乙型肝炎病毒基因型分布及临床意义

Distribution and significance of hepatitis B virus genotypes

目的 了解珠海地区乙型肝炎病毒（HBV）基因型流行病学分布特征,并分析不同基因型与HBV感染谱的相关性.方法 采用聚合酶链反应-限制片段长度多态性（PCR-RFLP）的基因型分型方法对62例HBV携带者及63例慢性乙型肝炎、7例慢性重症乙型肝炎、5例肝硬化患者感染的HBV进行分型,并分析不间感染谱中HBV基因型的分布.结果 137例感染者HBV基因型B型72例（52.6%）,C型65例（47.4%）,慢性肝炎患者、重症肝炎、肝硬化患者的C基因型比例[45例（69.2%）、5例（7.7%）、4例（6.2%）]明显高于B基因型[18例（25.0%）、2例（2.8%）、1例（1.4%）],差异均有统计学意义（均P＜0.05）;HBV携带者B基因型比例[51例（70.8%）]明显高于C基因型[11例（16.9%）],差异有统计学意义（P＜0.05）.C基因型慢性肝炎患者的HBV-DNA、平均ALT水平高于B基因型慢性肝炎患者,但差异均无统计学意义（P＞0.05）.结论 珠海地区HBV感染者以B型和C型为优势基因型,C基因型可能是乙型肝炎病情进展的相关因素.

Objective To understand the distribution of hepatitis B virus （HBV） genotypes in Zhuhai area and to analyze the relationship between HBV genotypes and patients with hepatitis B. Methods A polymerase chain reaction （PCR） and restriction fragment length polymorphism （RFLP） analysis assay amplifying S-segment sequences of HBV-DNA were used for analyzing the distribution of HBV genotypes among 62 HBV carriers （ASC group）,63 patients with chronic hepatitis B （CHB group）,7 patients with severe chronic hepatitis B （CSH group）and 5 cases liver cirrhosis （LC group）. Results The proportion of HBV genotyjpes B and C was 52.6% and 47.4%. There were no significant differences of indexes related to liver function damage （ALT） or serum HBV DNA levels between subtype B and subtype C infected patients. Conclusion The genotypes B and C are two predominant genotypes in Zhuhai area;genotype C may be associated with the development of hepatitis.