HBV基因型与前C/C启动子变异及抗病毒疗效的关系

目的 了解深圳市乙型肝炎病毒（HBV）基因分型情况，探讨HBV基因型与前C／C启动子变异、乙肝的病程进展及抗病毒疗效的关系。方法 用单克隆抗体ELISA法（mAbs ELISA）对深圳市165例HBV感染者进行HBV基因分型；随机抽取24例慢性乙型肝炎（CUB）患者，用基因芯片技术检测HBV前C／C启动子变异；回顾性分析HBV基因型与干扰素、贺普丁抗HBV疗效的关系。结果 ①165例患者中，以B型106例（64.2％）和C型48例（29．1％）为主。慢性无症状乙肝病毒携带者（ASC）组B型占95．4％，肝硬化（LC）组C型占64．7％（P〈0．05）。②24例CHB患者中，16例（10例B型，6例C型）发生HBV前C／C启动子变异：前C区变异（nt1896、1862）者10例（B型9例，C型1例）。基本C区启动子变异（BCP）变异（nt1762、1764）者6例（B型1例，C型5例）。③用干扰素治疗的27例HBeAg（＋）CHB患者，达到完全应答者B型11例（62．5％）较C型1例（9．1％）多见（P〈0．05）。用贺普丁治疗的29例HBeAg（＋）CHB患者，持续应答者B型15例（78．9％）较C型3例（30．0％）多见（P〈0．05）。结论 ①深圳市HBV基因分型以B型为主，C型次之。②C型较B型易发生BCP变异，发生肝硬化机会较高，且对于扰素及贺普丁疗效较差。

Relationship between Shenzhen HBV genotype and precore/core promoter mutation and antiviral effects

BACKGROUND: To study the relationship between hepatitis B virus genotyping Shenzhen isolates and HBV precore/core promoter mutation and antiviral effects. METHODS: The HBV genotyping of 165 patients with HBV was carried out with mAbs ELISA. HBV precore/core promoter mutation was detected with gene chip technology in 24 patients with CHB. The relationship between HBV genotyping and interferon, lamivudine effects was analyzed. RESULTS: (1) Out of 165 cases, 106 (64.2%) of type B but 48 (29.1%) of type C were found. Type B accounted for 95.4% in group ASC, and type C for 64.7%in group LC (P<0.05). (2) Precore/core promoter mutation was found in 16 cases (10 of type B, and 6 of type C) out of 24 cases. Out of 16 cases, precore/core promoter mutation (nt1896, 1862) was found in 10 cases (9 cases of type B and 1 case of type C), while basal core promoter mutation (BCP mutation, nt1762,1764) was found in 6 cases (1 case of type B and 5 of type C). (3) Among 27 patients with CHB HBAg (+) treated with interferon, 11 cases of type B but 1 case of type C were tested to be fully responsive to interferon. Among 29 patients with CHB HBAg (+) treated with lamivudine, 15 cases of type B but 3 cases of type C were tested to be continuously responsive to lamivudine. CONCLUSION: (1) HBV genotype popularity in Shenzhen area was classified as type B the first and type C the second. (2) Type C seems more apt to develop BCP mutation and cirrhosis, and to be less responsive to interferon or lamivudine.