乙型肝炎病毒基因型和亚型与病毒感染相关性研究

Clinical and Virological Manifestation of Hepatitis B Virus (HBV) Genotypes and Subtypes

目的探讨乙型肝炎病毒(HBV)基因型和亚型与慢性乙型肝炎(CHB)发病的关系。方法对454例CHB患者,定量PCR方法检测HBV DNA为阳性,再以型特异性引物PCR法检测HBV基因型及其亚型。结果 (1)454例HBV DNA阳性的CHB患者其中HBV B基因型68例(14.9%);其中Ba亚型35例,Bj亚型3例,未分B亚型30例,C基因型338例(74.5%),C基因型中C1亚型3例,C2亚型285例,未分型50例。B+C混合基因型48例(10.6%),均为Ba+C2基因型;(2)B与C基因型比较,B基因型中HBeAg阴性的患者多于HBeAg阳性的患者(2χ=17.69,P<0.001)。CHB患者中C基因型的HBeAg阳性率明显高于B基因型(χ2=17.025,P=0.000)。(3)定量PCR检测B基因型HBV水平低于其他基因型;C基因型HBV复制高于其他基因型。结论我国CHB患者中HBV基因型以C基因型为主;HBV基因亚型中Ba与C2亚型是主要的亚型,不同的HBV亚型间病毒载量差异有统计学意义;HBeAg阳性或HBeAg阴性的CHB患者中HBV基因型分布不同;HBV基因型和亚型的临床意义值得动态观察。

Objective To detect the genotypes and subtypes of hepatitis B virus（HBV） in patients with chronic hepatitis B（CHB）.Methods Using the type and subtype-specific primers to detect 454 patients with CHB in Beijing.Results（1）The genotype B、 C and mixed infection of B/C were 68（14.98%）,338（74.45%） and 48（10.57%） separately;The subtypes Ba,Bj were 35（51.47%） and 3（4.41%） cases,with 30（44.12%） neither Ba or Bj in B genotypes.In genotype C,only 3 cases（0.89%） were subtype C1,285 cases（84.32%） were subtype C2,with the remaining 50（14.79%） were neither C1 nor C2;All the 48 mixed B/C genotype were subtype Ba＋C2;（2）There were significantly different between the genotype B and C among patients with positive and negative HBeAg.（3）the level of HBV DNA in genotype B were lower than other genotype;the level of HBV DNA in genotype C were higher than B genotype.Conclusion Our results suggest：（1）The genotype C is the majoy type in patients with CHB in Beijing;（2）The Ba and C2 are most important subtypes in the patients.The level of HBV DNA are significantly among different subtypes;（3）the frequencies of genotype distributions are different between HBeAg positive and negative groups.