山东地区慢性HCV感染者病毒的基因型分布

Distribution of virus genotypes of patients with chronic hepatitis C infection in Shandong Province,China

目的明确山东地区慢性丙型肝炎及丙肝肝硬化患者感染丙型肝炎病毒(HCV)的基因型分布,探讨HCV基因型与肝脏疾病严重程度及感染途径之间的关系。方法根据HCV 5′非编码区(NCR)设计基因芯片,对山东地区慢性HCV感染者(慢性丙型肝炎128例,丙肝肝硬化42例)应用基因芯片法检测HCV基因型,并对其中22份标本进行测序,比较慢性丙型肝炎、肝硬化病人HCV基因型分布以及不同途径感染的病HCV人基因型分布的差别。结果 168例患者标本可以分型,HCV基因型分别为:1b型106例,2a型48例,1a及3b型均为2例,1b+2a混合型9例,1a+1b混合型1例;对22例患者标本测序,1b型12例,2a型9例,3b型1例,与基因芯片法检测结果完全一致;肝硬化和慢性肝炎病人的HCV基因型分布差异无统计学意义(χ2=1.82,P>0.05),有输血史者和无输血史者HCV基因型分布差异无统计学意义(χ2=7.63,P>0.05)。结论山东地区HCV主要流行株是基因1b型,其次为2a型,同时有少量的1a、3b型以及混合感染,HCV基因型与疾病的进展及感染途径无关。

Objective To investigate the hepatitis C virus（HCV） genotypes of patients with chronic hepatitis C and cirrhosis in Shandong Province and study the relationship between the genotypes of HCV and the severity of liver disease and route of HCV infection.Methods Gene chips were designed based on the 5＇ non-cording region（NCR） of HCV.Serum samples from patients with chronic HCV infection（128 with chronic hepatitis and 42 with liver cirrhosis） were tested for HCV genotypes using a gene chip assay.Twenty-two of the samples were sequenced to determine the HCV genotype.The distribution of HCV genotypes among patients with chronic hepatitis or cirrhosis was compared and the distribution of HCV genotypes in patients was investigated by the route of infection.Results One hundred and sixty-eight samples were genotyped.One hundred and six patients had the 1b HCV genotype,48 had the 2a genotype,2 had the 1a genotype,2 had the 3b genotype,9 had the 1b＋2a genotype,and 1 had the 1b＋2a genotype.Of 22 samples that were sequencing,12 were the 1b genotype,9 were the 2a genotype,and 1 was the 3b genotype.Genotypes indicated by the gene chip method were consistent with those indicated by gene sequencing.There was no significant difference in the distribution of genotypes in patients with chronic hepatitis or cirrhosis（χ2=1.82,P0.05）.There was no difference in genotypes among patients infected by blood transfusion and patients infected by another route（χ2=7.63,P0.05）.Conclusion The predominant genotypes of patients with chronic HCV infection in Shandong Province were 1b and 2a,while 1a,3b,and mixed genotypes were observed less often.There was no relationship between the genotype of HCV and the severity of liver disease and route of HCV infection.