HCV genotype-specific correlation with serum markers: Higher predictability for genotype 4a
HCV genotype-specific correlation with serum markers: Higher predictability for genotype 4a
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DOI：
10.1186/1743-422x-8-293
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发表时间：
2011-06-10
期刊：
影响因子：
4.8
通讯作者：
Hassan, Sajida
中科院分区：
文献类型：
--
作者：
Ahmad, Waqar;Ijaz, Bushra;Hassan, Sajida
背景：已经提出了几个因素来评估丙型肝炎病毒感染的临床结果。HCV基因型与可能的血清标志物在临床预测中的相关性仍有争议。本研究的主要目的是确定HCV基因型与病毒载量和不同临床血清标志物之间是否存在任何相关性。从4020例抗-HCV阳性患者中随机抽取3160例血清HCVRNA阳性患者。采用SPSS 16软件包进行统计学分析。结果：在巴基斯坦人群中，3a基因型最常见（73.9%），其次为1a（10.7%）、4a（6.4%）和3b（6.1%）。在大量样本（n = 2336）中，未发现病毒载量与基因型3a血清标志物之间存在相关性。3b型病毒载量与AST显著相关，1a型ALP与病毒载量和ALT显著相关。4a基因型患者病毒载量、Hb水平、AST与ALP呈显著负相关。4a型患者ALT、ALP、AST、胆红素、Hb和病毒载量的曲线下面积分别为0.790、0.763、0.454、0.664、0.458和0.872。3a基因型患者的病情严重程度与血清标志物水平无关，而4a基因型患者的肝损害可能与病毒的细胞病变效应以及免疫介导的过程有关。使用六种血清标志物的指数可以正确预测患者的基因型4a，准确率>= 75%。
Background: Several factors have been proposed to assess the clinical outcome of HCV infection. The correlation of HCV genotypes to possible serum markers in clinical prediction is still controversial. The main objective of this study was to determine the existence of any correlation between HCV genotypes to viral load and different clinical serum markers.Methods: We performed a prospective cross-sectional and observational study. About 3160 serum HCV RNA positive patients were chosen from 4020 randomly selected anti-HCV positive patients. Statistical analysis was performed using the SPSS 16 software package. ROC (receiver operating characteristics) curves were used to compare diagnostic values of serum markers to predict genotypes.Results: The most prevalent genotype was 3a (73.9%) followed by 1a (10.7%), 4a (6.4%) and 3b (6.1%) in Pakistani population. No correlation was found between viral load and serum markers for genotype 3a in a large no. of sample (n = 2336). While significant correlation was observed between viral load and AST in genotype 3b, ALP with viral load and ALT for genotype 1a. Patients with genotype 4a showed a significant inverse correlation with viral load and Hb level and AST with ALP. For genotype 4a, AUC (area under the curve) of ALT, ALP, AST, bilirubin, Hb level and viral load was 0.790, 0.763, 0.454, 0.664, 0.458 and 0.872 respectively.Conclusions: In conclusion, there was a significant variable response of HCV genotypes with serum markers. Severity of disease is independent of serum marker level in genotype 3a, while the liver damage in genotype 4a may associate with viral cytopathic effect as well as the immune-mediated process. An index using six serum markers may correctly predict genotype 4a in patients with >= 75% accuracy.