广州地区丙型肝炎患者病毒基因分型及其与临床病情的关系

The Genotypes of Hepatitis C virus in Patients with Hepatitis C in Guangzhou and the Relationships Between Genotypes and Clinical Features

目的：探讨广州地区丙型肝炎病毒（ＨＣＶ）基因型分布的特点以及ＨＣＶ基因型与临床病情的关系。方法：病例选自广州居民，基因分型使用Ｏｋａｍｏｔｏ的“型特异性引物ＰＣＲ法”，并加以改进，基因型的命名采用国际上统一的Ｓｉｍｍｏｎｄｓ两级命名体系。结果：广州ＨＣＶ基因型分布１ａ占７６％、１ｂ占４９５％、２ａ占２３８％、２ｂ占１９％、３ａ占２９％、１ｂ＋２ａ混合型占９５％、未定型占５％，同国内其它地区一些学者所报道的结果相似。结论：ＨＣＶ基因型分布不存在先前认为的地理上的南北差异。不同基因型传播途径没有差异，均以血液传播为主（８２９％）。１型及混合型感染病情较重。

Objective: The distribution of HCV genotypes in Guangzhou and the relationships between HCV genotypes and clinical features were studied. Cases were selected from the patients hospitalized in our department from 1994 to 1997. All of them are Guangzhou residents. Methods: HCV RNA and genotypes were detected by RT PCR with a pair of primers according to the sequence of 5′ NCR and with genotyping primers according to the sequence of C regionoriginally proposed by Okamotot et al. Results: 8(7.6%) of 105 patients with hepatitis C in Guangzhou were identified as 1a, 52(49.5%) were 1b, 25(23.8%) were 2a, 2(1.9%) were 2b, 3(2.9%) were 3a, 10(9.5%) were 1b+2a and 5(5.0%) were unidentified. The distribution of HCV genotypes is similar to those reported by other authors in China, with 1b as the predominant type, followed by 2a and other genotypes. Conclusions: The distribution of HCV genotypes has no geographical distinction between norhtem China and southern China previously proposed by some researchers. There is no evident relationship between HCV genotypes and different transmission routes. Blood transfusion was found to be the major transmission route (82.9%) for all HCV genotypes. Infection with 1b or 1b+2a tends to lead a more severe liver disease and poorer response to interferon therapy.