Investigation The Influence Of Alcohol To Genotype Disposition Of HCV And Change Of Cytokine In Patients With HCV Infected

[Backgroud]:Philo-hepatovirus and alcohol are the main causes of liver disease. On the base of infection by HBV and HCV drinking wine or on the base of alcoholic liver disease(ALD) developing infection by HBV and HCV can accelerate the development of liver disease,and patients can develop chronic hepatitis,cirrhosis and hepatoma easier.At present,people think infection by HBV and HCV have a synergistic effect with alcohol and which is more outstanding of infection by HCV.Also,heavy alcohol use results in increased probability for premature death among patients with hepatitis C virus infection and reduce the effects of therapy with interferon.The study in our country limited in the genotype disposition of HCV in crowd,but there is few about the comparison of genotype in alcoholic and nonalcoholic patients.[Objective]:To analyze the genotypes of HCV RNA in alcoholic and nonalcoholic patients with HCV infected and contrast the distribution of the genotypes between them, identify whether alcoholic patients have a higher affectivity than nonalcoholic patients to certain genotype.Meanwhile detection the level of IFN-γand TNF-αto gain the mechanism of hepatic lesion in alcoholic patients with HCV infected.[Method]:Collect 114 patients with chronic hepatitis C who was in Qilu Hospital of Shandong University and Infectious Disease Hospital of JiNan.Detect the hepatic function of all patients.Then detect the HBsAg and anti-HCV of all patients by enzyme linked immunosorbent assay(ELISA).Measure the quantity of HCV RNA in the serum of all the patients by reverse transcription polymerase chain reaction.According to whether the patients have a history of alcohol abuse divide them into the groups of alcohol and nonalcohol.The genotypes of HCV RNA in the two groups were performed by gene chip technique,then comparison the outcome of the typing.Extract PBMC of all patients used Ficoll gradient centrifugation,and then culture them.And detection the level of IFN-γand TNF-αused ELISA.Using(?)±s to express numeric type variance, and by paired t-test to contrast the hepatic function and cytokine of the two groups. Then by the chi-square test to compare the ratio of genotypes of the two groups.[Result]:(1) Collect 114 patients in all,among of them 50 patients are alcoholists and the other are nonalcoholists.There is no statistical significance on the clinical document between them(P＞0.05).(2) The genotype 1b is more than other genotypes in the two groups,and there is no statistics significance.(Alcohol group is 60%and nonalcohol group is 43.75%,P=0.22). And there is no statistics significance between the two groups about genotype 2a,mixed type and non-typed(P＞0.05).(3) The serum titers of HCV RNA of alcoholic group are(11100±14174.3)×10~3 copies/ml and the nonalcoholic group are(3927.8±4549.6)×10~3 copies/ml.And there is statistics significance between the two groups(P=0.025).(4) The level of TNF-αof the alcoholic group is 4528±3587ng/L and the nonalcoholic group is 3262±3131 ng/L.There is statistics significance between the two groups(P=0.048).But there is no statistics significance between the two groups about IFN-γ(P＞0.05).[Conclusion]:Alcohol can promote the copy of HCV RNA in patients with HCV infected,aggravate the injury of liver,but it can't add susceptibility to certain genotypes of HCV RNA.The liver inflammation of alcoholic patients is higher than nonalcoholic patients.TNF-αbuilds a important effect in alcoholic patients with HCV infected,is one of the important mechanisms in the injury of liver.