乙型肝炎病毒不同基因型感染者临床比较

Clinical Characteristies and Distribution of Hepatitis B Virus Genotype

目的调查杭州地区乙型肝炎病毒(HBV)的基因型分布,并分析基因型与临床表型之间的相关性。方法用基因芯片测定HBV感染者的基因型,统计分析基因型与临床表型的相关性。结果基因分型为B型37例,C型69例;C型HBV DNA水平和HBeAg阳性率分别为(7.02±1.26)log值和60.87%,明显高于B型的(5.62±1.02)log值和32.43%;C型HBeAb阳性率为39.13%,明显低于B型的67.57%;C型发展为慢性乙型肝炎、肝硬化和原发性肝癌分别为46.38%、30.44%、11.59%,明显高于B型的40.54%、13.51%、8.11%;B基因型感染者的年龄明显小于C型感染者,且在35岁以下、35～50岁、50岁以上年龄段中所占比例逐渐下降,C型感染者的比例呈相反趋势。结论杭州地区HBV基因型以C型为主,B型次之。C型HBVDNA水平、HBeAg阳性率显著高于B型,且HBeAb阳性率低于B型,C型HBV感染所致的肝病更严重。

Objective To investigate the distribution and virologic characteristics of HBV genotypes,and possible association with the severity of liver disease. Methods HBV genotype was determined, using oligonuleotides （oligo） mieroarray method. Results 37patients were differentiated as genotype B,69 genotype C. The clinical manifestations demonstrated that the serum lever of HBVDNA and HBeAg positive rate in patients of genotype C was 7.02 ± 1.26 and 60.87% higher than 5.62 ± 1.02and 32.43% in those of genotype B, the serum HBeAb positive rate in patients of genotype B was 67.57% higher than 39.13% in those of genotype C. The occurrence rates of those developed to chronic hepatitis B liver cirrhosis and hepatoma in those of genotype C were 46.38% ,30.44% and 11.59% bighter than that of 40.54% ,13.51% and 8.11% in those of genotype B. Patients with gcnotype B were much younger than those with genotype C. Conclusions Genotype B and C exsited in Hangzhou ,genotype C is a predominated genotype. The serum leverl of HBVDNA in those of genotype C is highter than that of genotype B. The positive rate of HBeAg in those of genotype B is highter than that of genotype C. The damage to liver induced by genotype C is severe than that of genotype B.