湖北地区慢性丙型肝炎患者HCV RNA基因测序分型及疗效评估

Gene Sequence-Based Genotyping and Therapy Evaluation of Hepatitis C Virus in 168 Patients with Chronic Hepatitis C Infection in Hubei Province

目的 应用基因测序技术检测分析湖北地区慢性丙型肝炎患者的基因型特点,探讨基因型、HCV病毒载量的治疗基线与聚乙二醇干扰素、利巴韦林抗病毒治疗效果的关系.方法 对168例慢性丙型肝炎患者,用基因测序仪测定靶片段的基因序列,分析患者HCV基因型及分布特点;选取进行抗病毒治疗的患者,检测治疗前后不同时间点HCV-RNA含量、HCV基因型,评估治疗效果.结果 本研究中检测的慢性丙型肝炎患者HCV基因型有1b型,2a型,6b型,1b/2a混合型,1b/2k混合型,6d/6k混合型.其中,HCV 1b型149例（89%）,2a型8例（5%）,1b/2a型5例（3%）,6b型3例（2%）,1b/2k型2例（1%）,6d/6k型1例（0.7%）.1b型患者显著多于其他型别患者（χ2=754.3,P〈0.01）.选取进行疗效评估的患者,非1b型患者的快速病毒应答（RVR）的比例显著高于1b型患者（χ2=4.67,P〈0.05）.不同基线HCV RNA水平与患者的病毒学应答无显著性差异（χ2=0.17,0.22,1.51,0.09,均P〉0.05）.结论 湖北地区HCV RNA基因型以1b型为主,亦可见混合型及罕见型别.非1b型患者使用聚乙二醇干扰素、利巴韦林抗病毒治疗能获得更好的治疗效果.

Objective To detect the genotype of hepatitis C virus in chronic hepatitis C infection patitents in Hubei province using gene sequence method,observe the distributive characteristic of HCV genotype in these area, and to explore the relationship among genotype,baseline HCV RNA,and antiviral effectsMethods The venous whole blood was drawn from chronic hepatitis C patients in Renming Hospital of Wuhan University and RNA was extracted, then mRNA was converted to cDNA by reverse transcriptase. PCR products were purified by kit,then were sequenced by ABI3130 gene sequence analyzer. The results of gene sequence were compared with NCBI genebank data to obtain the HCV genotypes in patients. Some patients were selected for the evaluation of antiviral therapy results, baseline HCV RNA level and HCV genotype. Results The genotypes detected in the study were 1b, 2a, 6b, 1b/2a, 1b/2k,and 6d/6k respectively. 149 （89 %） cases were genotype 1b,8（5%） cases were genotype 2a,5 （3%） cases were genotype 1b/2a,3（2%） cases were genotype 6b,2 cases were genotype 1b/2k and 1 case was genotype 6d/6k. The percentage of Genotype 1b patients was significantly higher than that of other genotypes （χ^2 = 754. 3, P〈0. 01）. RVR of genotype non-1b patients was significantly higher than genotype 1 b patients （χ^2 =4.67 ,P〈0. 05）. Conclusion Genotype lb was the major type of HCV in chronic hepatitis C patients in Hubei Province. Better rapid therapy effects could be found in Peginterferon and ribavirin treated genotype non-1b patients than that of lb patients.