HBV基因分型与病毒载量及血清标志物关系的探讨

目的探讨HBV基因型与HBV-DNA水平及血清标志物的相关性。方法选择125例乙肝患者血清HBV-DNA复制阳性的标本分别检测HBV病毒基因分型、HBV-DNA、乙肝血清标志物、谷丙转氨酶（ALT）和总胆红素（TBL）。结果 125例HBV-DNA复制阳性标本中HBV基因分型以B型为主占71.2%（89/125）,C型占24.0%（30/125）,BC混合型占2.4%（3/125）,非B非C型占2.4%（3/125）;B基因型患者血清ALT（297.3±193.6）U/L和TBL（105.1±59.7）mol/L水平高于C基因型患者ALT（158.1±107.5）U/L和TBL（53.1±22.7）mol/L,P〈0.01;B基因型患者血清抗-HBe阳性率91.0%（81/89）显著高于C基因型的23.3%（7/30）,P〈0.01;B型HBV-DNA水平（5.87±1.72）log10copies/mL与C型（6.01±1.91）log10copies/mL无差异（P〉0.05）。结论本地区HBV病毒基因型以B型为主,C型次之,B基因型对肝脏损害较C基因型重,并与HBV载量及HBeAg系统具有相关性,B基因型易发生YMDD突变。

Correlation among hepatitis B virus genotype, hepatitis B virus loads and serologic markers

Objective To study the relationships among HBV genotype,level of serum HBV-DNA and HBV markers in patients with hepatitis B.Methods Serum samples were collected from 125 HBV-DNA positive patients and HBV genotyping,HBV-DNA,ALT,TBL and HBV serum markers were tested respectively.Results Of the 125 patients,71.2%（89/125）were genotype B,24.0%（30/125）were genotype C,2.4%（3/125）were mixed genotype（B＋C）,and 2.4%（3/125）were unknown genotype.The level of ALT and TBL were significantly higher in genotype B than those in genotype C（P0.01）.The positive rate of anti-HBe was significantly higher in genotype B than that in genotype C（P0.0 1）.There was no significant difference of HBV-DNA level between genotype B and C.Conclusion The predominant HBV genotype in the local area is genotype B.Compared with genotype C,genotype B infection can seriously impair liver and is liable to induce YMDD mutant,which is closely related with the virus loading and the expression of HBeAb/HBeAg.