泰兴地区乙型肝炎病毒基因型分布与临床意义

目的 了解泰兴地区乙型肝炎病毒（HBV）基因型分布情况,探讨HBV基因型与临床的相关性.方法 选择HBV慢性感染者138例,其中慢性乙型肝炎（CHB）病例113例,肝硬化病例25例,采用荧光定量PCR法测定HBV基因型,并结合临床资料进行统计学分析.结果 138例病例中,基因B型46例（33％）,C型89例（65％）,B/C混合型1例（0.7％）,非B非C型2例（1.4％）;CHB组中,B、C基因型在ALT、HBV DNA、HBeAg阳性率差异无统计学意义（P＞0.05）;C基因型在CHB重度占77％、肝硬化中占80％,B基因型在CHB重度占20％,肝硬化中占20％,C基因型在CHB重度、肝硬化中比例明显升高.结论 本地区HBV基因型中以C型为主,其次为B型,有少量B/C混合型及其他类型,C基因型往往较B基因型病情严重.

Distribution of hepatitis B virus genotyps in Taixing area and its clinical significance

Objective To investigate the disttribution of hepatitis B virus （HBV） genotypes in Taixing,and explore its clinical relationship.Methods A total of 138 patients with chronic HBV infection,including 113 cases of chronic hepatitis B （CHB） and 25 cases of liver cirrhosis,were enrolled.Quantitative fluorescence PCR was used for determination of serum HBV genotyping,then the results were analyzed by statistical method.Results Of the 138 patients,46 （33％） were genotype B,89 （65％） were genotype C,1 （0.7％） were genotype B/C mixed; 2（1.3％） were neither genotype B nor genotype C.In CHB patients,genotype B and genotype C had no significant differences between the ALT value,HBV DNA levels and HBeAg positivity; genotype C showed a gradual increase in severe CHB and liver cirrhosis patients.Conclusion The predominant HBV genotypes in the district are confirmed to be genotype C,then,genotype B,few genotype B/C mixed and neither genotype B nor genotype C.Genotype C cause more serious hepatic lesion than genotype B.