广东深圳市乙型肝炎病毒基因型的检测及意义

Study of HBV genotype of Shenzhen and related clinical significance

目的了解深圳市乙型肝炎病毒(HBV)基因分型情况,探讨HBV基因分型与抗病毒治疗疗效及预后的关系。方法用单克隆抗体ELISA法(mAbsELISA)对143例乙型肝炎病毒感染的患者进行HBV基因分型。结果143例患者中,B型67.8%,C型26.6%。B型多见于无症状乙型肝炎病毒携带者(ASC)(95.4%);C型多见于肝硬化患者(LC)(64.7%)。年龄≤35岁及有乙型肝炎家族史的患者中B型均较C型多见(P<0.05)。拉米夫定治疗的LC中,HBVDNA持续阴性者B型较C型多见(P<0.05)。干扰素治疗的慢性乙型肝炎患者中,完全应答者B型较C型多见(P<0.05)。25例重型乙型肝炎患者中,B型存活(94.1%)较C型存活(57.1%)高(P<0.05)。结论深圳地区HBV基因分型以B型为主,C型次之。B型多见于年轻患者,C型多见于年老患者,且C型肝硬化患者对拉米夫定疗效差。

Objective To study the condition of hepatitis B virus（HBV） genotype in Shenzhen and to analyze the relationship of HBV genotype,anti-virus therapeutic effect and prognosis. Methods The HBV genotyping of 143 patients with HBV were carried out with mAbs ELISA. Results Among 143 cases, 97 （67.8 % ） were type B,38（26.6 % ） were type C. Type B accounted for 95.4 % in ASC group, but type C accounted for 64.7 % in LC group（ P 〈 0.05）. Among the patients younger than 35 and among the patients with family history of HBV,type I3 was more popular than type C（P 〈 0.05）. Twelve of 17 cases in group LC underwent lamivudine treatment, and 4 cases of type B but no case of type C were tested to be continuous HBV DNA negative（ P 〈 0.05）. Among 20 cases of imerferon treatment, 11 cases of type B but no case of type C were found to be full response to interferon. Among 25 cases of severe HBV, 17 were type B and 16 survived, but 7 were type C and 4 survived （P 〈 0.05）. Conclusion HBV genotype I）opularily in Shenzhen is classified as type B the first and type C the second. Type B,whiCh is effeclive to interferon;Type C,which is prone to cirrhosis and less effective to lanfivudine; HBV genotyping no relationship with HBeAg（ ＋ ） or HBV DNA level.