病毒性前葡萄膜炎患者感染水痘-带状疱疹病毒基因特征分析

Genetic analysis of varicella-zoster virus in patients with viral anterior uveitis

目的分析临床诊断为病毒性前葡萄膜炎患者眼内水痘-带状疱疹病毒(VZV)感染情况及基因特征。方法收集全国范围内2018年6月至2019年7月临床诊断为病毒性前葡萄膜炎感染患者房水样本共计83份。使用实时荧光定量多聚核苷酸链式反应技术筛查被VZV感染的阳性样本,扩增并分析阳性样本开放阅读框22、38和62上的单核苷酸多态性位点,根据扩增目的片段基因特征,鉴别参考株(包括8个疫苗株,其余均为野毒株),确定基因型别。结果83份共来源于病毒性前葡萄膜炎感染患者样本,年龄为51.0(45.5,61.0)(15~83)岁,女31例,男52例,其中50岁及以上患者占57.8%(48例),所有患者均无水痘或带状疱疹疫苗接种史。83份感染患者样本中,VZV阳性样本共57份(68.6%),其中14份成功扩增获得目的片段基因序列,经分析均为野毒株,且基因分型均属分支(Clade)2,与我国水痘和带状疱疹患者感染的VZV疫苗株型别相同。结论2018—2019年我国病毒性前葡萄膜炎患者感染VZV均为野毒株,基因型别与疫苗株相同均属Clade2,与我国水痘和带状疱疹患者感染VZV的主要流行基因型相同。

Objective To analyze the intraocular varicella-zoster virus(VZV)infection and genetic characteristics in patients clinically diagnosed with viral anterior uveitis.Methods A total of 83 aqueous humor samples were collected from patients clinically diagnosed with viral anterior uveitis infection in China from June 2018 to July 2019.The positive samples infected with VZV were screened by real time polymerase chain reaction,and the single nucleotide polymorphisms on the open reading frames 22,38 and 62 of the positive samples were amplified and analyzed.According to the gene characteristics of the amplified target fragment,the vaccine strain and wild strain(8 vaccine strains and the rest were wild strains)were identified to determine the genotype.Results There were 83 patients(31 females and 52 males)with viral uveitis infection,whose mean age was 51.0(45.5,61.0)(range:15-83)years,,and,of which 57.8%(48 cases)were infected with viral uveitis over 50 years of age.None of the patients had a history of varicella or herpes zoster vaccination.Of the samples of 83 patients infected with viral uveitis,57(68.6%)were positive for VZV.Among them,14 were successfully amplified to obtain the target fragment gene sequences,all of which were wild strains by analysis,and belonged to Clade2 of genotype,which was the same as the VZV vaccine strain types infected by varicella and herpes zoster patients in China.Conclusion From 2018 to 2019,VZV infection in Chinese patients with viral anterior uveitis was a wild strain,and the genotype belonged to Clade2 as the vaccine strain,which was the same as the main epidemic genotype of VZV infection in Chinese patients with varicella and herpes zoster.