新疆地区丙型肝炎病毒基因型分布特征

Distribution characteristics of hepatitis C virus genotypes in Xinjiang

目的了解新疆地区丙型肝炎病毒(HCV)基因型分布特征。方法选取2013年1月至2018年9月在新疆医科大学第一附属医院就诊的慢性HCV感染者6462例,排除了重复检测者,有效纳入了检测HCV基因型者共4773例,采用PCR-反向点杂交法,并回顾性分析基因型的分布。组间比较采用χ2检验或F检验,P<0.05为差异有统计学意义。结果4773例标本中检测出了5种基因型:1b型2928例(占61.3%)、2a型1241例(占26%)、3a型375例(占7.9%)、3b型205例(占4.3%),6a型24例(占0.5%)。患者年龄在(48.14±13.93)岁,各年龄段均以检出基因1b型为主;汉族2965例,18个少数民族共1808例,其中汉族和少数民族基因1b型分别为1798例(占60.6%)、1130例(占62.5%),基因3型分别为235例(占7.9%)、345例(占19.1%)。在少数民族中主要以维吾尔族居多,且可检测出基因6a型,其他民族未检测出6a型,检出基因1b型维吾尔族704例(占62.1%),基因3型维吾尔族共269例(占23.7%)。男性2413例,女性2360例,其中基因1b型男性1418例(占58.8%)、女性1510例(占64.0%);基因3型男性424例(占17.6%),女性156例(占6.6%)。基因1b型与基因非1b型患者性别比例比较,差异有统计学意义(P<0.05);汉族与少数民族患者基因型2a、3a、3b、6a型的检出率比较,差异均有统计学意义(P值均<0.05)。结论新疆地区HCV基因型分布呈多样性,以1b型为主。少数民族HCV基因3型较汉族比例高。新疆HCV基因型检测丰富了我国HCV基因型分布特征,并为患者个体化治疗提供依据。

Objective To understand the hepatitis C virus(HCV)genotype distribution characteristics in Xinjiang region.Methods 6462 cases with chronic HCV infection that were treated at the First Affiliated Hospital of Xinjiang Medical University from January 2013 to September 2018 were selected,and repeated testers were excluded.A total of 4773 cases with HCV genotypes were efficiently included.PCR-reverse dot hybridization method was used to retrospectively analyze the genotypes distribution.χ2 test or F-test was used for intergroup comparison.P<0.05 was considered as statistically significant.Results Five genotypes were detected in 4773 samples:genotype 1b 2928 cases(61.3%),genotype 2a 1241 cases(26%),and genotype 3a 375 cases(7.9%),genotype 3b 205 cases(4.3%),and genotype 6a 24 cases(0.5%).Patients were 48.14±13.93 years old.Genotype 1b was mainly detected in all age groups.There were 2965 cases of Han ethnicity and 1808 cases of 19 ethnic minorities,of which 1798 cases(60.6%)and 1130 cases(62.5%)were genotype 1b,and 235 cases(7.9%)and 345 cases(19.1%)were genotype 3,respectively.Among the ethnic minorities,Uyghur were the predominant,and genotype 6a could be detected;however,no other ethnic groups had detected genotype 6a.There were 704 Uyghur of genotype 1b(62.1%),269 Uyghur of genotype 3(23.7%),and 235 Hans of genotype 3(7.9%).There were 2413 males and 2360 females,of which 1418 males(58.8%),and 1510 females(64%)were of genotype 1b,and 424 males(17.6%),and 156 females(6.6%)were of genotype 3.There was a statistically significant difference between the gender of patients with genotype 1b and non-genotype 1b(P<0.05).There was a statistically significant difference in the detection rate of genotype 2a,3a,3b,6a between Han and ethnic minority patients(P<0.05).Conclusion HCV genotypes distribution in Xinjiang region is diverse,and is mainly type 1b.An ethnic minority has higher proportion of HCV genotype 3 than that of Han ethnicity.HCV genotypes detection in Xinjiang region enriches the distribution characteristics of HCV genotypes and provides a basis for individualizing treatment for patients in China.