HBsAg与HBsAb双阳性慢性乙肝患者Pre-S/S区基因突变研究

Gene mutation in Pre-S/S region of HBsAg and HBsAb double positive chronic hepatitis B

目的探讨HBsAg与HBsAb双阳性慢性乙肝患者S区、Pre-S1区、Pre-S2区基因的突变情况。方法选择浙江省温州市人民医院2018年3月-2020年3月64例HBsAg/HBsAb双阳性慢性乙肝患者(双阳组),同期选择72例HBsAg单阳性慢性乙肝患者(对照组),分析两组S区、Pre-S1区、Pre-S2区氨基酸突变情况。结果两组S区N端(aa1-99)、C端(aa170-226)、"a"决定簇第一环(aa124-137)差异有统计学意义(P<0.01),且C基因型突变率较B基因型高。双阳组中7例发生S区无义突变(χ^(2)=6.213,P<0.05),6例Pre-S区碱基大片段缺失(χ^(2)=5.104,P<0.05),双阳组杂合突变率(54.4%)较高(χ^(2)=10.186,P<0.01)。结论发生Pre-S区碱基大片段缺失,S区无义突变、氨基酸的N端、C端、"a"决定簇第一环氨基酸的突变可能与HBsAg与HBsAb双阳性现象的产生有关。

Objective To investigate the mutations of S,Pre-S1,Pre-S2 region’s amino acids in patients with chronic hepatitis B who are both positive for HBsAg and HBsAb.Methods Selected 64 with HBsAg and HBsAb double-positive chronic hepatitis B patients were selected as the test group from Wenzhou People’s Hospital during March 2018 to March2020,meanwhile,72 HBsAg single-positive chronic hepatitis B patients as the control group.To analyzed the mutations of amino acids regions of S、Pre-S1 and Pre-S2.Results Compared with the control group there was a significant difference in N-terminal(aa1-99)、C-terminal(aa170-226)(P<0.05)and the first ring of"a"determinant(aa124-137)(P<0.01),the mutation rate of C genotype was higher than B genotype.In the experimental group,7 cases of S nonsense mutations(χ^(2)=5.104;P=0.024),6 cases of Pre-S deletion mutations(χ^(2)=5.104;P=0.024),heterozygous mutation rate was 54.4%(χ^(2)=10.186,P<0.01).Conclusion The occurrence of Pre-S deletion mutations,S nonsense mutations,N-terminal,C-terminal,and the first ring of"a"determinant amino acid mutations in the S region may be related to the HBsAg and HBsAb double positive patients.