山西省不同人群丙型肝炎病毒的基因分型研究

Genotype study of hepatitis C virus in different population in Shanxi

目的 探索丙型肝炎病毒 (HCV)基因型在山西省不同人群中的分布规律及流行的优势型。方法 用RT -PCR和型特异性引物逆转录巢式PCR法 ,对山西省 2 71例抗HCV阳性的丙型肝炎病人、原发性肝细胞癌患者、非肝癌癌症患者、性关系混乱者和性病患者、职业献血员、吸毒者及公共场所从业人员进行了HCVRNA的检测和基因分型。结果 2 71份抗HCV阳性标本中 ,HCVRNA检出率为 45 .45 %～ 89.6 6 % ,平均 6 7.5 2 %。以丙型肝炎病人、献血员和吸毒者的HCVRNA检出率较高 (76 .9%～ 89.7% ) ,χ2 =30 .44 ,P <0 .0 1。在 133份HCVRNA阳性血清中 ,仅检出了 10 8例 1b型、2a型和此两种基因型的混合感染者。未检出 1a型、2b型和 3a型。其中 1b型占 80 .0 0 % (88例 ) ,2a型占 11.81% (13例 ) ,混合型占 6 .36 % (7例 )。在肝癌患者和献血员中 ,仅检出 1b型的感染 ;非肝癌的其他癌症患者中 ,未发现混合感染。各基因型在各人群中的分布比例也有差别 ,丙型肝炎患者、非肝癌的其他癌症患者、吸毒者和从业人员的各基因型构成比较接近 ,均以 1b型为主。而性病患者和性关系混乱者中 1b型和 2a型感染者比例相等。结论 山西省HCV的基因以

Objective To find out the distribution of HCV genotypes in different populations and predominant genotype in Shanxi and the relationship of HCV infection with HCV genotype. Methods HCV RNA detection was carried out by RT nested PCR with primers deduced from 5′ non coding region of HCV in 271 anti HCV positive samples from hepatitis C patients, primary hepatocellular carcinoma (PHC) patients,other cancer patients, STD patients, demimondes, drug addicts, paid blood donors and staff in public service. The genotyping of HCV was conducted using type specific primers deduced from core region of HCV on 133 HCV RNA positive samples. Results The average positive rate of HCV RNA was 67.52%(45.45%～89.66%). Hepatitis C patient, paid blood donors, drug addicts had higher positive rate of RNA (76.9%～89.7%). 108 samples were genotyping positive. Only 1b, 2a and 1b/2a mix infection were found. No genotype of 1a, 2b, and 3a were detected. The predominant genotype was 1b(80.00%). The distribution of 2a and 1b/2a mix infection was 11.81% and 6.36% separately. All three kinds of infections were found in hepatitis C patients, STD patients, demimondes, drug addicts and staff in public service. Only genotype 1b was detected in PHC cases and in paid blood donors. 1b/2a mix infection was not found in other cancer cases. Except STD patients and demimondes had same ratio of 1b and 2a, other groups distribution of genotypes predominated by genotype 1b. Conclusion The predominant genotype of HCV in Shanxi is 1b. The distribution of HCV genotypes is variable in different populations.