福州市乙型肝炎病毒基因型分布及其临床意义

Distribution of Hepatitis B Virus Genotypes in Fuzhou and its Clinical Significance

目的分析福州市乙型肝炎病毒(HBV)感染者病毒基因型分布情况及其与部分临床指标的关系。方法收集346份HBV DNA阳性标本,利用PCR熔解曲线法检测其基因型,同时进行HBeAg定量的检测,其中91例经肝脏穿刺确诊为肝纤维化。根据分型结果探讨基因型与肝纤维化、HBeAg阳性率以及HBV DNA水平的关系。结果 346例HBV感染者中,检出B型193例,占55.78%;检出C型95例,占27.46%;检出B/C混合型58例,占16.76%。91例肝纤维化标本中,检出C型39例,占42.86%(39/91),显著高于C型在全部研究对象中所占的比例(27.46%,82/346);检出B型38例,占41.76%(38/91),低于B型在全部研究对象中所占的比例(55.78%,193/346)。对346例标本进行HBV DNA定量检测,发现C型的病毒载量明显高于B型和B/C混合型;HBeAg定量检测发现C型的HBeAg阳性率(87.37%,83/95)亦显著高于B型(68.39%,132/193)和B/C混合型(41.38%,24/58),差别均有统计学意义(P<0.05)。结论福州市乙型肝炎患者中以B型HBV感染为主;肝纤维化、HBeAg阳性率及HBV DNA病毒载量与乙型肝炎患者感染HBV的基因型相关;C型与肝纤维化有关。

Objective To understand the distribution of HBV genotype in Fuzhou, and investigate the association between HBV genotype and liver fibrosis, HBeAg and HBV DNA. Methods 346 sam pies were genotyped by PCR melt curve analysis; all of them were HBV DNA≥103 copies/mL and HBeAg are detected. 91 of them were diagnosed as liver fibrosis by liver biopsy. Based on the laboratory re suits we analysed the relationship between HBV genotypes with liver fibrosis, HBeAg positive incidence, and HBV DNA level. Results HBV genotype B,C and genotype B/C were detected in 346 serum sam- pies, at rate of 55. 78%（193/346）,27.46%（95/346）,16. 76%（58/346） of total number of specimens re spectively. Of the 91 samples that were diagnosed as liver fibrosis, 39 samples were with genotype C, ac counting for 42.86% （39/91）,which was higher than the proportion（27.46%） of genotype C among the 346 samples. 38 samples were genotype B, accounting for 41. 76%（38/91）, which was lower than the proportion（55.78%） of genotype B among the 346 samples. All of 346 samples were tested for HBV DNA. The HBV DNA detetion results showed that the HBV DNA of genotype C is higher significantly than that of genotype B and B/C（P〈0.05） ,the HBeAg positive rate of genotype C（87.37%） is higher sig nificantly than that of genotype B（68.39%0） and B/C（41.38%）（P〈0.05）. Conclusion The main geno type of HBV is B in Fuzhou population, the genotype of HBV is associated withto liver fibrosis, HBeAg positive incidence, and HBV DNA level. Genotype C is closely associated with the severity of liver dis ease.