武汉地区散发性戊型肝炎流行病学及病毒基因型

Epidemiology and the genotypes of HEV isolated from patients with hepatitis E in Wuhan

为了解武汉地区戊型肝炎病毒（HEV）流行病学特点及基因型。回顾性分析2000年至2004年同济医院就诊急性肝炎916例流行病学特点，应用逆转录-套式聚合酶链反应法（RT-nested—PCR），扩增HEV开放读码框架2（ORF2）的部分序列120份，用Clustal X和Treeview软件比较武汉地区HEV序列与4个HEV主要代表株序列。发现所扩增的HEV，核苷酸同源性为（82．61～98．55）％，与Ⅰ型（缅甸株）、Ⅱ型（墨西哥株）、Ⅲ型（美国株）、Ⅳ型（中国／台湾株）核苷酸同源性分别为（76.52～81．74）％、（70．43～73．04）％、（76．52～81．16）％和（84．35—88．70）％。故认为武汉地区散发性戊型肝炎患者以HEVⅣ型感染为主，其发病率呈上升趋势，发病年龄以30-59岁为主，全年均可发病，3，6月为高峰季节。

To investigate the epidemiology and the genotypes of hepatitis E virus existed in Wuhan. 363 serum samples were collected from patients with hepatitis E in Tongji Hospital of Wuban. The partial genome of open reading frame 2 of 120 HEV was amplified using polymerase chain reaction, 25 of which were sequenced. Clustlx and Treeview softwares were used for nucleotide sequences phylogenetic analysis of HEV among genotype Ⅰ , Ⅱ , Ⅲ, Ⅳ and HEV of Wuban. And enrolled the 916 cases clinically diagnosed as acute hepatitis E during the period of January 2000 to August 2004. The results showed 25 isolates shared the same genotype with nucleotides of 82.61 - 98.55%. They had 76.52 - 81.74% ,70.43 - 73.04% ,76.52 - 81.16% ,and 84.35 - 88.70% homology at the nucleotide level with HEV genotypes 1 - 4, respectively. Phylogenetic analysis suggested that these 25 isolates maybe represent 3 different subtypes at least. HEV sequences isolated from patients of Wuban belong to HEV genotype 4 with different subtypes. The infection rate of HEV is increasing now. Male patients are 3.3 times high than women patients in clinic investigation, Age from 30 to 59 and time from March to June are susceptible factors for patients to take hepatitis E.