摘要丙型肝炎病毒(HCV)持续感染导致的慢性丙型肝炎(CHC)是一个全球性的公共卫生问题.HCV感染是病毒因素与宿主因素相互作用的复杂的过程,HCV基因型与宿主基因型均在其中发挥重要作用.HCV分为6个基因型和多个亚型,不同基因型对聚乙二醇干扰素α联合利巴韦林的标准化抗病毒治疗的应答不同,因此治疗前需要确定HCV基因型以制定相应的治疗方案.近几年随着HCV蛋白酶抑制剂等特异性靶向治疗药物的研究进展,要求基因型的检测要精确到“亚型”的水平.基于测序法、反相杂交或实时PCR的HCV分型方法已经被广泛应用,但必须解决几个问题以实现方法学的标准化.近两年来,宿主白细胞介素28B的基因型被发现与CHC的自然清除和抗病毒治疗的应答有密切的关系,此外,肌苷腺苷三磷酸酶的基因型与利巴韦林引起的溶血性贫血相关,这些宿主基因型的检测已经在预测抗病毒治疗疗效和监控药物不良反应上得到初步的应用.

abstractsPersistent infection of hepatitis C virus (HCV) remains as a worldwide threat to public health,which involves a complex interaction between virus- and host related factors.HCV is classified as six genotypes and many subtypes according to the sequence heterogenecity.HCV genotype should be determined prior to treatment initiation since it plays a key role in selection of therapeutic regimen for chronic hepatitis C.Development of the antiviral treatment with protease inhibitor in combination with pegylated IFN-α and ribavirin requires the accurate determination of subtypes,e.g. 1a and 1b,as well.Genotyping methods based on sequence analysis, reverse hybridization or real-time PCR have been developed and evaluated.Some issues,however,should be settled to standardize the utility and result interpretation of these methods.More recently,host genotypes of IL28B have been found to be closely associated with HCV spontaneous clearance and the response to antiviral therapy.Moreover,polymorphisms in inosine triphosphate pyrophosphatase gene affect ribavirin-induced anemia.Therefore, host genotyping will be beneficial in predicting the outcome of chronic hepatitis C and monitoring the drug-induced adverse events.