慢性HBV感染者BCP区A1762T/G1764A和前C区G1896A变异的影响因素分析

Influencing factors of BCP region A1762T/G1764A and Pre-C region G1896A mutations in patients with chronic hepatitis B virus infection

目的:探讨慢性HBV感染者基本核心启动子(BCP)区A1762T/G1764A和前C区G1896A变异的影响因素。方法:回顾性收集2010年10月至2022年8月宁波市第二医院464例慢性HBV感染者的临床资料,分析慢性HBV感染者BCP区A1762T/G1764A和前C区G1896A的变异情况。采用Logistic回归分析BCP区A1762T/G1764A和前C区G1896A变异的影响因素。结果:A1762T/G1764A变异率为62.1%(288/464),G1896A变异率为32.8%(152/464),A1762T/G1764A和G1896A同时变异率为20.9%(97/464)。终末期肝病患者的A1762T/G1764A变异率、A1762T/G1764A和G1896A同时变异率均高于慢性乙型肝炎患者(χ^(2)=9.285和6.748,P值均<0.05)。单因素分析结果显示,A1762T/G1764A变异组年龄、血清天冬氨酸转氨酶水平及基因C型比例均高于无变异组(P<0.05或<0.01);G1896A变异组年龄、HBeAg阴性比例及血清γ-谷氨酰转肽酶水平均高于无变异组(P<0.05或<0.01)。多因素Logistic回归分析结果显示,年龄是A1762T/G1764A变异的独立影响因素(OR=1.035,95%CI 1.017~1.054,P<0.001),HBeAg状态是G1896A变异的独立影响因素(OR=0.171,95%CI 0.112~0.261,P<0.001)。结论:对于慢性HBV感染者,年龄越大,A1762T/G1764A变异可能性大;HBeAg阴性,G1896A变异可能性大。

Objective To explore the influencing factors of BCP region A1762T/G1764A and Pre-C region G1896A mutations in patients with chronic hepatitis B virus(HBV)infection.Methods Clinical data of 464 patients with chronic HBV infection admitted to Ningbo No.2 Hospital from October 2010 to August 2022 was retrospectively analyzed.The mutations in the BCP region A1762T/G1764A and the pre-C region G1896A were examined in all patients.Logistic regression was used to analyze the influencing factors of these mutations.Results The mutation rate of A1762T/G1764A and G1896A was 62.1%(288/464)and 32.8%(152/464);and the co-mutation rate of A1762T/G1764A and G1896A was 20.9%(97/464).The mutation rate of A1762T/G1764A and the co-mutation rate of A1762T/G1764A and G1896A in patients with end-stage liver disease were higher than those in patients with chronic hepatitis B(χ^(2)=9.285 and 6.748,both P<0.05).Univariate analysis showed that A1762T/G1764A mutation was associated with higher age,serum AST levels,and proportion of genotype C(P<0.05 or<0.01);while G1896A mutation was associated with higher age,proportion of negative HBeAg,and serum GGT levels(P<0.05 or<0.01).Multivariate logistic regression analysis indicated that higher age was an independent influencing factor for A1762T/G1764A mutation(OR=1.035,95%CI 1.017-1.054,P<0.001),while HBeAg status was an independent influencing factor for G1896A mutation(OR=0.171,95%CI 0.112-0.261,P<0.001).Conclusion Chronic HBV infection patients with higher age is likely to have A1762T/G1764A mutation,while those with negative HBeAg is more likely to have G1896A mutation.