Kronik hepatit C tedavisine yanıtı tahmin etmede IL28B gen polimorfizmi

Amaç: Hepatit C, kronik karaciğer hastalığına neden olan büyük bir sağlık sorunudur. Dünya’da 170 milyon insanın enfekte olduğu düşünülmektedir. Hepatit C’li hastaların yaklaşık % 30’unda spontan viral klirens meydana gelirken, % 70’inde hastalık kronikleşmekte, bir kısmında siroz ve hepatosellüler kanser gelişebilmektedir. Konak faktörleri içinde kalıcı viral yanıtın en iyi belirleyicisi, son yıllarda ortaya konan kromozom 19q13 üzerindeki IL28 B polimorfizmidir. Çalışmadaki amacımız bölgemizdeki hasta populasyonunda IL28B gen polimorfizminin tedaviye yanıta olan etkisini ortaya koymaktır. Gereç ve yöntem: Çalışmaya 48 haftalık peginterferon ve ribavirin tedavisi ve sonrasındaki 24. haftada kontrole gelen 95 hasta alındı. Hastaların tedavi öncesi yaş, cinsiyet, AST, ALT değerleri, insülin ve açlık glukozu, karaciğer biyopsisinde fibrozis düzeyleri,- 0-4-12-24-48-72. hafta HCV RNA değerleri kaydedildi.Bulgular: Hastaların yaş ortalaması 52,4±11 idi. Çalışma sonunda hastaların 54’ünde (%56.8) kalıcı viral yanıt gözlendi. Tedaviye yanıta etki eden demografik ve laboratuvar özellikleri kalıcı viral yanıt ve kalıcı olmayan viral yanıt gruplarında benzerdi. Kalıcı viral yanıt olan hastalarda IL 28B SNP rs12979860 polimorfizmine bakıldığında; CC 26 (% 47.2), CT 25 (% 45.4), TT 4 (% 7.2) hastada saptandı. Kalıcı viral yanıt olmayan hastalarda IL 28B SNP rs12979860 polimorfizmi; CC 4 ( % 10) ,CT 23 (% 57.5), TT 13 (% 32.5) hastada saptandı. Sonuç: HCV genotip 1 rs12979860 CC genotipte kalıcı viral yanıt oranının yüksek olması nedeniyle karaciğer hastalığının şiddetine dayalı tedavi kararını değiştirebilir. Bu konuda ülkemizde daha büyük hasta populasyonlarını içeren çalışmalara ihtiyaç vardır.

Anahtar Kelimeler:

Hepatit C, interlökin-28B, , gene polimorfizmiene polimorfizmi

IL28B polymorphism predict the response to chronic hepatitis C treatment

Purpose: Hepatitis C is an important medical problem which causes chronic liver disease. 170 million people are believed to be infected throughout the world. While spontaneous hepatitis C virus (HCV) clearance occurs in almost 30 % of patients with hepatitis C, it becomes chronic in 70 % which may progress to cirrhosis or hepatocellular carcinoma (HCC). In recent years, IL28B polymorphism on chromosome 19q13 has been suggested as the most important predictor among the host factors for sustained virologic response (SVR). In the present study, we aimed to evaluate the effect of IL28B gene polymorphism on conventional treatment response.Materials and methods: Totally 95 patients treated with a combination of peginterferon and ribavirin during 48 weeks were included the study. Age, gender, AST and ALT levels, insulin and fasting glucose levels, BMI, fibrosis levels on liver biopsy and 0-4-12-24-48-72-week HCV RNA values were recorded. Results: In the study group of 95 HCV-infected patients, the mean age was 52.4±11 years. SVR was observed in 54 (%56.8) of patients at the follow up. Demographical and laboratory variables were similar in SVR and non-SVR groups. IL28B SNP rs12979860 was positive in CC 26 (47.2 %), CT 25 (45.4%) and TT 4 (7.2 %) patients with SVR group and in CC 4 (10 %), CT 23 (57.5 %), TT 13 (32.5 %) patients with non-SVR group. Conclusion: SVR was achieved more likely in HCV genotype 1 rs12979860, and treatment decision may be changed based on the degree of liver disorder. In this regard, new studies involving larger patient population from our country are needed.

Keywords:

Hepatitis C, interleukin-28B, genetic variation,

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