCV level was defined as 100 KIU/mL or less.ResultsSVR was achieved in 94 patients (92.2%). HCV levels (≤50 KIU/mL) and ISDR (≥2 mutations) were associated with SVR on univariate analysis. The rates of SVR in the patients with IL‐28B genotypes TT, TG and GG were 94.5%, 77.8% and 100%, respectively. The G allele tended to be associated with poor response to IFN therapy (P= 0.0623). On multivariate analysis, the ISDR was the factor predictive of SVR (P= 0.004).ConclusionThe ISDR is significantly associated with a good response to PEG IFN monotherapy in patients with low HCV levels.