山东省人群乙型肝炎病毒＂a＂抗原决定簇突变分析

The analysis of ＂a＂ dominant mutation of hepatitis B virus in community-based population of Shandong province,China

目的 了解目前山东省社区人群乙型肝炎病毒（HBV）＂a＂抗原决定簇突变率和突变形式,探讨乙肝疫苗（HepB）接种对＂a＂抗原决定簇突变的影响.方法 在全省1～59岁社区人群中通过多阶段随机抽样确定调查对象,通过询问（15岁以上）或查阅接种记录（14岁以下）了解调查对象HepB免疫史;采集血标本,酶联免疫吸附方法 检测血清乙肝表面抗原（HBsAg）,阳性者提取血清DNA,采用巢式PCR方法 扩增HBV S基因,测序后与标准序列进行比较.结果 共对7601人进行调查和血标本采集,得到HBsAg阳性标本239份（3.14%）,可用于HBV DNA提取206份,扩增HBV S基因并成功测序102份.15份血清标本检测到13种HBV＂a＂抗原决定簇突变,突变率为14.70%（15/102）.新生儿普种HepB前、后出生调查对象间,以及有、无HepB免疫史调查对象间＂a＂抗原决定簇突变率差异均无统计学意义.结论 目前山东社区人群中＂a＂抗原决定簇突变率较低且突变位点比较分散;未发现HepB接种对人群＂a＂抗原决定簇突变产生影响.

Objective To determine the rate and type of ＂a＂ dominant mutation of hepatitis B virus （HBV） in community-based population of Shandong province and the possible effect of hepatitis B vaccination upon ＂a＂ dominant mutation. Methods The anticipants aged 1-59 years were selected by multi-stage random sampling from the general population of Shandong province. Hepatitis B vaccination status was obtained by inquisition （for those over 15 years old） or immunization record （for those under 14 years old）. The blood samples were collected and detected for HBsAg by ELISA. HBV DNA was extracted from the sera with positive HBsAg and S gene was amplified by nested-PCR. The PCR produce was sequenced and compared with the standard sequence. Results Overall, 7601 anticipants were investigated.HBV DNA was successfully amplified and sequenced in 102 of 239 samples with positive HBsAg. 14. 70% sera samples mutated in HBV ＂a＂ determinant region and 13 mutation types were detected. There were no statistically differences in the mutation rate by age groups （ born before or after national universal infant hepatitis B vaccination） and hepatitis B vaccination status. Conclusion The ＂a＂ determinant mutation seemed to be uncommon in community-based population of Shandong province and the mutation sites were relatively scattered. Hepatitis B vaccination has no effect on ＂a＂ dominant mutation of hepatitis B virus.