一例中国重型肝炎病人乙型肝炎病毒基因组全序列的测定

Complete Sequence of Genome of Hepatitis B Virus Precore Stop Codon Variant Isolated from a Chinese Patient with Fulminant Hepatitis

用聚合酶链反应（PCR）产物直接和克隆后序列分析，测定1例重型肝炎病人感染的HBV变异毒株全基因组序列，该毒株长3221个碱基，为adw亚型，与同一地区HfuAg阳性无症状携带者感染的adw亚型全序列比较，有35个罕见和独特的核着酸改变，导致27个氨基酸替代，其中前C和C基因变异最多，这一毒株在多种调节序列，包括启动子SPI、SP11、XP、增强子ENI和EN11，也存在变异。但并无日本毒株的X区和ENHll－CP的聚集变异。结果说明我国重肝HBV毒株有独特的变异特点。

The sequence of entire hepatitis B virus (HBV) genome from one Chinese patient with fulminant hepatitis and also from a hepatitis B e antigen (HBeAg) positive carrier from the same region was determined using direct sequencing of amplified viral DNA. The fulminant case was infected with the precore stop codon variant. Compared the sequence from this fulminant case with sequences from fulminant isolate previously reported and also from HBeAg positive carrier from the same region, the results showed significant genetic variations throughout the HBV genome in the precore stop variant sequence and less in the wild type. The increase of variability in the core region in fulminant cases in the Far East origin was found: codon 84 ~97 showing high rates of changes. A clustered mutations previously described in the X region (126 ~ 132) in sequences reported in Japanese patients and encompassing the enhancer Ⅱ - core promoter region were not found in the isolate. This study firstly characterized a Chinese fulminant isolate which has some rare and unique changes compared with previously reported isolate from fulminant case.