| Objective : The research was aimed to acquire and analyze the characteristics of genotypic distribution of HCV in hepatitis C patient in Xingtai, and study its relationship with progression and severity of hepatitis C as well as sustained virological response(SVR). The factor impacting SVR would also be analyzed so that virological rationales for individualized therapy and prognosis of hepatitis C would be provided.Methods: 1 Material SourcesTwo hundred and thirty-two hepatitis C patients who underwent first visit and treatment in Xingtai People’s Hospital from December 2010 to December 2014 were included in our study. The diagnostic criteria for hepatitis C was based on Guidance on Prevention and Treatment of Hepatitis C issued in March 2004 by Liver Cancer Study Group and Infectious Diseases Parasitic Disease Group of Chinese Medical Association. 2 Data sources 2 1Data acquisition: this paper analyzed the cases of 231 patients with hepatitis c laboratory indicators, including HCV genotyping, HCV RNA loads, SVR, ALT, AST, the WBC, and organized the basic material of related cases. 2.2 Indicators detection: 2.2.1 genotypingHCV genotyping reagent was provided by Taipu Bioscience Limited Corporation. The method adopted was PCR-Fluorescence probe using ABI7500 Prism Fluorescent PCR instrument. 2.2.2 viral loadHCVRNA determination reagent was offered by Zhongshan University Daan Gene Co., LTD., The method adopted was RT-PCR-Fluorescence probe PCR, using ABI7300 Prism Fluorescent PCR instrument. 2.2.3 Biochemical indexAST reagent was offered by Beijing Wan Tai De Diagnosis Technology Co., LTD. The determination method was rating,using Hitachi automatic biochemical analyzer 7600-110. 2.2.4 Hemogram AnalysisWBC testing reagent was provided by instrument manufacturer, The method is five taxonomy, using. Mai Rui 5380. 3. Data statistics: using SPSS17.0 software for statistical analysis, multiple sets of measurement data comparison with variance analysis, two groups of measuring data is using t test, the comparison of count data using X2 test and Fisher’s exact probability method.Results:1 The Basic Situation: There are 231 cases in line with the selected criteria for the diagnosis of hepatitis c cases, among which 132 are male, 99 are female. Age distribution: the average age was 44.3 + /- 3.7 years old. Occupation distributions, most of them are workers and peasants, followed by merchants, freelances. Geographical distribution: The cases distributed in city are higher than in the countryside.2 Genotyping: In the selected 231 cases of patients, genotype 1b type are 109 cases, accounting for 47.2%; 2a subtype are 89 cases, accounting for 38.3%; 1a subtype are 15 cases(6.5%); 2b subtypes are 13 cases(5.6%), 5 cases are the unknown types, accounting for 2.2%. Male of 1b type are significantly more than female of 1b type; female of 2a type are more than 2a type male. The rates of hepatitis c patients with genotype 2 after treatment may get SVR are higher than that of type 1.3 Sustained Virology Immune Response: Among the 231 cases of hepatitis c patients, 185 cases are diagnosed with SVR, and the SVR rate is 80.1%. Male group of SVR rate is 70.5%, significantly lower than the 92.9% of female group, the X2 value of the two groups is 17.918, P < 0.001, the difference is statistically significant;The SVR rate of cases that are under 40 years old is 97.8%; the SVR rate of cases that are older than 40 years old is 69%, the X2 value 28.333, P < 0.001, the difference is statistically significant.Drinking SVR rate was 86.1%, not drinking SVR rate was 79. 0%, both more X2 value of 0.971, P value is 0.325, no statistically significant differences between the two groups; the SVR rate is 25% for the patients with cirrhosis, the SVR rate is 88.9% for patients with no cirrhosis, both comparisons X2 value are 70.680, P<0.001, the difference is statistically significant; the SVR rate for the patients with fatty liver disease is 50.0%, the SVR rate is 85.3% for patients with no fatty liver, both comparison X2 value are 22.629, P<0.001, the difference is statistically significant; divide the cases into two groups according to the viral load less than or equal to 5 log10 copies/ml before treatment, the SVR rate is 93.3% for the cases with low viral load, the SVR rate is 93.3% for the cases with high viral load, two groups compare X2 value is 34.849, P < 0.001, the difference is statistically significant; Compare ALT, AST, the WBC level for the hepatitis c patient group with the SVR and the group with no SVR before treatment, t value are 0.652, 0.449 and 0.062, p values are 0.850, 0.654 and 0.951, the difference has no statistical significance, ALT,AST,WBC level before treatment has nothing to do with the SVR; Respectively layer the three biochemical indexes, the boundary of ALT is less than or equal to 60 U/L, the boundary of AST is less than or equal to 70 U/L, the boundary of white blood cells is less than or equal to 6×109, compare each SVR rates, after statistics analysis, X2 values are 2.398, 0.247 and 2.235, p values are 0.122, 0.619 and 0.135, SVR rate difference between different layers has not statistical significance, ALT, AST, WBC is no significant relationship with the SVR rate at the end of the treatment for the hepatitis c patients.4 Viral Load: HCV virus load between different genotypes are different. Type1(mainly are 1b type) virus load is significantly higher than that of type 2 and type 3.5 Genotype: The hepatopathy degree of different genotypes is different. The proportion of the type 1b cases progressing to liver cirrhosis and liver cancer is higher than of other genotypes.6 Adverse Drug Reactions: The main adverse reactions of using drugs are fever, fatigue, reducing the white blood cells, the differences among the different genotypes adverse reactions are not obvious. ALT, AST, the WBC of different genotypes are not obvious.Conclusions:1 The most widespread hepatitis c genotype is 1 b subtype, followed by 2 a subtype. In the treatment for patients with hepatitis c genotype, RVR and CEVR can well predict the SVR, patients’ gender, age, fatty liver and cirrhosis or not and patient’s viral load before treatment has close relationship with patients’ gaining SVR or not after treatment.2 There are distinct difference between the genders of different genotype patients, RNA viral load, SVR and the rate of leading to Cirrhosis or liver cancer. For patients with hepatitis c having genotype analysis before treatment is of great clinical significance for patients’ treatment, prognosis and guidance for guiding medicine taking.There are no close relationship between genotype and adverse reactions in thetreatment.3 Genotyping hepatitis c patients before treatment, dynamic monitoring HCVRNA loads during treatment, actively preventing and treating adverse reactions can maximize the curative effect of treatment. |
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