Study On The Chronic Factors And Sensitivity To Interferon In Both Aspects Of Virus And Host And Special Clinical Manifestation Of Hepatitis B And C

PART I Distribution of hepatitis C virus(HCV) genotypes in JILIN province and its prognosis and sensitivity to interferon Objection: To investigate the distribution of hepatitis C virus genotypes in JILIN province, confirm the relationships between genotypes of HCV and prognosis and condition of illness , carry out prediction in sensitivity to interferon and the prognosis of hepatitis C and to increase interferon response rate in clinic. Methods : PCR-miniplate nuclec acid hybridization –ELASA was used to detect the quantity of HBV-DNA and to distinguish the genotypes of HCV. Thymosin alpha 1 was used combinate with interferon to treat HCV type Ⅱinfection. Result: Positive rate of type Ⅳinfection was 48.02%,higher than that of other types(p<0.05).Levels of serum ALT and TBIL in patients with type ⅡHCV was 154.37±87.93IU/L and 69.89±29.91umol/L respectively,occurrence of cirrhosis of liver(LC) and Primary liver cancer(PLC) was 66.66%,higher than those of other types. Response rate to interferon was increased by 19.29% when treated HCV Ⅱtype with Thymosin alpha 1 combinate alpha-interferon . Conclusion: Type Ⅳwas the major genotype in JILIN province. Clinic circumstance and occurrence of LC and PLC of type Ⅱinfection were the most serious in all of the types which patients infected. Response to interferon could be increased by treating with Thymosin alpha 1 combinate with alpha-interferon. PART II Hereditary susceptibility of hepatitis C and it effect on prognosis condition of illness and sensitivity to IFN Objection:To analyze the relationship between HLA Class ⅡDRB and the prognosis , manifestation and sensitivity to IFN of HCV infection. Methods: Gene CMOS chip was used to detect the alleles of HLA-ⅡDRB. Result: Frequency of DRB1*04,DRB1*12 and DRB1*13 in patients with type ⅡHCV chronic infection was 30%,50% and 20%,higher than those in normal(p<0.05). Serum levels of ALT and TBIL in patients with DRB1*15 and DRB5 was 166±84.86IU/L and 80.33±33.23 umol/L, level of TB and CHE was 50.33±4.16g/L and 4017.67±435.16IU/L;serum levels of ALT and TBIL in patients with DRB*11 was 53±15.56IU/L and 27±5.66umol/L,that of TB and CHE was 83.5±6.36g/L and 6315.5±945.40IU/L. In 10 patients who accept the IFN treatment ,3 patients with DRB1*04 presents no reaction to IFN,1 patient with DRB1*07 presents complete reaction .The response of other types was DRB1*09012:66.67%;DRB1*11:50%;DRB1*12:80%;DRB1*13:50%;DRB1*15:33.33%;DRB3*02/03:63.33%;DRB4:42.86%;DRB5:33.33%。Conclusion: DRB1*04,DRB1*12 and DRB1*13 may relate to the occurrence of type ⅡHCV chronic infection. DRB1*15 and DRB5 may relate to serious symptom and DRB1*04 may relate to irresponsivity to IFN. PART III Clinical features and sensitivity to interferon treatment of hepatitis B and C virus mixed infection Objection: To investigate the occurrence of different genotypes of hepatitis C virus and hepatitis B virus markers(HBVM) in hepatitis B and C virus mixed infection, analyze the clinical features of mixed infection ,and comprehend its prognosis and sensitivity to interferon treatment . Methods :PCR-miniplate nuclec acid hybridization –ELASAwas used to detect the quantity of HBV-DNA and distinguish the genotypes of HCV. Result: In hepatitis B and C virus mixed infection , Positive rates of type Ⅰand Ⅲwere 8.06% and 21.77% respectively, proportion of patients with HBsAg negative ,anti-HBc positive was 51.47%,all of them were higher than those of infected alone(p<0.05). Positive rate of two or more types HCV infection and e antigen in hepatitis B and C virus mixed infection were 12.91% and 0.58%,lower then those of infected alone . In mixed infection positive rate of HBV-DNA and HCV-RNA were 26.9% and 72.51% respectively. Level of HBV-DNA was 75.77±47.89%,all these were lower than that of infected alone(p<0.05),but occurrence of LC or PLC was 60.23%,higher than that of infected alone. Response rate to interferon in mixed infection was 26.32%,lower than that of infected alone (p<0.05).There was no difference in the levels of serum ALT , TBIL and occurrence of LC and PLC among different types HCV and HBV infection, the response to interferon was no difference either. Conclusion: Type Ⅰand Ⅲbut not two or more types coexist did mixed with HBV easily,In mixed infection, HBVM was mainly in the form of anti-HBc positive, and the serum level of virus was lower than that of infected alone ,but the occurrence of LC or PLC was higher. There was no difference in interferon response and clinic station among different HCV types mixed with HBV. PART IV Clinic features and prognosis of special types HCV and HBV infection Objection: To investigate the clinic features and prognosis of special types HCV and HBV infection, promote the diagnosis and treatment in earlier period. Methods: PCR-miniplate nuclec acid hybridization –ELASA was used to detect the quantity of HBV-DNA and to distinguish the genotypes of HCV. Result: Positive rate of HBV-DNA and HCV-RNA in patients with Serum virus markers negative were 13.16% and 18.42% respectively , there is no difference in ALT and TBIL levels between serum virus markers negative but HCV-RNA/ HBV-DNA positive patients and serum virus markers positive but HCV-RNA/...