感染乙型肝炎病毒不同基因型和亚型患者的临床特点分析

目的明确乙肝病毒不同基因型和亚型在国内的分布及其与病情的相关性。方法收集来自国内8个地区884例慢性乙型肝炎病毒感染者的血清和临床资料,用PCR-RFLP方法鉴定病毒基因型和亚型,分析不同基因(亚)型与病情间的相关性。结果乙肝病毒B(20.77%)和C (78.22%)基因型为最常见,仅1例为D基因型;所有B基因型均为Ba亚型,C基因型中仅发现C2和C1亚型。北方地区患者多感染C基因型(83.62%)/C2亚型(90.32%)。B基因型患者的年龄明显小于C基因型患者(P<0.000)。不同年龄段B基因型和C基因型比较发现,感染B基因型的患者在30岁以下、30～50岁和50岁以上年龄段中所占比例逐渐下降,感染C基因型的患者比例呈现相反趋势(P=0.000)。C1和C2亚型患者的年龄相近。各基因型在肝硬化、慢乙肝和无症状携带者中的分布无差别。B和C基因型(C1和C2亚型)患者的病毒量之间无差别。B基因型患者的肝脏炎症和纤维化评分明显低于C型患者(P<0.05)。结论北方地区以C基因型和C2亚型为主。B基因型患者的年龄明显小于C基因型。B和C基因型(C1和C2亚型)患者的肝脏炎症和病毒量之间无差别。B基因型患者的肝脏炎症和纤维化评分明显小于C型患者。

Clinical characteristies and distribution of hepatitis B virus genotype and sub-genotype

Objective To determine the distribution and virologic characteristics of HBV genotypes, sub-type and possible association with the severity of liver disease.Methods 884 patients infected with HBV were enrolled from 8 provinces in China.HBV genotype and sub-type was determined,using PCR- RFLP method,Results The most common HBV genotypes were B(20,77%)and C(78.22%)but only 1 patient showed genotypes D.We found sub-type Ba in patients with genotype B,C1 and C2 sub-type in patients with genotype C.Genotype C(83.62%)and sub-type C2(90.32%)were predominant in northern China.Patients with genotype B were much younger than those with genotype C.There was no significant difference between patients with sub-type C1 and C2.There was no significant difference in liver function and serum HBV-DNA load between patients with genotype B and C,or between patients with sub- type C1 and C2.However,hepatic inflammation and fibrosis score in patients with genotype B were significantly lower than those with genotype C.Conclusion There were no significantly differences in liver function and HBV-DNA load between patients with genotype B and C,or between patients with sub-type C1 and C2.Hepatic inflammation and fibrosis score in patients with genotype B were significantly lower than those with genotype C.Genotype G/sub-type C2 were preponderance in northern China.