100例乙型肝炎病毒基因分型的探讨

Studies on distribution of hepatitis B virus genotypes in 100 patients

目的:为了解宁波及毗邻地区乙型肝炎患者HBV基因型分布、优势型与临床的相关性。方法:选择宁波及毗邻地区HBV DNA阳性的HBV感染者100例,应用基因芯片对其进行基因分型,其中7例优势基因型进行S基因序列同源性测序复核。结果:100例HBV阳性的血清标本分型率为96.0%,其中B基因型36例(37.5%),C基因型47例(48.9%),BC混合基因型11例(11.5%)及BCD混合基因型2例(2.1%),未分出型的4例。乙型肝炎感染者检出的基因型以B、C型为主;重型肝炎与肝癌组中C型检出率分别为60%和55%,明显高于其他基因型(P<0.05),B、C基因型与HBV DNA拷贝数、丙氨酸氨基转移酶水平及总胆红素在统计学上无显著差异(P>0.05)。结论:基因芯片分型方法可应用于HBV基因的分型。宁波及毗邻地区的HBV基因型以B、C为优势基因型,重型肝炎和肝癌患者检出的基因型多为C型,提示C基因型患者预后较差。

Objective：To investigate the distribution of hepatitis B virus genotypes,dominant genotype and its relatetion to clinical cases in Ningbo City.Methods：One hundred HBV DNA-positive samples were genotyped by gene chip technique.S gene fragments of 7 dominant genotypes were re-checked for sequencing and homology analysis.Results：Ninety-six（96.0%） samples were successfully genotyped among 100 serum samples and 4 samples were unknown genotypes.The proportion of B genotype,C genotype,BC mixed-genotype and BCD mixed-genotype were 36（36.0%）,47（47.0%）,11（11.0%） and 2（2.0%）,respectively.The genotyping results by gene chip technique were consistent with genotypes by S gene fragments sequencing and homology analysis.C and B genotypes were dominant genotypes in HBV positive patients.C genotype was detected with the proportion of 60% and 55% in severe hepatitis and liver cancer patients respectively（P〈0.05）.There was no statistical significance in C and B genotype,HBV DNA copies,level of alanine aminotransferase and total bilirubin（P〉0.05）.Conclusion：Regional difference was found in HBV genotypes.C and B genotypes are dominant in Eastern part of Zhejiang Province,which is different from previous reports.Correlation exists between clinical hepatitis and genotypes,i.e.,C genotype exists in most of severe hepatitis and liver cancer patients,which suggests that patients of C genotype have worse prognosis.Gene chip technique can be used for rapid HBV genotyping.