中国15个民族HBV基因型及基因亚型分布特征分析

Epidemiological distribution of genotypes and sub-genotypes of hepatitis B virus in 15 ethnic groups in China

目的了解我国不同民族人群感染HBV的基因型及基因亚型分布特征。方法利用多阶段分层整群随机抽样结合系统抽样的方法从2020年全国乙型肝炎血清流行病学调查HBsAg阳性样本库中抽取样本,利用巢式PCR扩增阳性样本HBV S区基因,构建系统发育树分析判定HBV基因型和亚型,结合社会人口学资料进行综合分析。结果成功扩增15个民族的1539份样本,检出B、C、D、I型和C/D重组型5种基因型。B型占比较高的民族包括汉(74.52%,623/836)、壮(49.28%,34/69)、彝(53.19%,25/47)、苗(94.12%,32/34)和布依族(81.48%,22/27);C型占比较高的民族为瑶族(70.91%,39/55);D型占比较高的民族为维吾尔族(83.78%,31/37);C/D重组型占比较高的民族为藏族(92.35%,326/353);检出I型11例中,8例来自于壮族。除藏族外,各民族的B型中B2亚型均>80.00%;在C型中,C2亚型占比较高的民族包括汉、藏、彝、维吾尔、蒙古、满、回和苗族8个民族,C5亚型占比较高的民族包括壮(55.56%,15/27)和瑶族(84.62%,33/39);在D型中,彝族均为D3亚型,维吾尔和哈萨克族均为D1亚型。C/D1和C/D2亚型在藏族占比分别为43.06%(152/353)和49.29%(174/353)。I型均为I1亚型。结论我国15个民族中发现HBV 5种基因型和15种基因亚型,不同民族的HBV基因型和基因亚型分布差异明显。

Objective To understand the distribution of genotypes and sub-genotypes of HBV in different ethnic groups in China.Methods The HBsAg positive samples were selected by stratified multi-stage cluster sampling from the sample base of national HBV sero-epidemiological survey in 2020 for the amplification of S gene of HBV by nested PCR.A phylogeny tree was constructed to determine the genotypes and sub-genotypes of HBV.The distribution of genotypes and sub-genotypes of HBV were analyzed comprehensively by using laboratory data and demographic data.Results A total of 1539 positive samples from 15 ethnic groups were successfully amplified and analyzed,and 5 genotypes(B,C,D,I and C/D)were detected.The proportion of genotype B was higher in ethnic group of Han(74.52%,623/836),Zhuang(49.28%,34/69),Yi(53.19%,25/47),Miao(94.12%,32/34),Buyi(81.48%,22/27).The proportions of genotype C were higher in ethnic groups of Yao(70.91%,39/55).Genotype D was the predominant genotype in Uygur(83.78%,31/37).Genotype C/D were detected in Tibetan(92.35%,326/353).In this study,11 cases of genotype I were detected,8 of which were distributed in Zhuang nationality.Except for Tibetan,sub-genotype B2 accounted for more than 80.00%in genotype B in all ethnic groups.The proportions of sub-genotype C2 were higher in 8 ethnic groups,i.e.Han,Tibetan,Yi,Uygur,Mongolian,Manchu,Hui and Miao.The proportions of sub-genotype C5 were higher in ethnic groups of Zhuang(55.56%,15/27)and Yao(84.62%,33/39).For genotype D,sub-genotype D3 was detected in Yi ethnic group and sub-genotype D1 was detected in both Uygur and Kazak.The proportions of sub-genotype C/D1 and C/D2 in Tibetan were 43.06%(152/353)and 49.29%(174/353).For all the 11 cases of genotype I infection,only sub-genotype I1 was detected.Conclusions Five genotypes and 15 sub-genotypes of HBV were found in 15 ethnic groups.There were significant differences in the distribution of genotypes and sub-genotypes of HBV among different ethnic groups.