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目的 了解湖北地区乙型肝炎病毒(HBV)基因型的分布及其与临床的相关性。 方法 选择湖北地区HBV DNA阳性的慢性HBV感染者190例,其中乙型肝炎表面抗原(HBsAg)携带者52例、慢性乙型肝炎56例、重型肝炎32例、肝硬化22例、原发性肝癌28例,应用多对型特异性引物-聚合酶链反应检测HBV的基因型。 结果 多对HBV型特异性引物法可快速准确鉴定HBV的基因型。190份HBV DNA阳性血清标本中,B基因型140例(73.7％),C基因型42例(22.1％),BC混合型8例(4.2％),未发现A、D和E基因型;B基因型在重型肝炎和肝癌患者中占绝对优势,分别为87.5％和89.3％,显著高于HBsAg携带者的67.3％;B基因型患者血清丙氨酸氨基转移酶水平(253.1±306.7)U／L高于C基因型患者的(154.1±192.9)U／L,差异有统计学意义(P<0.05);除HBsAg携带者外的慢性HBV感染者中,B基因型患者血清抗-HBe阳性率50.5％(53／105)显著高于C基因型的18.5％(5／27),P<0.01。 结论 多对型特异性引物同时进行聚合酶链反应的基因分型方法可用于HBV基因型的流行病学调查;湖北地区存在HBV的B、C和BC混合基因型,B型为本地区的优势基因型并在严重肝病和肝癌中的比例较高,基因型的分布可能有较大的地区差异。
Objective To understand the distribution of hepatitis B virus (HBV) genotype in Hubei Province and its clinical relevance. Methods 190 patients with HBV DNA positive chronic HBV infection in Hubei Province were selected. Among them, 52 were carriers of hepatitis B surface antigen (HBsAg), 56 were chronic hepatitis B, 32 were severe hepatitis, 22 were liver cirrhosis, In 28 cases, HBV genotypes were detected by using multiple pairs of type-specific primers - polymerase chain reaction. The results of multiple pairs of HBV-specific primer method can quickly and accurately identify the genotype of HBV. Among 190 HBV DNA positive sera samples, there were 140 (73.7%) B genotypes, 42 (22.1%) C genotypes and 8 (4.2%) BC genotypes. No genotypes A, D and E were found. Genotypes accounted for 87.5% and 89.3% of patients with severe hepatitis and hepatocellular carcinoma, respectively, which was significantly higher than that of HBsAg carriers (67.3%). Serum alanine aminotransferase levels in patients with genotype B (253.1 ± 306.7) U / (154.1 ± 192.9) U / L in patients with genotype C were significantly higher than those in patients with genotype C (P <0.05). The positive rate of anti-HBe in patients with genotype B was significantly higher than that of patients with chronic HBV infection 50.5% (53/105) was significantly higher than 18.5% (5/27) of C genotype, P <0.01. Conclusion The genotypes of multiple pairs of type-specific primers in simultaneous polymerase chain reaction can be used for the epidemiological investigation of HBV genotypes. The mixed genotypes of B, C and BC in HBV exist in Hubei Province, and the genotypes of B are the advantages in this region Genotype and in a high proportion of severe liver disease and liver cancer, the distribution of genotypes may have greater regional differences.