长春地区丙型肝炎病毒的基因分型及其与肝脏疾病的相关性

Genotyping of Hepatitis C Virus in Changchun Region,China and Relationship between HCV Genotype and Severity of Liver Diseases

目的分析长春地区丙型肝炎病毒(HCV)基因型的分布及其与HCV RNA含量、感染途径、肝病程度的相关性。方法采用荧光定量PCR和型特异性引物PCR对82份抗-HCV阳性病人的血清标本进行HCV RNA检测及HCV的基因分型,并分析基因型与感染途径、HCV RNA含量和肝病程度的相关性。结果78份HCV RNA阳性血清标本中1a型占5.1%、1b型占48.7%、2a型占33.3%、2b型占11.6%、3a型占1.3%,未发现混合型。血源性与非血源性感染患者间HCV基因型构成比差异无统计学意义。基因1b型的HCV RNA含量高于2a型,且差异有统计学意义。HCV感染的不同程度肝病患者的基因型分布差异有统计学意义,基因1b型比率显著高于其他基因型。结论长春地区丙型肝炎病毒基因型流行株为1b和2a型;HCV基因型与感染途径无明显相关性;基因lb型的病毒含量明显高于2a型;HCV基因型与慢性丙型肝炎的严重程度及肝硬化、肝癌的产生有一定的相关性。

Objective To analyze the distribution of hepatitis C virus （HCV） genotype in Changchun Region, China and its relationship to HCV RNA content as well as infectious route and degree of liver disease. Methods The serum specimens from 82 anti-HCV patients were determined for HCV RNA by fluorescent quantitative PCR, and analyzed for HCV genotype by PCR using type-specific primers, based on which the relationship of genotype to infectious route, HCV RNA content and degree of liver disease was analyzed. Results Of the 78 HCV RNA-positive serum specimens, 4（5. 1%） were identified as genotype 1a, 38（48.7%） as 1 b, 26 （33. 3%） as 2a, 9（11.6%） as 2b, and 1 （1.3%） as 3a. No mixed infection of HCV of various genotypes was observed. No significant difference was observed in the distributions of HCV genotypes in the patients with blood-transmitted and non-blood-transmitted hepatitis C. The RNA content of HCV of genotype lb was significantly higher than that of genotype 2a. However, the distribution of genotypes showed significant difference in the patients with liver diseases at various degrees caused by HCV infection. The proportions of genotype lb in patients with chronic hepatitis C, liver cirthosis and liver cancer were significantly higher than those of other genotypes. Conclusion The epidemie HCV strains in Changehun Region were of genotypes lb and 2a. No significant relationship was observed between HCV genotype and infectious route. The HCV content of genotype lb was significantly higher than that of genotype 2a. HCV genotype showed a certain relationship to the severity of chronic hepatitis C and the onsets of liver cirthosis and liver cancer.