乙型肝炎病毒基因分型与HBV-DNA水平及血清标志物关系的探讨

Investigation of relationship between hepatitis B virus genotyping and HBV-DNA level and serologic markers

目的探讨HBV基因型与HBV-DNA水平及血清标志物的相关性,分析不同基因型的临床表现。方法对532例HBV-DNA阳性感染者分别检测HBV病毒基因型、HBV-DNA、乙型肝炎血清标志物及肝功能。结果 532例慢性HBV感染者中HBV基因型以C型为主60.2%,其次为B型31.6%,B、C混合型6.0%,未分型2.3%例;C基因型HBV-DNA水平和HBeAg阳性率分别为6.41±1.15和91.3%,明显高于B型5.88±1.30和83.3%,P<0.01;C基因型患者的ALT、AST及TBIL均高于B型,但差异无统计学意义,C基因型ALB 28.68±4.32显著低于B基因型30.55±5.84,差异有统计学意义(P<0.01)。结论该地区HBV基因型以C型为主,B型次之,C基因型HBV-DNA水平显著高于B基因型,C基因型HBeAg阳性率较B基因型高,C基因型对肝脏损害较B基因型重,并与HBV载量及HBeAg系统具有相关性。

OBJECTIVE To investigate the relationship between hepatitis B virus genotype and serum level of HBV-DNA and HBV markers in patients with hepatitis B,and analyze different HBV genotypes leading to the change of clinical manifestations.METHODS The genotype of HBV and serum level of HBV-DNA in 532 patients positive for HBV DNA were determined.ELISA was used for detection of HBV serum markers and liver function was also examined.RESULTS Of the 532 patients,60.2% were genotype C,31.6% were genotype B,6.0% were mixed genotype（B＋C）,and 2.3% were unknown genotype.The level of ALT and TBL was higher in genotype C than that in genotype B,but there was no significant difference.The level of ALB was significantly lower in genotype C than that in genotype B（P0.01）.The clinical manifestations demonstrated that the serum level of HBV-DNA and HBeAg positive rate in patients of genotype C was（6.41±1.15） and 91.25%,higher than（5.88±1.30） and 83.33% in those of genotype B（P0.01）.CONCLUSION Genotype C is a predominant genotype and genotype B is the second in Gansu province.The serum level of HBV-DNA in those of genotype C is higher than that of genotype B.The positive rate of HBeAg in those of genotype C is higher than that of genotype B.The damage to liver induced by genotype C is more severe than that induced by genotype B,which is closely related with the level of HBV-DNA and the expression of HBeAb/HBeAg.