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目的了解山东省≤15岁人群感染的乙型肝炎(乙肝)病毒(Hepatitis B Virus,HBV)中,“a”抗原决定簇变异株流行强度及分布特征,探讨其流行与乙肝疫苗(Hepatitis B Vaccine,HepB)免疫的关系。方法对2009年国家法定传染病报告系统报告的山东省≤15岁乙肝病例进行个案调查和血标本采集,采用巢式聚合酶链反应方法扩增其血清HBV S基因,测序后与基因数据库中的标准序列进行比对分析。结果山东省2009年共报告≤15岁乙肝326例,对302例(92.64%)进行了个案调查和血标本采集,对其中158份标本进行HBV-脱氧核糖核酸提取,扩增HBV S基因并成功测序137份。14份标本检出“a”抗原决定簇变异株,检出率为10.22%;有HepB免疫史和无HepB免疫史者检出率分别为10.66%和6.67%,差异无统计学意义(χ2=0.23,P=0.63);未发现不同性别、地区、接种HepB种类和母亲乙肝病毒表面抗原携带状态者间检出率的差异有统计学意义(P>0.05)。14份标本共检出“a”抗原决定簇6个氨基酸位点发生9种变异,其中126位点和144位点检出率较高,分别为4.38%(6/137)和2.92%(4/137),但差异无统计学意义(χ2=7.39,P=0.19)。结论目前山东省≤15岁乙肝病例中,HBV“a”抗原决定簇变异株流行率较低,存在多种变异形式,尚未出现强变异株;尚未发现其流行与HepB免疫有关。
Objective To investigate the epidemiological characteristics and distribution of the “a” antigenic determinants in Hepatitis B Virus (HBV) of ≤15 years old population in Shandong Province and to discuss the prevalence and epidemiological characteristics of the epidemic and hepatitis B vaccine (Hepatitis B) B Vaccine, HepB). Methods A case-by-case survey and blood samples were collected from a case of hepatitis B ≤15 years in Shandong Province reported by the State Legal Infectious Disease Reporting System in 2009. The serum HBV S gene was amplified by nested polymerase chain reaction (PCR) Standard sequence alignment analysis. Results A total of 326 cases of hepatitis B ≤15 years were reported in Shandong Province in 2009. 302 cases (92.64%) were investigated with blood samples and 158 cases of HBV DNA were extracted and HBV S gene was amplified and amplified successfully 137 sequenced. The detection rate of the mutant with “a” antigenic determinant in the 14 samples was 10.22%. The detection rates of HepB immunization history and no HepB immunization history were 10.66% and 6.67% respectively, with no significant difference ( χ2 = 0.23, P = 0.63). There was no significant difference in the detection rate of HepB in different sexes, regions, mother HBsAg carriers status (P> 0.05). Among the 14 samples, 9 mutations were detected in 6 amino acid sites of the “a” epitope, among which, the detection rates of 126 sites and 144 sites were higher (4.38% (6/137) and 2.92% (4/137), but the difference was not statistically significant (χ2 = 7.39, P = 0.19). Conclusions Currently, the prevalence of HBV “a” antigenic determinants in Shandong province is less than 15 years of age. There are many variants and no strong mutants have been found. It has not been found that the epidemic is related to HepB immunization.