湖南省乙肝病毒基因型分布及临床意义

目的 :研究湖南省乙肝病毒 (HBV)基因型分布及临床意义。方法 :选择湖南省HBVDNA阳性慢性乙肝病人共 185例 ,其中病毒携带者 (ASC) 4 2例 ,慢性轻、中度肝炎 (CH) 38例 ,重型肝炎 (FHF) 80例 (伴有肝硬化者 4 9例 ) ,肝细胞癌 (HCC) 2 5例 ,采用聚合酶链反应 限制性片段长度多态性 (PCR RFLP)方法检测HBV基因型。结果 :基因型B136例 (73.5 % ) ,基因型C 4 9例 (2 6 .5 % )。基因型B在FHF中占绝对优势 (83.7% ) ,其次为HCC(76 % ) ,与ASC(5 7.1% )比较 ,差异有显著性 (P <0 .0 1)。与基因型B相比 ,基因型C在垂直传播感染者中多见 (38.8%与 13.2 % ,P <0 .0 0 1) ;HBeAg阳性率明显增高 (5 7.1%与 30 .9% ,P <0 .0 0 1) ;抗HBe阳性率明显下降 (36 .9%与 6 6 .2 % ,P <0 .0 0 1)。与基因型C相比 ,基因型B感染者ALT水平明显增高 (2 6 4 .5± 2 5 6 .5与 10 0± 12 0 .6 ,P <0 .0 0 1)。结论 :湖南省存在乙肝病毒基因型B和基因型C ;基因型B为优势基因型并与肝脏疾病活动性相关 ,基因型C与母婴垂直传播感染有关

Distribution of hepatitis B virus genotype in Hunan Province and its clinical significance

Objective To study the distribution of hepatitis B virus genotype in Hunan Provine and its clinical significance. Methods HBV genotype was determined by the restriction fragment length polymorphism analysis in 185 PCR positive patients, including 42 asymptomatic HBV carriers (ASC), 38 chronic mild or moderate hepatitis (CH), 80 fulminant hepatic failure (FHF), and 25 hepatocellular carcinoma (HCC) patients in Hunan Province. Results Of the 185 patients ,136 (73.5%) were genotype B, and 49 (26.5%) were genotype C.There was a statistical significance in the distribution of genotype B between FHF and ASC, and between HCC and ASC (83.7% vs. 57.1%, 76% vs. 57.1%, P<0.01, respectively). Vertical transmission and HBeAg positivity were higher in genotype C than in genotpye B (38.8% vs.13.2%,57.1% vs.30.9%, respectively,P<0.001). The ALT value was significantly higher in genotype B than in genotpye C (P<0.001). Conclusion Genotypes B and C exist in Hunan . Genotypes B is the major genotype in this area and associated with the development of severe liver diseases. Genotype C is associated with vertical transmission.