家族性乙型肝炎病毒基因型分布与临床转归关系的研究

Familial Hepatits B Virus Genotypes and Clinical Prognosis

目的调查家族性乙型肝炎病毒(HBV)基因型的分布,分析基因型与临床转归的相关性。方法以136例家族性乙型肝炎患者为研究对象,用S基因巢式聚合酶链反应-限制片段长度多态性(ntPCR-RFLP)基因型分型方法测定HBV基因型。结果家族性乙型肝炎患者HBV基因分型为C型124例、B+C混合型7例、B型3例、未确定型2例;C型在原发性肝癌(HCC)中占有绝对优势(100.0%),其次为肝硬化(LC,96.0%),慢性乙型肝炎(CHB,95.3%),慢性乙型肝炎携带者(ASC,66.7%),与C型相比基因型B型、B+C混合型仅在ASC和CHB中存在,其所占比例分别为9.5%、23.8%和1.2%、2.3%。山西地区家族性乙型肝炎患者中未发现A～H中其他基因型的存在。结论山西地区家族性HBV基因型主要以C型为主,有少量B型和B+C混合型;C型感染所致的肝病预后差。

OBJECTIVE To investigate the distribution of familial hepatitis B virus （HBV） genotypes and analyze the relationship between genotypes and clinical outcome. METHODS A total of 136 cases of familial hepatitis B were involved in this study, including 25 cases of asymptomatiee HBV carriers （ASC）, 85 cases of chronic hepatits 13 （CHB）, 24 cases of liver cirrhosis （LC） and 4 cases of hepatocellular carcinoma （HCC）. Nested polymerase chain reaction-restriction fragment length polymorphism （ntPCR-RFLP）was used to identify the genotypes of HBV. RESULTS There were 124 cases with hepatitis genotype C, 7 cases with genotypes B＋ C mixed,3 cases with genotype B and 2 cases that did not conformed to be any of genotypes from A to H. Genotype C in the HCC was predominant genotype （100%）, next in the LC（96%）, CHB （95. 3%） and ASC（66. 7%）. Compared with genotype C, genotypes B and B--C only existed in ASC and CHB, the proportion was 9.5% vs 23.8% and 1. 2% vs 2. 3%, respectively. There were no other HBV genotypes from A to H seen in familial hepatitis B in Shanxi province. CONCLUSIONS ttBV genotype C is the major one in familial hepatitis B in Shanxi. There are a few genotypes B and B＋C existed. Genotype C induces a relatively bad prognosis.