贵州省乙型肝炎病毒前C区及基本核心启动子变异分布

目的调查贵州省乙型肝炎病毒(HBV)前C区A1896、基本核心启动子区(BCP) T1762/A1764变异分布。方法收集贵阳、遵义、凯里、都匀4地区不同民族无症状携带者(ASC)、慢性肝炎(CH)、肝炎肝硬化(LC)、肝细胞肝癌(HCC)患者血清482份,用测序及限制性片段长度多态性检测A1896、T1762/A1764变异,用S基因PCR-RFLP确定基因型。结果A1896、T1762/A1764变异检出率分别为23.03%和29.67%。汉族感染者A1896、T1762/A1764变异检出率为27.64%和36.04%,高于侗、苗、布依族感染者合并后的7.96%、8.85%(P<0.01)。A1896变异在B、C基因型中的分布为20.34%和27.13%(P>0.05),T1762/A1764变异为18.97%和46.28%(P<0.01)。A1896、T1762/A1764变异在HBeAg阴、阳性组间的分布差异有统计学意义(P值均<0.01)。从ASC到HCC组,A1896、T1762/A1764变异分布逐渐增高,LC、HCC组的检出率明显高于CH和ASC组(P值均<0.01)。A1896、T1762/A1764变异的分布:贵阳(分别为31.79%和41.06%)高于遵义(10.94%和14.06%)、都匀(8.64%和11.1I%)及凯里(2.86%和2.86%),但多因素logistic回归分析在控制了HBeAg、HBV基因型及临床类型影响后,在地区间分布差异无统计学意义。结论A1896、T1762/A1764变异在贵州省不同民族间分布有一定差异。C型感染者易发生T1762/A1764变异,两种变异均与疾病进展有关。

Study on the distribution of hepatitis B virus precore and basic core promoter mutations in Guizhou area

OBJECTIVE: To investigate the distribution of hepatitis B virus (HBV) precore A1896 and basic core promoter (BCP)T1762/A1764 mutations in Guizhou area. METHODS: 482 patients with chronic HBV infection, belonging to 4 nationalities, including 225 asymptomatic carriers (ASC), 158 chronic hepatitis (CH), 57 liver cirrhosis (LC), 42 hepatocellular carcinoma (HCC), from 4 areas of Guizhou province were examined. HBV A1896 and T1762/A1764 mutations were determined by direct sequencing and restriction fragment length polymorphism (RFLP). HBV genotypes were determined by PCR-RFLP based on S gene. The relationship among these mutations and genotype and the progression of liver disease were studied by multi-normal logistic regression analysis. RESULTS: A1896 and T1762/A1764 mutations were detected 23.03% and 29.67% among 482 patients. These mutations were more prevalent in Hans than in Dong, Miao and Buyi minorities (P < 0.01, respectively). The mutations of A1896 and T1762/ A1764 were more commonly seen in HBeAg negative than in HBeAg positive patients (P < 0.01, respectively). The mutation of T1762/A1764 was significantly higher in genotype C than in genotype B (P < 0.01). There were significantly statistical differences in the detective rate of A1896 and T1762/ A1764 mutations between patients with HCC, LC and CH, ASC. The distribution of these mutations in Guiyang (31.79% and 41.06%) was higher than in Zunye (10.94%, 14.06%), Duyun (8.64%, 11.11%) or Kaili (2.86%, 2.86%). However, there was no statistical difference by multi-normal logistic regression analysis after controlling the influence of HBeAg statu, genotype and clinical types. CONCLUSION: The distributions of A1896 and T1762/A1764 mutations were different in some nationalities of Guizhou province. The mutation of T1762/A1764 was more commonly seen in genotype C than in genotypr B. These mutations were closely related to progression of chronic liver diseases. Hepatitis B virus; Genotype; Restriction fragment length polymorphism