昆明地区HBV DNA基因型的分布特征

The characteristics of Hepatitis B virus genotypes in Kunming

目的 研究云南省昆明地区乙型肝炎病毒（HBV）的基因分型特征.方法 采用荧光定量PCR及基因型特异性引物PCR方法 ,对云南省昆明地区360例HBV感染血清进行HBV DNA定量及基因分型检测,以ELISA法检测血清乙肝标志物.结果 360例 HBV感染血清中有346例（96.11%）可以直接分型,其中196例（56.65%）为C型,91例（26.30%）为B型,37例（10.69%）为C/B混合型,21例（6.07%）为D型,A型仅1例（0.29%）;比较显示,C型基因分布率显著高于其他基因型（P〈0.01）;C基因及C、B混合基因型患者HBV-DNA定量显著高于B基因及其他基因型患者（P〈0.01或P〈0.05）;另除B型基因在＂大三阳＂模式中比例显著较低（P〈0.05）,HBV基因型在其他各血清模式组间的分布差异无统计学意义（P〉0.05）;14例标本未能直接分型（3.89%）,其HBV-DNA定量平均水平为4.136×103IU/mL显著低于其他检样（P〈0.05）.结论 昆明地区HBV基因型的分布较为丰富,存在C型、B型、C/B混合型及D型和A型,其中以C型和B型为本区域的主要HBV基因型;当C/B混合型和C型的HBV感染时,往往伴随HBV较高水平复制,且HBV感染B基因型与HBeAg的检出呈负相关;本区域内D基因型分布率介于内地低海拔区域和拉萨高原地带之间.这些可能是本区域内HBV基因型分布的流行病学特征.未能直接分型检样的HBV-DNA定量均较低,可能说明HBV基因分型应该在一定的HBV-DNA定量水平基础上进行.

Objective To investigate the distribution and the characteristics of HBV genotype in Kunming City,China.Methods The HBV genotypes and HBV-DNA levels of 360 patients in Kunming were detected by real-time quantitative PCR using type-specific primers,the serum-types were also detected in ELISA at the same time.Results Of the 360 specimens,346（96.11%） could be detected directly,among them 196 were genotype C（56.65%）,91 were genotype B（26.30%）,91 were genotype B（26.30%）,37 were in B-C mix-type （10.69%）,21 were genotype D（6.07%）,1 were genotype A（0.29%）.Among them,the genotype C was higer than the others （P〈0.01）;HBV-DNA levels of the patients with genotype C and B-C mix-type were higer than the genotype B and the others（P〈0.01,P〈0.05） （beside the positive proportions of genotype B was lower in the serum with＂HB-sAg（ ＋ ）,HBeAg（ ＋ ）,anti-HBc（ ＋ ）＂（P〈0.01）,the other genotypes were no relation with their serum-types （P〉0.05）;the 360 specimens,14（3.89%）could not be detected directly,the average level of them was 4.136X 103IU/ml,it was lower than that of others（P〈0.05）.Conclusion The HBV-genotypes in Kunming area are abundant,including genotype C,B,D,A and B/C mix-type.The dominant genotype of HBV are C and B,and the HBV-DNA level of genotypes B/C mix-type and C were singnificantly higher than that of others ;The negative relation existed between the genotype B＇s frequency and the positive proportions of HBeAg;The genotype D frequency of this region is higher than that of lower-altitude inland areas and lower than that of plateau areas around Lahsa,which probably stands for its epidemiologic feature.Meanwhile,those samples without direct identification contain relatively lower level of HBV-DNA,which probably suggests that HBV genotype should be conducted on a basis of a certain HBV-DNA quantity.