An analysis of related factors for hepatitis C genotyping and sustained virologic response in Xingtai, China
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摘要:
目的分析邢台地区丙型肝炎患者病毒基因型分布特征,及其与疾病进展程度和持续病毒学免疫应答(SVR)的关系,为其预后判断提供依据。方法选取2010年12月-2014年12月邢台市人民医院收治的邢台地区丙型肝炎患者231例,收集患者一般资料,测定ALT、AST、白细胞(WBC)、基因分型及病毒载量。计量资料采用方差分析,计数资料采用χ2检验进行统计学分析。结果231例患者中1b亚型109例(47.2%),其次为2a亚型89例(38.5%),不同基因型患者的性别分布差异有统计学意义(χ2=13.461,P=0.009);不同基因型患者间HCV RNA载量差异有统计学意义(F=3.176,P=0.034),其中1型的病毒载量明显高于2型和3型;不同基因型患者间肝病严重程度差异有统计学意义(P<0.001),1b型患者中进展为肝硬化和肝癌的比例高于其他基因型;基因型为2型的患者治疗后获得SVR率为93.1%,远高于1型患者的69.4%,差异有统计学意义(χ2=19.850,P<0.001);112例(48.5%)患者出现了快速病毒学应答(RVR),其中96.4%最终产生SVR,未产生R...
Abstract:Objective To analyze the distribution characteristics of hepatitis C virus( HCV) genotypes in Xingtai,China,and their relationship with disease progression and sustained virologic response( SVR),and to provide a basis for the prognostic judgment. Methods A retrospective analysis was performed among 231 patients with hepatitis C who lived in Xingtai and were newly diagnosed and treated in our hospital from December 2010 to December 2014. In those patients,general information was collected,and alanine aminotransferase,aspartate aminotransferase,white blood cell,genotype,and viral load were determined. Continuous data were analyzed using analysis of variance,and categorical data were analyzed using χ2test. Results In all patients,patients with 1b subtype accounted for the highest proportion( n =109,47. 2%),followed by patients with 2a subtype( n = 89,38. 5%). There was significant difference in gender distribution between patients with different genotypes( χ2= 13. 461,P = 0. 009). There was significant difference in HCV RNA load between patients with different genotypes( F = 13. 461,P = 0. 034). Particularly,patients with type 1 HCV had a significantly higher viral load than patients with type2 or 3 HCV. There was also significant difference in severity of liver disease between patients with different genotypes( P < 0. 001). Particularly,the incidence rate of cirrhosis or liver cancer in patients with type 1b HCV was higher than that in patients with other genotypes. The incidence of SVR was significantly higher in patients with type 2 HCV than type 1 HCV( 93. 1% vs 69. 4 %,χ2= 19. 850,P < 0. 001).In all patients,112( 48. 5%) had a rapid virologic response( RVR),and there was significant difference in the incidence of SVR between patients with and without a RVR( 96. 4% vs 64. 7%,χ2= 36. 407,P < 0. 001). In all patients,169 had a complete early virologic response( c EVR),and there was significant difference in the incidence of SVR between patients with and without a c EVR( 88. 8%vs 56. 5%,χ2= 29. 684,P < 0. 001). Conclusion In patients with HCV in Xingtai,1b subtype accounts for the highest proportion,followed by 2a subtype. There are significant differences in sex,RNA viral load,SVR,and severity of liver disease between patients with different genotypes. An analysis of genotype before treatment is important for the treatment,disease progression,and prognosis of patients with HCV. RVR and cEVR well predict the incidence of SVR: patients with these virologic responses are likely to achieve a SVR.
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Key words:
- hepatitis C /
- hepacivirus /
- gerotype /
- sustained virologic response /
- Hebei
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