2015—2023年河南省信阳市丙型肝炎病毒基因型分布特征

Genotype distribution characteristics of hepatitis C virus in Xinyang,Henan,2015-2023

目的了解信阳市丙型肝炎病毒(hepatitis C virus,HCV)基因型分布特征,为丙型肝炎(丙肝)临床治疗方案的选择提供依据。方法收集2015—2023年南阳市丙肝临床诊断和确诊病例,筛选丙肝病毒载量(HCV-RNA)≥1.0×10~3IU/mL病例的血清样本,进行HCV基因型检测,描述性分析基因型人群分布、时间分布及地区分布特征。结果795例丙肝病例血清样本中,共检出1、2、3、6等4种HCV基因型,1b、2a、3a、3b、6a等5种基因亚型。主要为1b型646例(81.26%),其次为2a型138例(17.36%)。不同性别HCV基因型分布差异无统计学意义(χ^(2)=1.675,P>0.05)。1型基因15~<31岁构成比最高(100.00%),41~<51岁年龄组最低(77.46%);2型基因在41~<51岁年龄组构成比最高(19.72%),15~<31岁年龄组最低(0.00%)。2015—2019年检出1b型和2a型2种亚型,2020、2022、2023年分别新增3a型、6a型、3b型和混合型。11个县区丙肝患者基因型均以1b型为主,构成比为58.00%~95.65%。结论2015—2023年信阳市丙肝基因型主要以1b型和2a型为主,2020—2023年逐渐增加至4种基因型、5种基因亚型。在丙肝治疗前推荐进行HCV分型检测,以便临床选择基因型特异性方案,对减轻疾病负担有重要意义。

Objective To investigate the genotype distribution of hepatitis C virus in Xinyang from 2015 to 2023,so as to provide guidance for clinical treatment.Methods Serum samples from patients with HCV viral load(HCV-RNA)≥1.0×10~3IU/mL were collected for HCV genotype detection.Descriptive analysis was used to examine the population,temporal,and regional distribution of genotypes.Results Five genotypes were detected in 795 serum samples:HCV genotypes 1,2,3,6,and the subtypes1b,2a,3a,3b,6a.Genotype 1b was predominant,accounting for 646 cases(81.26%),followed by genotype 2a with 138 cases(17.36%).There was no significant difference in genotype distribution between males and females(χ^(2)=1.675,P>0.05).Genotype 1 was the most prevalence in the 15-<31 age group(100.00%),and the least in the 41-<51 age group(77.46%).In the contrast,genotype 2 was the most prevalence in the 41-<51 age group(19.72%),and the least in the 15-<31 age group(0.00%).From 2015 to 2019,Subtypes 1b and 2a were detected.In 2020,2022 and 2023,subtypes 3a,6a,3b and mixed subtypes were also identified.Genotype 1b was the major genotype across 11 counties,with a constituent ratio was 58.00%to 95.65%.Conclusions Between 2015 and 2023,hepatitis C wasprimarily genotypes 1b and 2a.The number of genotypes nd subtypes increased from 2020 to 2023.It is recommended that HCV genotyping be conducted before treatment to enable doctors to select genotype-specific regimens,thereby reducing the disease burden.