干擾素-gamma的表現在慢性B 型肝炎病毒量控制所扮演的角色

Abstract

背景: 個體間HBV病毒量具有寬廣的變異。根據先前的動物實驗，IFN-γ對HBV清除扮演著重要的角色。本研究首先利用家族樣本與一群個體互相獨立之樣本，探討IFN-γ表現與單時點與長期病毒量測量值之間的關係；其次，調查影響HBV帶原者IFN-γ表現之決定因子。 材料/方法:透過肝細胞癌指標個案，我們收集其親屬總計309家共849位HBV帶原者(477位男性和372位女性)納入研究分析。個體互相獨立之樣本來自一個包含1143名男性HBV帶原者的病例世代樣本，其源自於追蹤長達17年之一個前瞻性世代。 結果: 我們發現IFN-γ表現與病毒量間有負相關存在，特別是在女性 (p=0.0168)和HBV基因型C感染者 (p=0.0285)身上。家族和個體互相獨立之樣本皆發現抽菸及喝酒與降低的IFN-γ表現有關。 結論:本研究顯現，IFN-γ表現在HBV帶原者體內具有控制病毒量之作用，已知的肝細胞癌危險因子，包括抽菸、喝酒，皆和IFN-γ表現呈現負相關。

Background & Aims There is remarkable variation in the degree of viremia among hepatitis B virus (HBV) carriers. In experimental studies, IFN-γ is critical for HBV clearance. The purpose of this study is two-fold: first, to assess the association of IFN-γ expression with cross-sectional and longitudinal measures of HBV viral load in both a family sample and a sample of unrelated individuals; second, to investigate factors that might determine IFN-γ expression among chronic HBV carriers. Materials and Methods Family-based study consisted of 849 consecutive HBV carriers (477 men and 372 women) from 309 different families each ascertained via a single proband patient with hepatocellular carcinoma (HCC). Unrelated subjects included 1143 male HBV carriers enrolled from an existing case-cohort study nested within a prospective cohort of 2903 HBV carriers followed for up to 17 years. Results We found an inverse association between IFN-γ expression and the degree of viremia, particularly for women (p=0.0168) and those infected with genotype C HBV (p=0.0285). Tobacco and alcohol use were associated with reduced IFN-γ expression in both family sample and unrelated subjects. Conclusions Our results suggest that IFN-γ expression is involved in the control of HBV viremia among chronic HBV carriers. IFN-γ expression is influenced by putative HCC risk factors, such as cigarette smoking and alcohol consumption.