上海地区慢性乙型肝炎患者HBV基因型特点分析

Study on HBV genotypes and their clinical significance in chronic hepatitis B patients in Shanghai

目的探讨上海市乙型肝炎病毒(HBV)基因型分布及与HBV感染患者的临床意义。方法选择2005年2月至2006年2月上海华山医院门诊及住院患者中HBVDNA阳性(荧光定量PCR法)的HBV感染者45例,采用S基因序列分析法检测HBV基因型,并分析相应的前-C/C基因序列特点。根据患者的HBV标志物和HBVDNA水平判断不同基因型与疾病的相关性。结果45例HBV感染者中基因型B共15例,C型30例,无A、D、E、F、G、H基因型。15例HBV/B均为Ba亚型,其中2例的前-C/C基因与HBV/C在nt1975～nt2293之间发生重组。HBV/C的HBeAg阳性率显著高于HBV/B(分别为83.3%,33.3%;P<0.05),抗-HBe阳性率则显著低(分别为53.3%,73.3%;P=0.02)。2种基因型的HBVDNA水平无显著差异。结论本次抽样检查结果中HBV基因型为B型和C型,以C型为主,未发现A、D、E、F、G、H型。HBV/C型与B型相比有较高的HBeAg阳性率和较低的抗-HBe阳性率。

Objective To study the status of hepatitis B virus（HBV）genotyping and its clinical significance to patients with chronic hepatitis B（CHB）in Shanghai.Methods Forty-five CHB patients have been enrolled in this study from out-patient and in-patient clinics,Department of Infectious Diseases,Huashan Hospital,Fudan University,from Feb.,2005 to Feb.,2006.HBV DNA was detected by real-time fluorescent quantitation polymerase chain reaction（PCR）.HBV genotyping was conducted by HBV S gene sequencing,and characteristics of pre-C/C regions were analyzed.The relationships between HBV genotypes and HBV markers and HBV DNA levels were also analyzed.Results Fourty-five CHB patients were identified as genotype B for 15,and genotype C for other 30,none was genotype of A,D-H.All 15 patients with genotype B are subgenotype Ba.Among them,2 has recombination with genotype C in pre-C/C region（nt 1975-nt 2293）.Positive rate of HBeAg is significantly higher in genotype C than that in genotype B（83.3% vs 33.3%;P0.05）,and anti-HBe positive rate also has significant difference（53.3% vs 73.3%;P=0.02）.HBV DNA levels remain no difference between the two genotypes.Conclusions In this study only B and C genotypes were found in CHB patients in Shanghai,and genotype C is the majority.None was genotype of A,and D-H.Comparing with genptype B,genotype C patients have significant higher positive rate of HBeAg and lower positive rate of anti-HBe.