皖江地区自然人群HBV M及HBV基因型的检测分析

Detecting Analysis on HBV Serological Biomarkers and HBV Genotypes Among General Population in Areas Along Yangzi River in Anhui Province

目的了解皖江地区自然人群乙型肝炎病毒(HBV)感染及其基因型分布状况,探讨安徽省乙肝流行规律,为乙肝的治疗及预防控制提供理论依据。方法采用分层整群抽样方法对皖江地区自然人群进行问卷调查并采集血标本,用ELISA方法检测乙肝病毒感染标志,对表面抗原阳性的血清用型特异性引物巢式PCR法进行HBVDNAA-F基因型检测及分析。结果在2282例血清标本中,乙肝五项HBsAg、HBsAb、HBeAg、HBeAb及HBcAb流行率分别为:9.8%、43.5%、1.0%、7.8%、10.3%。224份HBsAg阳性的血标本中HBV基因型检出率分别为:B型54.9%、C型32.6%、BC混合型7.1%,另外有12例未分出型别(5.4%)。HBsAg流行率男性高于女性(χ2=3.992,P<0.05);224份HBsAg阳性标本共呈现5种模式:①HBsAg、HBeAg、HBcAb阳性;②HBsAg、HBeAb、HBcAb阳性;③HBsAg、HBcAb阳性;④HBsAg、HBeAg阳性;⑤仅HBsAg阳性;HBeAg阳性标本基因型检出率为100%,C型在HBeAg阳性者中检出率(59.1%)高于HBeAg阴性者(29.7%),但HBeAg阴性者B型检出率(56.9%)高于HBeAg阳性者(36.4%)。结论皖江地区乙型肝炎的流行水平与2002年全国流调结果基本一致;HBV基因型以B,C型为主,优势基因型为B型;HBV基因型与血清标志物有关系;此外,多引物对巢式PCR法适用于大样本筛检及临床流行病学应用。

Objective To understand the epidemiological statue of HBV infection, to detect HBV serological biomarkers and genotypes among general population in the areas along the Yangzi River in Anhui Province, and to provide the evidence for treatment, control, and prevention of HBV. Methods A cross - sectional seroepidemiological survey was conducted by stratified cluster sampling. Hepatitis B virus serological biomarkers were tested using enzyme - linked immunosorbent assay （ELISA） reagents. Genotypes of HBV were detected by nested polymerase chain reaction （PCR） with multiplex pairs of genotype- specific primers. Results The prevalence rates of HBsAg, HBsAb, HBeAg, HBeAb and HBcAb were 9.8%, 43.5 %, 1.0 %, 7.8 %, and 10.3 % respectively. Of the 224 cases, 54.9 % were found with genotype B, 32.6 % were found with genotype C, 7.1% were found with mixed genotype BC, and 5.4 % were uncertain genotype （12/224）. The prevalence rate of HBsAg among male was higher than that of female （χ^2 = 3. 992, P〈 0.0.5）. The positive rate of genotype C in the HBsAg positive specimens was higher than in the HBsAg negative specimens. Conclusions The results reveal that in the areas along the Yangzi River inAnhui Province the general prevalence levels and epidemic characteristics of hepatitis B are the same as before. Genotype B and genotype C are the major HBV genotypes. The predominant genotype is genotype B. There is a relationship between HBV genotypes and serological biomarkers. The nested PCR with multiplex pairs of genotype - specific primers method can be used in large- scale surveys and clinical research.