The Research Of HCV Genotype And Immunization And The Response Of Antiviral Treatment

Objective: To investigate the influence of HCVgenotype and immunization on the antiviral treatment ofpatients with chronic hepatitis C and the relationship betweenHCV genotype and immunization.Methods: The genotype of HCV virus and serum IFN-γand IL-4 levels were determined in the patients enrolled into thetrial of IFN-alpha and Ribavirin treatment, controlled withIFN-alpha and Ribavirin and Oxymatrine, on chronic hepatitis Cpatients in China. The serum ALT levels and HCV RNAconcentration of the patients were detected before treatment, andthe end of therapy.Results: The HCV genotypes of 63 cases weredetermined. 49(77.78%) cases were infected with genotype 1bHCV and 14(22.22%) cases with genotype 2a. The serum IFN-γlevel in the overall patients was significantly lower than thecontrolled(p<0.05), while the serum IL-4 level in the overallpatients was significantly higher than controll(p<0.05). TheHCV RNA concentration of genotype 1b HCV wassignificantly higher than which of genotype 2a(p<0.05). Theserum IFN-γlevel of genotype 1b was significantly lower thanwhich of 2a(p<0.05). But there was no difference between twotypes of the serum ALT level and IL-4 level(p>0.05). There wasno correlation between the serum IFN-γand IL-4 levels andclinical variables (age, gender), liver biochemistry (serum ALTlevel) or virological (HCV RNA level) parameters(p>0.05). Andjust in patients with the same genotype, there was no correlationbetween serum IFN-γand IL-4 levels and the serum ALT leveland HCV RNA level(p>0.05). For overall patients, the viralresponse at the end of treatment(ETVR) was 28.57% in patientswith IFN-alpha and Ribavirin treatment(group A), and withIFN-alpha and Ribavirin and Oxymatrine treatment(group B)which was 39.29%, but the difference of ETVR between the twogroups was not significant(p>0.05). In the group A, the ETVRwas 21.42% in the patients with genotype 1b HCV ,but ingenotype 2a patients which was 57.14%, and the difference ofETVR between genotype 1b and 2a was significant(p<0.05). Inthe group B, the ETVR was 28.57% in the patients withgenotype 1b HCV ,but in genotype 2a patients which was71.43%, and the difference of ETVR between genotype 1b and2a was significant(p<0.05) too. In the patients with genotype 1bHCV, the serum IFN-γlevel between the patient who got ETVRand who didn't got ETVR was significant(p<0.05) whether withIFN-alpha and Ribavirin treatment or with IFN-alpha andRibavirin and Oxymatrine treatment. But the serum IL-4 levelswasn't significant.Conclusion: The immunization of the patients with...