中国东北丙型肝炎病毒感染基因特征及人群易感性分析

Investigation on the distribution of HCV genotypes and the susceptibility of HCV infection in northeast China

采用微板核酸杂交-ELISA法及基因芯片技术对5 79例HCV感染者的HCV基因型以及30例HCV感染者以及30例健康人HLA -DRB1等位基因分布情况进行分析,探讨中国东北丙型肝炎病毒(HCV)感染基因型特征及丙型肝炎病毒感染的人群易感性。5. 79例患者中Ⅳ/ 2b型HCV感染率最高,为5 1 .12 % ;约34 .72 %的HCV感染者ALT持续正常;Ⅱ/ 1b型和混合型HCV感染在ALT反复升高组中的感染率明显高于ALT持续正常组(P <0 .0 5 )。Ⅰ型和Ⅲ型HCV合并HBV感染的发生率较高,混合型HCV合并HBV感染的发生率较低,与单独感染比较差异显著(P <0 .0 5 ) ;混合型HCV感染主要见于有2次或2次以上输血史者。HLA -DRB1 0 4和DRB1 13在HCV感染者中的出现频率较高,与健康对照组相比差异显著(P <0. 0 5 )。因此,中国东北地区HCV感染以Ⅳ/ 2b型为主,约34 72 %的HCV感染者不表现出肝炎的症状,可能成为重要的传染源。Ⅱ/ 1b型和混合型HCV感染更容易导致肝细胞损伤。Ⅰ/ 1a型和Ⅲ/ 2a型HCV可能更易于同HBV共存,两种或两种以上基因型共存的HCV则不易于同HBV合并感染。反复接受血液或血制品可能是出现混合型HCV感染的主要原因。HLA -DRB1 0 4和DRB1 13等位基因可能与HCV的人群易感性有关。

To investigated the distribution of HCV genotypes and the susceptibility of HCV infection in northeast China,579 patients in fected with HCV were divided into p ersistently normal ALT group and elevated ALT group on the basis of serum ALT le vel.HCV genotypes and HBV markers of them were detected by sandwich hybridizatio n on microplate and ELISA assay.Gene chips were used to analyze the frequency of HLA-DRB1 in 30 patients with HCV infection and 30 healthy controls.The results showed:Infection rate of HCV Ⅳ/2b was 51.12%,the highest in the four genotype s.Normal level of serum ALT was found in 34.72% patients with HCV infection.Inf ection rates of HCV Ⅱ/b and mixed type HCV infection in elevated ALT group were higher than those in normal ALT group (P<0.05).Positive rates of type I/1 a and Ⅲ/2a were higher and that of mixed type were lower in patients who coinfe cted with HBV,significant difference was found between those coinfected and infe cted HCV alone (P<0.05).Mixed type HCV infection were mostly found in thos e patients with more than twice transfusion history.The frequency of HLA-DRB1*04 and HLA-DRB1*13 in patients with HCV infection were higher than those in contro l (P<0.05).In conclusion,HCV Ⅳ/2b was the major genotype in northeast Chi na.About 34.72% HCV infection presented normal ALT,which might be the hidden so urce of HCV infection.HCV Ⅱ/1b and mixed type HCV infection were liable to indu ce liver damage.Type Ⅰ/1a and Ⅲ/2a but not two or more types coexist did compl icated with HBV easily.Accept transfusion or blood manufactures repeatedly may b e the major reason of two or more types of HCV coexist.Those people with HLA-DRB 1*04 and HLA-DRB1*13 allels may be more liable to suffer HCV infection.