丙型病毒性肝炎病毒基因型与病毒载量及疾病进展的相关性

Hepatitis C virus genotype and correlation analysis of viral load and disease progression

目的探讨丙型病毒性肝炎(HCV)病毒基因型与病毒载量及疾病进展的相关性。方法选取2013年1月至2015年1月于湖北省孝感市中心医院就诊的100例慢性HCV感染者为研究对象,采用基因芯片法对HCV基因型进行检测,采用反转录-聚合酶连反应法(RT-PCR)对HCV DNA基因型进行检测。结果共100份标本,其中HCV基因型中1a型4份,1b型49份,2a型14份,3a型9份,3b型8份,6型15份,混合型1份(1b+2a)。男性与女性患者的HCV基因型整体分布差异无统计学意义(P>0.05),但是各类HCV基因型差异有统计学意义(P<0.05)。1型、2型、3型、6型、混合型患者的平均年龄分别为(39.20±3.50)、(45.20±3.10)、(38.84±3.20)、(36.06±3.30)、(39.20±3.60)岁。各类HCV基因型患者年龄差异无统计学意义(P>0.05)。6型的HCV RNA平均水平最高,不同基因型的HCV RNA平均水平差异有统计学意义(F=10.863,P=0.027)。100例患者中11例患者伴存免疫缺陷病,8例患者为1型患者,89例患者无伴存缺陷免疫病,45例患者为1型患者,差异有统计学意义(P<0.05)。慢性丙型肝炎(CHC)患者的HCV RNA水平最低,终末期肝病、CHC、伴存免疫缺陷病三组患者HCV RNA水平两两比较差异无统计学意义(P>0.05)。结论 HCV基因型主要为1b型,6型患者感染率最高,临床上应当加强对这部分患者的检控。

Objective To explore the hepatitis C virus（HCV） genotypes and correlation between viral load and disease progression. Method 100 cases of chronic HCV infection were analyzed. Gene chip method,and RT-PCR were used to detect genotypes of HCV. Results Among the 100 cases,4 cases were HCV genotype 1a,49 were 1b,14 were 2a,9were 3a,8 were 3b,15 were 6,and 1 was a mix of 1b＋2a. The HCV genotype overall distribution in male and female patients showed no significant differences（P〉 0.05）,but weresignificant in different genotypes（P〈 0.05）. The average ages of patients infected with genotype 1,2,3,6 and mix were（39.20 ±3.50）,（45.20 ±3.10）,（38.84 ±3.20）,（36.06 ±3.30） and（39.20 ±3.60） years old,respectively,showing no significant differences（P 〉0.05）. The patients infected with genotype 6 had the highest level of HCV RNA; the RNA levels of different genotypes were significantlydifferent（F=10.863,P =0.027）. Among 100 cases,11 had immune deficiency disease,in which,8 were infected with type 1 HCV;89 patients had no accompanying defect autoimmune disease,in which,45 were infected with type 1 HCV,showing significant difference（p〉0.05）. Patients with chronic hepatitis C（CHC） had the lowest levels of HCV RNA. Among the three groups of patients,there were no significant differences in paired comparison（P〉0.05）. Conclusion The main genotype of HCV was genotype 1b; genotype 6 had the highest infection rate,and these patients should strengthen the detection of this genotype.