| Objective To investigate the distribution of HBV genotypes in Qing Dao area and toanalysis the relationship of HBV genotypes and the liver function,the level of HBVDNAand to study the long term therapeutic efficacy of chronic hepatitis B(CHB) withα-2binterferon combined with matrine on liver function,serum HBeAg and HBVDNA andserum fibrosis markers. Methods 150 patients were detected hepatitis B virus genotypesusing immunofluorescence quantitative analysis. And based on the similar generaltreatment, 40 cases of chronic hepatitis B usedα-2b interferon combined with matrine.The serum HBsAg,HBeAg and HBVDNA of 40 cases were all positive. The serum ALTwere all 2-10 times normal and all the patients were excluded from heart and pulmonarydiseases,diabetes mellitus,nephritis, et al. The time of therapy is 24 weeks. The time offollow-up is also 24 weeks. Pretreatment and after therapy the biochemical indicators,HBV serum indicators(HBsAg,HBsAb,HBcAb,HBeAg,HBeAb,HBVDNA),serumfibrosis markers were all detected every four weeks. Results The serum HBVDNA ofone hundred and fifty samples were all positive ,and 40(26.7%) samples were classifiedas genotype B,C 98(65.3%),B+C 12 (8%). 102 CHB (L.M) samples among them wereclassified as genotype B 35 cases, C 63 cases, B+C 4 cases. 48 CHB (S)and LC samplesamong them were classified as genotype B 5 cases,C 35 cases,B+C 8 cases .At the endof the treatment and follow-up, the converting rates of serum HBeAg/HBeAb,thenegative rates of serum HBVDNA and the depressed rates (2-51og) of serum HBVDNAofB genotype group were respectively 66.7%,66.7%,25.0%; 58.3%,50.0%,25.0%;and those ofC genotype group were respectively 25.0%,25.0%,53.6%;17.9%,14.9%,46.4%. The patients' serum ALT,AST and serum fibrosis markers of B genotype groupshowed significant lower than those of C genotype group. There is significant differencein the therapeutic efficacy between the two groups (P＜0.05). Conclusions The genotypeB. genotype C and genotype B+C exist in Qing Dao area. And they are respectively26.7%,65.3% and 8%.The reproducing ability of genotype C virus is much stronger thanthat of genotype B virus. Genotype C is associated with the development of severe liverdisease. The clinical therapeutic efficacy ofα-2b interferon combined with matrine isvery good for chronic hepatitis B. And the clinical therapeutic efficacy of genotype B issuperior to genotype C. And there is no severe adverse event related toα-2b interferoncombined with matrine in patients during therapy. It is anticipated that cases usingα-2binterferon combined with matrine will result in significant clinical benefit and especiallyon cases of HBV B genotype.
|
PDF Full Text Request