湖南省怀化市少数民族及汉族慢性乙型肝炎患者病毒基因分型及临床分析

Genotyping of hepatitis B virus and clinical analysis in patients with chronic hepatits B from minority and Han people in Huaihua city of Hunan province

目的了解湖南省怀化市少数民族及汉族慢性乙型肝炎患者病毒基因型分布特点及不同基因型与临床肝病的相关性。方法采用S基因序列分析法对湖南省怀化市111例慢性乙型肝炎患者进行乙型肝炎病毒基因分型,并分析相关流行病学、病例构成、HBV DNA载量、HBeAg阳性率及肝功能情况。结果该地区111例慢性乙型肝炎患者HBV基因型检测到B型及C型,其中B型90例(81.08%),C型19例(17.12%),2例(1.80%)无法分型。B、C基因型分布情况:33例少数民族组患者B基因型31例(93.93%),C型2例(6.07%);76例汉族组患者B基因型59例(77.63%),C基因型17例(22.37%)。C基因型患者肝硬化及肝癌构成比高于B基因型患者,HBV DNA载量、HBeAg阳性率及球蛋白水平高于B基因型,而白蛋白水平低于B基因型。结论该地区乙型肝炎病毒基因型以B型为优势基因型,少数民族与汉族患者HBV基因型构成有显著差异,C基因型患者HBeAg血清转换率低,可能较易发生肝病进展。

Objective To investigate the genotypes of hepatitis B virus(HBV)and the relationship between genotypes and liver diseases in patients with chronic hepatitis B(CHB)from minority and Han people in Huaihua city of Hunan province.Methods S region sequencing was employed to detect HBV genotypes in 111 CHB cases in Huaihua city of Hunan province.The data of epidemiology,case composition,serum HBV DNA level,HBeAg positive rate and liver function were analyzed,respectively.Results Genotype B and C were detected in 111 CHB cases in this area.Ninety cases(81.08%)were genotype B,19 cases(17.12%)were genotype C and 2 cases(1.80%)couldn't be genotyped.Among 33 cases of minority people,31 cases(93.93%)were genotype B and 2 caese(6.07%)were genotype C.Among 76 cases of Han people,59 cases(77.63%)were genotype B and 17 caese(22.37%)were genotype C.The constituent ratio of hepatic cirrhosis and hepatocellular carcinoma,serum HBV DNA level,HBeAg positive rate and serum globulin level in patients with genotype C HBV infection were all higher than those in patients with genotype B.And serum albumin level in patients with genotype C HBV infection was lower than that in patients with genotype B.Conclusions Genotype B is the major HBV genotype in this area.The composition of HBV genotypes in minority people is significantly different from that in Han people.HBeAg seroconversion rate is lower and liver disease progression is worse in patients with genotype C.