宁波地区HCV基因型分布特征及与血清病毒载量、IL-6水平相关性分析

Distribution characteristics of HCV genotypes and its correlation with viral load and cytokine levels in Ningbo area

目的调查宁波地区丙型肝炎病毒(HCV)感染患者的病毒基因型分布情况,分析病毒基因型与RNA载量及血清细胞因子水平间的相关性。方法2018年10月—2021年10月首诊于宁波地区多家医疗机构的慢性丙型肝炎患者366例,分析HCV基因型在年龄、性别、肝脏相关指标之间的差异性;并选取HCV RNA载量高于检测限的患者为研究对象,进一步分析病毒基因型与RNA载量、血清细胞因子水平之间的相关性。结果366例研究对象中1b型202例(55.2%)、2a型98例(26.8%)、3a型26例(7.1%)、3b型14例(3.8%)、6a型26例(7.1%);按照分型结果分为1b型、2a型与3a/3b/6a型3组,结果显示3组在年龄分布上差异有统计学意义(F=14.54,P<0.001),1b型、2a型的年龄大于3a/3b/6a型,而3组在性别构成上差异无统计学意义(χ^(2)=0.741,P=0.691);肝脏相关指标ALT、AST、ALP检测结果均高于对照组,2a型血清的AFP水平高于对照组(P<0.05)。在HCV RNA水平上,1b型、3a/3b/6a型以检出高病毒载量为主,而2a型以中病毒载量的检出为主,定量分析也显示1b型的HCV RNA水平高于2a型(P=0.013);与对照组比较,血清细胞因子谱中仅见IL-6水平在1b型、2a型、3a/3b/6a型组中升高(P<0.001);Spearman相关性分析显示HCV RNA水平、血清IL-6水平存在正相关性(r_(s)=0.86,P=0.016)。结论宁波地区慢性丙型肝炎患者的基因型以1b型为主,1b型的HCV RNA水平显著高于2a型,且血清IL-6水平与病毒载量间存在正相关;及早进行HCV基因分型、RNA水平及IL-6检测,对临床治疗及预后评估具有较大价值。

Objective To investigate the distribution of hepatitis C virus(HCV)genotypes in Ningbo area,and to analyze its correlation with viral load and serum cytokine levels.Methods A total of 366 patients with chronic hepatitis C who were first diagnosed in several hospitals in Ningbo from October 2018 to May 2021 were collected.The differences of HCV genotypes in respect to age,gender and liver related indicators were analyzed.The correlation between the viral genotype and RNA load as well as serum cytokine levels was further analyzed in the patients with HCV RNA load higher than the detection limitation.Results Among the 366 patients,there were 202 cases of type 1 b(55.2%),98 cases of type 2 a(26.8%),26 cases of type 3 a(7.1%),14 cases of type 3 b(3.8%)and 26 cases of type 6 a(7.1%).They were divided into three groups according to the results,respectively type 1 b group,type 2 a group and type 3 a/3 b/6 a group.The results showed that there was statistical significance on the difference in age distribution among the three groups(F=14.54,P<0.001).The average age of type 1 b group and type 2 a group was significantly higher than that of type 3 a/3 b/6 a group.There was no statistical significance on the difference in gender composition among the three groups(χ^(2)=0.741,P=0.691).The results of liver-related indicators(ALT,AST,ALP)were significantly higher than those in the control group,and the serum AFP level of type 2 a group was higher than that in the control group(P<0.05).In respective of HCV RNA levels,type 1 b and 3 a/3 b/6 a type 1 b group and type 3 a/3 b/6 a group predominantly had high viral loads,while type 2 a group had medium viral loads.Quantitative analysis alsoshowed that HCV RNA levels of type 1 b group were significantly higher than that of type 2 a group(P=0.013).Compared with the control group,only IL-6 levels in the serum cytokine profiles were increased in the type 1 b,2 a,and 3 a/3 b/6 a groups(P<0.001).Spearman correlation analysis showed that there was a positive correlation between HCV RNA level and serum IL-6 level(r_(s)=0.86,P=0.016).Conclusion The predominant chronic hepatitis C genotype in Ningbo is type 1 b.Its HCV RNA level is significantly higher than that of type 2 a,and the serum IL-6 level is positively correlated with viral load.Early detection of HCV genotype,RNA level and IL-6 is of great value for clinical treatment and prognosis.