乙型肝炎病毒基因分型及临床应用

HBV Genotyping and Its Clinical Meaning

目的:了解常州金坛地区乙型肝炎病毒基因分布特征,探讨基因型与肝功能损害、病毒复制水平的关系。方法:采用巢式聚合酶链反应(nest PCR),扩增乙型肝炎病毒S基因区,用末端标记方法对PCR产物标记并直接测序,测序结果和GenBank中登录的标准基因型序列相比较。结果:对该地区122例不同HBV感染者血清HBV DNA进行了基因分型,B型40例(占32.9%),C型82例(占67.1%),未发现B、C以外其他基因型;谷丙转氨酶(ALT)水平分别为(366.8±322.5)U/L和(354.3±315.2)U/L(t=0.339,P>0.05);HBV DNA含量(对数值)分别为(7.69±1.15)和(7.58±1.16)拷贝/m l(t=0.141,P>0.05);HBeAg阳性数分别为28/40和50/82(2χ=0.162,P>0.05);96例慢性乙型肝炎中B型为34例、C型为62例,18例肝硬化和肝癌患者检出B型3例、C型15例,二组比较2χ=7.72,P<0.01。结论:本地区HBV DNA基因型为B型和C型;二种基因型ALT水平、病毒复制水平和HBeAg表达水平均无显著性差异;C基因型与肝硬化和肝癌关系密切。

Objective To investigate the local HBV genotype distribution pattern in Jiangsu Jintan and its clinical meaning. Methods Altogether, 122 HBV infected blood specimens were examined （acute hepatitis 8, chronic hepatitis 96, cirrhosis and cancer 18）. The HBV -DNA copies were extracted with SiO2 adsorption and amplified with nest PCR. The PCR product was purified, labelled with Big Dye, and sequence analysis was performed to determine the genotype. Results Genotyping study revealed that 40 of the 122 were of B type （32.9%） and 82 were of C type （67.1%）. The ALT levels, HBV - DNA contents and HBeAg positiveness in the two groups were not much different （P 〉0. 05 ）. However, a higher percentage of cirrhosis and carcinoma cases was associated with type C infection （ 15/18 = 83.4% vs 62/96 = 64.6% for chronic hepatitis, P 〈 0.01 ）. Conclusion Clinically, patients infected with B type and C type HBV did not differ very much, yet most of the advanced cases with cirrhosis or carcinoma were of C type.