山东烟台地区丙型病毒性肝炎患者的基因分型及临床意义

Genotyping and clinical significance in patients with hepatitis C in Shandong Yantai area

目的：探讨山东烟台地区丙型肝炎病毒常见的HCV基因型、HCV RNA含量，HCV不同基因型与转氨酶相关性及干扰素治疗的应答关系。方法：筛选HCV-Ab及HCV RNA阳性患者作为研究对象，采用特异性PCR引物对HCVRNA5’UTR区和／或NS5B区进行扩增，PCR产物进行序列分析，通过与GenBank中参考序列的比对，对样本予以分型。同时，对其使用干扰素治疗前后分别测定HCV RNA含量、谷丙转氨酶、谷草转氨酶。结果：70份HCV—RNA阳性标本有42例可明确分型，可分型率为60．0％；检出1b、2a、3a、6a五种基因亚型，分别为30（71．4％）、10（23．8％）、1（2．4％）、1（2．4％）例。1b亚型是烟台地区HCV携带者的优势流行基因亚型，2a型携带者的ALT、AST均值明显高于1h型，使用干扰素治疗HCV RNA含量明显降低，但转氨酶高的2a患者在丙肝病毒含量降低的同时转氨酶也明显降低，而转氨酶升高不明显的1b患者经干扰素治疗后其转氨酶也无明显变化。结论：山东烟台地区HCV常见基因型为1b、2a、3a、6a，以1b亚型为主。HCV基因型别与转氨酶指标相关，丙肝病毒含量与干扰素治疗相关。

Objective ： to investigate the common HCV genotype of shandong yantai area, HCV RNA expression and the relationship of different HCV genotype with transaminase and interferon treatment response. Methods ： The HCV-Ab and HCV RNA positive samples were selected for analyze. HCV RNA5 ＇UTR and/or NS5B area was amplified using specific PCR primers and PCR products were performed sequence analysis. The samples were genotyping through comparing with the GenBank reference sequence.. At the same time, the HCV expression, ALT and AST were detected before and after interferon treatment.Results ： Among 70 HCV - RNA positive specimens, 42 （60.0%）cases were accurately genotyping.Four subtypes of 1b, 2a, 3a and 6a were detected. The distribution was respectively 30（71.4%）,10（23.8%）,1（2.4%） and 1（2.4%）, lb subtype is the dominant subtype in HCV carriers ofyantai area.The ALT and AST mean value of 2a subtype were obviously higher than lb subtype. The HCV RNA expression reduced after interferon treatment. The transaminase also reduced in 2a subtype patients which had higher transaminase after interferon treatment. However, there was no change of transaminase in lb subtype after interferon treatment. Conclusions ： The common subtype of HCV is 1b, 2a, 3a and 6 a in shandong yantai area and 1b subtype is the dominant subtype.HCV genotype is correlated with transaminase index and HCV RNA expression is correlated with interferon treatment.