感染两种HBV C基因亚型患者病毒变异特点比较

目的调查乙型肝炎病毒C1和C2亚型感染者的临床、病理和前C基因区的变异特点。方法运用聚合酶链反应-限制性片段长度多态性法，并结合HBV前C／C区序列测定，对广东地区63例慢性乙型肝炎患者C基因亚型和前C区变异特点进行分析，并对两种基因亚型感染者的多项临床和病理检测指标进行比较。结果所选C1和C2亚型感染者的年龄和性别构成无差异，其肝功能指标、HBV DNA水平以及肝组织炎症活动度和纤维化分期评分也无显著性差异。在前C基因区变异方面，C1亚型毒株发生C基因核心启动子变异机率高于C2亚型，C2亚型毒株发生前C终止密码变异的机率显著高于C1亚型，但两种变异的总发生率在两种亚型间并无显著性差别。结论两种C基因亚型的临床致病性并无明显差异，但在形成HBeAg阴性HBV感染方面两种毒株会采取不同的变异模式。

Clinical characteristics and precora mutation patterns in patiens with hepatitis B viral genotype C1 or C2 infection

Objective To investigate the clinical characteristics and precore mutation in patients with hepatitis B viral genotype C1 or C2 infection. Methods A cohort of 63 patients with chronic hepatitis B were enrolled in this study. HBV genotype C subtypes were determined with polymerase chain reaction-restriction fragment length polymorphism （PCR-RFLP）. Precore mutation patterns were analyzed by nucleotide sequencing and clinical data of the two subgenotypes were compared. Results No significant difference were found in liver functional indexes,HBV DNA level, inflammation and fibrosis scores between C1 and C2 infected patients when age and sex were matched. As to precoro mutation,subgenotype C1 was associated with higher tendency to develop basal core promoter mutation. In contrast, suhgenotype C2 showed the more tendency to develop precore stop mutation. But the total mutation rate between these two subgenotypes had no significant statistically difference. Conclusion There is no significant difference between subgenotype C1 and C2 infected patients as respect to their clinical characteristics. But different mutations in the core promoter and precore regions will be selected during hepatitis B e antigen seroconversion.