中国HCV基因型分布的Meta分析*

目的 分析中国不同地区、民族和感染途径人群丙型肝炎病毒(HCV)基因型的分布特点。方法 通过检索万方数据库和NCBI数据库中有关中国HCV基因型分布的文献,按照地区、民族和感染途径进行数据分类,应用Meta分析研究HCV基因型的分布特点。结果 在我国,HCV1型流行最广泛,北部地区主要为1型(52.7%～79.7%)和2型(13.9%～44.9%),东南部地区主要为1型(51.7%～79%),6型在香港(31.3%)、广东(23.1%)、福建(21.8%)、澳门(20.6%)地区分布较多,西南部地区主要为1型(19.7%～73.4%)和3型(13.4%～58.5%),西部地区主要为1型(53.6%～66.8%),也有较多的2型(15.8%～32.1%)和3型(12.8%～15.8%);朝鲜族2型比例(42.2%)显著高于汉族(22.4%,P<0.001)、维吾尔族(13.1%,P<0.001)和哈萨克族(18.5,P=0.004),维吾尔族3型比例(16.6%)显著高于汉族(9.4%,P<0.001);静脉吸毒人群感染HCV 3型比例(31.1%)显著高于血液感染相关人群(4.5%,P<0.001)、性传播感染人群(24.1%,P=0.003),静脉吸毒人群感染HCV6型比例(26.7%)显著高于血液感染相关人群(4.1%,P<0.001)和性传播感染人群(15.1%,P<0.001);在HCV/HIV混合感染者中3型和6型比例显著高于单纯HCV感染者(P<0.001)。结论 在不同地区、民族和感染途径人群中HCV基因型分布存在显著性差异,了解这些差异并进行针对性的处理可能有助于防治研究。

Meta-analysis on distribution of hepatitis C virus genotypes in China

Objective The aim of this study was to investigate the distribution of hepatitis C virus (HCV) genotypes among people in different regions, ethnic groups and transmission risk factors in China. Methods Papers on the studies of HCV genotypes in China were searched in Wanfang and NCBI database, and the data was classified by different regions, ethnic groups, and transmission risk factors. The data was analyzed by meta-analysis to observe the distribution of genotypes. Results In China, the HCV genotype 1 was the most prevalent, the HCV genotypes were mainly genotype 1 (52.7%-79.7%) and genotype 2 (13.9-44.9%) in the northern region, the HCV genotypes were mainly genotype 1 (51.7%-79%) in the southeast region, and the genotype 6 was widely distributed in Hong Kong (31.3%), Guangdong (23.1%), Fujian (21.8%) and Macau (20.6%); the HCV genotypes were mainly genotype 1 (19.7%-73.4%) and genotype 3 (13.4%-58.5%) in the southwest region; the main genotypes distributed in the western region were genotype 1 (53.6%-66.8%), genotype 2 (15.8%-32.1%) and genotype 3 (12.8%-15.8%); the proportion of genotype 2 in Korean nationality was (22.4%, P<0.001), in Uyghur(13.1%, P<0.001) and in Kazakh (18.5%, P<0.05), and the proportion of genotype 3 in Uyghur was 16.6%,significantly higher than 9.4% of the Han nationality 42.2%, significantly higher than that in Han (P<0.001); the proportion of genotype 3 in persons with intravenous drug use was 31.1%, significantly higher than with blood transmission infected (4.5%, P<0.001) or sexual transmission infected (24.1%, P<0.05), and the proportion of genotype 6 infection in intravenous drug users was 26.7% , significantly higher than by blood transmission infection (4.1%, P<0.001) or by sexual transmission infection (15.1%, P<0.001); the proportion of type 3 and type 6 in individuals with HCV/HIV mixed infection were higher than that in with HCV infection alone (all P<0.001). Conclusion There are differences in the distribution of HCV genotypes among individuals in different regions, in different ethnic groups and with different transmission routs.