上海市金山地区乙型肝炎病毒基因型分布及其与临床的关系

Distribution of hepatitis B virus genotype in Jinshan district of Shanghai and its clinical relation

目的了解上海金山地区乙型肝炎病毒(HBV)感染者基因型分布及其与临床的关系。方法401例HBV DNA阳性患者采用聚合酶链反应(PCR)-酶联免疫吸附试验(ELISA)进行HBV DNA定量、微流基因芯片法进行基因分型、ELISA检测e抗原(HBeAg)及肝功能检查后进行综合分析。结果B型198例(49.38%),C型169例(42.14%),B/C混合型20例(4.99%),未分型14例(3.49%),未发现其他基因型。B型在慢性乙型重度肝炎(CSHB)患者中的比例显著低于无症状携带者(ASC)和慢性乙型轻、中度肝炎(CMHB)(P<0.01),而C型在CSHB患者中的比例显著高于ASC和CMHB(P<0.01)。ASC中B型患者的HBV DNA水平最低。C型患者的丙氨酸氨基转移酶(ALT)和γ-谷氨酰基转移酶(GGT)水平均高于B型。结论上海金山地区HBV感染者基因型以B型为主,C型次之,少量B/C混合型,C型与重肝病关系比B型密切。

Objective To investigate the distribution of hepatitis B virus （HBV） genotype in Jinshan district of Shanghai and its clinical significance. Methods The genotype of HBV and serum level of HBV DNA in 401 patients with positive HBV DNA were determined. Polymerase chain reaction enzyme-linked immunosorbent assay（PCR-ELISA） was used for detection of serum level of HBV DNA. Gene array was used for detection of the distribution of HBV geno- types. ELISA was used for detection of hepatitis B e antigen （HBeAg） and liver function was also examined. Results The genotype B was 198 （49.38%） ,C was 169（42.14 % ） , B/C was 20（4.99% ） ,the unknow genotype was 14 （ 3.49% ）, and others genotypes were not found. The percentage of genotype B in patients with chronic severe hepatitis B（ CSHB ） was lower than that in patients with asymptomatic carrier （ASC） and chronic mild-moderate hepatitis B （CMHB） （P 〈 0.01 ）. However, the percentage of genotype C in patients with CSHB was higher than that in patients with ASC and CMHB（P 〈0.01 ）. The levels of HBV DNA of genotype B in patients with ASC was the lowest. The levels of alanine transferase （ALT） and γ-glutamyltransferase （GGT） in patients with genotype C were higher than the levels of those with genotype B. Conclusions HBV genotype B is the predominant genotype. Genotype C is the second and genotype B/C is rare in Jinshan of Shanghai area. The liver damage induced by genotype C is severe than that by genotype B.