吉林大学第一医院肝胆胰内科 陈林姣 摘译
本文首次发表于[Gastroenterology. 2012;142(1):78-85.]
Serum Level of IP-10 Increases Predictive Value of IL28B Polymorphisms for Spontaneous Clearance of Acute HCV Infection
Abstract
BACKGROUND AND AIMS：Single nucleotide polymorphisms (SNPs) in IL28B and serum levels of interferon γ inducible protein 10 (IP-10) predict outcome of antiviral therapy in patients with chronic hepatitis C. We associated IL28B SNPs rs12979860 and rs8099917,along with serum levels of IP-10,with outcomes of patients with acute hepatitis C (AHC).
METHODS：We studied 120 patients with AHC (64mail;37+-16 years old) and 96 healthy individuals (controls). The IL28B SNPs rs12979860 and rs8099917 were detected using real-time polymerase chain reaction; serum concentrations of IP-10 were measured by enzyme-linked immunosorbent assays of 62 patients with AHC.
RESULTS：Hepatitis C virus was cleared spontaneously from 59 patients (49.2%).The IL28B rs129798860 C/C genotype was more frequent among patients with AHC than controls (62.5% vs 39.6%; p<0.001).and among patients with spontaneous clearance than those without (74.6% vs 51.7%; p=0.02)(positive predictive value, 60.3%). Patients with IL28B rs12979860 C/C more frequently developed jaundice .(53.2% vs 27.6%;P=0.022) than carriers of the T allele. The median level of IP-10 was lower among patients with AHC and spontaneous clearance (764[113-2407] pg/ml) than those without spontaneous clearance (1481[141-4412]pg/ml; p=0.006).Based on receiver operating characteristic analysis, 540pg/ml IP-10 was set as the cutoff for patients most likely to have spontaneous clearance (positive predictive value,71.4%;negative predictive value, 65.9 %).Including data on IP-10 levels increased the ability of the IL28B rs 12979860 C/C to identify patients most likely to have spontaneous clearance (83% of those who had an IP-10 level<540 pg/ml and 32% who had an IP-10 level>540pg/ml)(p<0.01)
CONCLUSIONS：The combination of serum level of IP-10 and SNPs in IL28B can identify patients with AHC who are most likely to undergo spontaneous clearance and those in need of early antiviral therapy.
