海南省IDUs和non-IDUs人群中HCV的基因型分布

Genotype distribution of HCV among the populations of IDUs and non-IDUs in Hainan

目的了解海南省静脉吸毒人群(inject drug users,IDUs)中HCV-Ab、HCV-RNA的情况,以及IDUs与非静脉吸毒人群(non-inject drug users,non-IDUs)中丙型肝炎病毒(Hepatitis C virus,HCV)亚型分布特点。方法从海南省的美沙酮维持治疗门诊、戒毒所和海南省人民医院住院患者中选择HCV-Ab阳性者检测HCV-RNA,对HCV-RNA阳性者抽取血清进行RT-PCR及巢式PCR扩增Core-E1区并测定其核酸序列、确定其基因亚型。根据是否存在静脉吸毒行为分为IDUs组和non-IDUs组,然后并对两组的资料统计分析。结果海南省802例美沙酮维持治疗门诊、戒毒所吸毒者中HCV-Ab阳性309例,HCV-Ab阳性率38.53%,其中215例HCV-RNA阳性,阳性率为69.58%。海南省人民医院就诊HCV-RNA阳性者251例,共466例HCV-RNA检测阳性。466例HCV-RNA阳性者中448例样本成功测序和基因分型及具体如下:IDUs组(320例)中6a(58.75%)是最主要的基因型,其次是3b(16.88%)、3a(15.63%)、1a(4.38%)、1b(2.81%)和非6a(0.93%);而non-IDUs组(128例)中最主要的基因亚型是1b(30.47%),其次是6a(28.12%)、3b(10.16%)、3a(3.91%)、1a(7.03%)和非6a(14.84%),两组亚型之间的差异具有统计学意义(P<0.01)。结论海南省IDUs人群中HCV感染后自发清除率较高,其感染的主要亚型为6a,其次为3b;但有些地区的IDUs人群中存在其他亚型的小范围流行。

Objective To define the main gene subtypes and HCV-Ab,HCV-RNA of hepatitis C virus(HCV)infectors among inject drug users(IDUs)and non-inject drug users(non-IDUs)in Hainan Province.Methods The HCV-RNA(s)of 581 samples,that were from Methadone Maintenance Treatment Clinics,drug treatment center and Hainan Provincial People′s Hospital Infection Department,were extracted,amplified in the HCV Core-E1 region by RT-PCR and nested-PCR,and determine the HCV genotype distribution.Based on whether or not absence of intravenous drug abuse,the subjects were divided into IDUs group and non-IDUs group,statistical analysis was made on the demographic data.Results Among 802 methadone maintenance treatment outpatients and drug addicts in Hainan Province,309 were HCV-Ab positive,with the HCV-Ab positive rate of 38.53%,and 215 were HCV-RNA positive,with the positive rate of 69.58%.And 251 patients tested HCV-RNA positive in Hainan People′s Hospital,466 patients tested positive for HCV-RNA.Of the 581 HCV-Ab positive cases,466 of them HCV-RNA positive cases.And 448 out of the 466 sampleswere successfully sequenced and genotyped as follows,the subtypes and proportion among 320 IDUs were found as 6a(58.75%)in mainly,and followed by 3b(16.88%),3a(15.63%),1a(4.38%),1b(2.81%)and non-6 a(0.93%);128 non-IDUs were 1b(30.47%),6a(28.12%),3b(10.16%),3a(3.91%),1a(7.03%)and non-6a(14.84%),the difference was statistically significant(P<0.01).Conclusion The spontaneous clearance rate of HCV infection in IDUs population was high in Hainan Province,6a is the main subtype among IDUs,followed by 3b.There is a range transmission of HCV subtypes other than 6a in different regions.