合肥地区不同类型乙型肝炎病毒感染者病毒基因型和基因亚型分布及其临床意义

Distribution and clinical significance of genotypes and subtypes of hepatitis B virus in HBV-infected patients

目的:研究合肥市不同类型乙型肝炎病毒(HBV)感染者血清中HBV基因型和亚型分布情况及其临床意义。方法:收集192例合肥市HBV感染者血清,提取HBV基因组DNA,通过对PCR扩增的HBV产物电泳及其酶切后电泳片段大小确定其基因型及其基因亚型。结果:192份血清中,82例B型,其中57例为Ba亚型,8例为Bj亚型,17例为非Ba/Bj亚型;99例为C型,其中8例为C1亚型,56例为C2亚型,35例为非C1/C2亚型;11例为B型与C型混合感染,其中6例为Ba与C2亚型混合感染,2例为Bj与C2型混合感染,2例为Ba与非C1/C2亚型混合感染,1例为非Ba/Bj亚型与C2亚型混合感染。不同类型HBV感染者中基因型分布有差异,在肝硬化和肝细胞癌患者中C型所占比例较高,无症状携带者中B型所占比例较高。在HBeAg阳性和阴性感染者中,HBV基因型分布差异也有统计学意义。结论:该市HBV感染者中,以Ba和C2亚型占优势,C基因型可能与肝硬化和肝细胞癌的发生有关。

Objective To study the distribution and its clinical significance of hepatitis B virus genotypes and subtypes in HBV-infected patients in Hefei. Methods 192 serum samples from HBV-infected patients were collected to extract HBV DNA. HBV the genotypes and subtypes of HBV were detected by PCR. Results Among 192 HBV-infected patients, 82 had genotype B, 99 had genotype C, and 11 had B/C. In genotype B, 57 were subtype Ba, 8 were subtype Bj, and the remaining 17 were neither Ba nor Bj. In genotype C, 8 were subtype C1, 56 were subtype C2, and the other 35 were neither C1 nor C2. In genotype B/C, 6 were Ba/C2, 2 Bj/C2, 2 Ba/ neither C1 nor C2, and one neither Ba nor Bj/C2. Tthe distribution of HBV genotypes and subtypes exhibited significant differences in the various clinical types; and it showed that genotype C was predominant among patients with liver cirrhosis and hepatocellular carcinoma, while genotype B was predominant in asymptomatic carriers. In addition, there were no differences in HBV genotype distribution among patient wih different gender; but the genotype distribution differed significantly between patients positive with HBeAg and those negative with HBeAg. Conclusions Subtypes Ba and C2 are predominant in HBV-infected patients in Hefei. Genotype C may be associated with the development of liver cirrhosis and hepatocellular carcinoma.