广东地区HBV基因型在家庭聚集感染中的分布及意义

Significance and Distribution of HBV Genotypes in Infected Family Members in Guangdong Province

【目的】分析家庭聚集的慢性HBV(乙型肝炎病毒)感染者的HBV基因型分布特点,探讨HBV基因型与传播途径的相关性。【方法】采用型特异性引物巢式PCR法,检测HBV慢性感染者的HBV基因型;应用病例对照研究方法比较家庭内不同成员组中慢性HBV感染者的HBV基因型分布特点,分析HBV基因型与不同传播途径的可能关系。【结果】179例患者中,B基因型111例(62.0%),C基因型共59(33.0%),重叠基因型9例(5.0%)。100例家庭聚集感染病例分别来自48个家庭,家庭内基因型基本一致。家庭内两代成员组中的父代与子女感染组,C基因型所占百分比显著高于家庭内水平成员组(59.1%vs.23.1%,P<0.05),及对照组(59.1%vs.26.6%,P<0.05)。家庭内水平成员组及对照组中B基因型比例显著高于家庭内两代成员组(74.4%vs.45.9%,P<0.05;68.4%vs.45.9%,P<0.05)。【结论】家庭内HBV聚集感染的基因型别基本相同。HBV基因型可能与传播途径有关,C基因型更易发生垂直传播,B基因型可能与HBV水平途径的传播有关。

[ Objective ] To study the distribution feature of HBV genotypes in clustering family patients infected with chronic hepatitis B （CHB）, and identify the relativity between HBV genotypes and transmission routes of HBV. [Methods] HBV genotypes were detected in patients with CHB by the type-specific primers PCR, The distribution features of HBV genotypes in families of patients were compared, and the probable relationship of HBV genotypes and different transmission routes of HBV was analyzed by case control study. [Results] Of the 179 patients, 100 came from 48 families. In all samples, the most frequent genotypes were B （111/179, 62%） and C （59/179, 33%）, respectively, followed by mixed genotypes （9/179, 5%）. The HBV genotypes in the family were coincident. In group of parents and their children, the percentage of genotype C were significant higher than that in group of other infected family members and in control group [61/29 （47.5%） vs. 9/39 （23.1%） （P〈 0.05） and 61/29 （47.5%） vs 21/79 （26.6%） （P〈0.05）, respectively]. The percentage of genotype B in control group and group of other infected family members are significant higher than that in group of parents and their children [54/79 （68.4%） vs. 28/61 （45.9%） （P 〈 0.05） and 29/39 （74.4%） vs. 28/61 （45.9%） （P 〈 0.05）, respectively]. [Conclusions] HBV genotypes from the same family were the same. It seems that HBV genotypes were associated with transmission route of virus. HBV genotype C may be easier to spread from parents to their children. HBV genotype B may be related to family horizontal transmission of Hepatitis B virus.