乙肝病毒基因型及病毒变异对慢性肝病进展的影响

Influences of HBV Genotype and Mutations on Progression of Liver Disease

目的进一步研究HBV基因型及病毒变异与慢性肝病进展的关系。方法用聚合酶链式反应-限制性片段长度多态性(PCR-RFLP)以及部分PCR产物测序的方法对401例慢性HBV感染者,包括112例HCC患者(HCC组),129例无症状携带者(ASC组),70例肝硬化患者(LC组)和90例慢性肝炎患者(CH组)进行HBV基因分型以及BCP和PC变异检测。结果401例慢性HBV感染者中181例发生B基因型感染,220例发生C型感染。HCC组中C型分布高于其他3个疾病组;C基因型感染者BCP变异多于B基因型;B基因型感染者PC变异多于C基因型;同时BCP变异发生率随着病程进展而递增:在ASC组、CH组、LC组和HCC组里的BCP变异阳性率分别为22.4%、35.0%、50.0%、74.1%。C1与C2亚型相比,C1有较高BCP变异阳性率,而C2有较高PC变异发生率。结论BCP变异与肝病进程存在依从关系,因此BCP变异的检测对慢性HBV感染的疾病进展和临床结局的评估有重要意义。

Objective To investigate the influences of HBV genotype and viral mutations on the progression of liver disease. Method A cohort of 401 patients with chronic HBV infection, including 112 with hepatocellular carcinoma （HCC）, 129 with asymptomatic HBV carriers （ASC）, 70 with liver cirrhosis （LC） and the remaining 90 with chronic hepatitis B （CH）, collected from Guangdong Province of China, was analyzed by polymerase chain reaction-restriction fragment length polymorphism （PCR-RFLP） or nucleotide sequencing. Result Among the 401 patients, 181 were infected with HBV/B and 220 with HBV/C. Among the ASC, LC and CH patients, genotype C had a higher prevalence in HCC patients. HBV/C showed a higher frequency of BCP mutation than HBV/B, while HBV/B had a higher PC mutation rate than HBV/C. There was a correlation between the increase in BCP mutation rate and the progression of liver disease. In ASC, CH, LC and HCC patients, the BCP mutation rate was 22.4%, 35.0%, 50.0% and 71.4%, respectively. Conclusion There was a positive relationship between BCP mutation and the progression of chronic HBV infection.