慢性乙型肝炎患者196例病毒基因分型与临床的关系

Genotypes of hepatitis B virus in 196 patients with chronic infection and its relationships with clinical features

目的探讨西安市中心医院感染科诊治的慢性乙肝患者血清中HBV基因型的分布状况及HBV基因型与临床特征的关系。方法采用巢式PCR法对196例慢性HBV患者的血清进行病毒基因型检测,并分析HBV基因型与患者临床特征的关系。结果 196例慢性HBV患者的基因分型结果为C型138例(70.4%)、B型40例(20.4%)、B/C混合型18例(9.2%),基因型的分布在性别上无统计学差异;各基因型在无症状携带者、慢性乙肝、肝硬化、肝癌中的分布差异也无统计学意义(P>0.05);C型感染者血清HBeAg阳性率(75.2%)高于B型感染者(14.2%),差异有统计学意义(P<0.05)。各基因型患者在HBV-DNA载量和ALT水平上无统计学差异(P>0.05)。结论西安市中心医院感染科诊治的HBV患者的基因型以C型和B型为主;基因C型患者血清HBeAg阳性率高于B型;基因C型患者与B型相比在肝脏炎症程度、HBV-DNA载量方面无显著差异;基因B型和C型患者临床特点相似。

Objective To investigate the distribution and clinical significance of hepatitis B virus genotypes in patients with chronic infection in Xi＇an Central Hospital.Methods Nested PCR with genotype specific primers was used to determine the genotype in 196 chronic HBV patients.The clinical features of patients with HBV genotype were analyzed.Results Of 196 patients,138（70.4%）were diagnosed with genotype C,40（20.4%）with genotype B,18（9.2%） with mixed genotype B and C.The distribution of genotypes was not different between male and female in 196 patients（P0.05）.There was no significant difference among the patients with chronic hepatitis,liver cirrhosis,hepatocelluar carcinoma and chronic asymptomatic HBV carriers.HBeAg positive rate of genotype C patients was significantly higher than that of genotype B（75.2% vs 14.2%,P0.05）.The level of ALT and HBV-DNA was not significantly different among patients with genotype C,B and mixed B/C（P0.05）.Conclusion The predominant HBV genotypes in Xi＇an Central Hospital,are confirmed to be genotype C and genotype B.HBeAg positive rate of genotype C patients is higher than that of genotype B.Patients with genotype B and genotype C have no difference in the severity of liver disease and HBV-DNA,and have similar clinical features.