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目的了解有偿献血人群血浆炎症细胞因子、25-羟基维生素D(25(OH)D)水平与丙型肝炎病毒(Hepatitis C Virus,HCV)感染转归及其HCV RNA病毒载量的关系。方法收集既往有偿献血人群322例,其中HCV持续感染者99例,自限清除者108例,健康对照115例,检测该人群的炎症细胞因子IFN-γ、IL-10,血浆25(OH)D水平及各项肝功能指标,分析其与HCV感染转归、病毒载量及其相互间的关系。结果 HCV持续感染者及自限清除者的血浆25(OH)D、IFN-γ水平均低于健康对照者;HCV持续感染者的血浆IL-10水平高于健康对照者,而其IFN-γ/IL-10比值低于对照者,差异均有统计学意义(均有P<0.05)。控制年龄、性别和BMI后的偏相关分析结果显示HCV持续感染者的病毒载量与25(OH)D水平呈显著负相关关系(r=-0.139,P=0.016),与IL-10接近正相关关系(r=0.111,P=0.054);血浆25(OH)D水平与IFN-γ(r=0.111,P=0.054)、IFN-γ/IL-10比值(r=0.112,P=0.052)均接近正相关关系。结论 HCV感染者存在Th1/Th2细胞因子失衡及维生素D缺乏现象,维生素D水平可能与HCV病毒复制、感染转归及慢性化有关。
Objective To investigate the relationship between plasma levels of inflammatory cytokines and 25-hydroxyvitamin D (25 (OH) D) and the prognosis of Hepatitis C virus (HCV) infection and its HCV RNA viral load in the blood donors. Methods A total of 322 blood donors were enrolled in this study. Among them, 99 were persistent HCV infection, 108 were self-limited and 115 were healthy controls. The levels of IFN-γ, IL-10 and 25 (OH) D Levels and various liver function indicators, analysis of HCV infection and prognosis, viral load and their relationship with each other. Results The levels of plasma 25 (OH) D and IFN-γ in patients with persistent HCV infection and those with self-limited clearance were lower than those in healthy controls. The levels of plasma IL-10 in patients with persistent HCV infection were significantly higher than those in healthy controls / IL-10 ratio lower than the control group, the difference was statistically significant (both P <0.05). Partial correlation analysis after controlling for age, sex and BMI showed a significant negative correlation (r = -0.139, P = 0.016) between viral load and 25 (OH) D in HCV cohorts and positive correlation with IL-10 (R = 0.111, P = 0.054) and IFN-γ / IL-10 ratio (r = 0.112, P = 0.054) Are close to a positive correlation. Conclusion The imbalance of Th1 / Th2 cytokines and vitamin D deficiency exist in HCV infected patients. The level of vitamin D may be related to HCV replication, infection and chronicity.