我国部分地区静脉吸毒人群HCV基因型分布的探讨

目的了解静脉吸毒人群丙型肝炎病毒(HCV)感染者的基因亚型分布及影响因素,为防治静脉吸毒人群感染HCV提供依据。方法收集828份静脉吸毒人群样本,HCV抗体初筛用酶联免疫吸附试验(ELISA),有反应性的样本再用重组免疫印迹法(RIBA)进行补充试验,阳性的样本进行核酸检测;核酸阳性的样本先用HCV基因分型试剂盒进行分型,未通过分型试剂盒确定型别的样本,再用巢式聚合酶链式反应扩增HCV CORE区进行测序,以确定HCV基因型。结果 828份静脉吸毒人群样本中,HCV抗体阳性498份,核酸检测呈阳性反应的样本390份,通过HCV基因分型试剂盒确定型别的样本311份,经CORE区测序确定型别的样本70份,有9份未成功扩增出序列,共有381份样本确定了基因亚型。其主要基因亚型为3b、3a、1b、6n及6a五种型别,分别占38.6%(147/381)、20.5%(78/381)、18.6%(71/381)、10.8%(41/381)、8.7%(33/381);不同地区之间流行的HCV基因型别差异具有统计学意义(χ~2=282.23,P0.01);男性和女性之间主要基因型不太一致;各年龄段间HCV基因亚型分布的差异无统计学意义(χ~2=40.93,P0.05),但30~50岁感染者居多。不同基因型之间HCV核糖核酸含量的差异有统计学意义(F=5.85,P0.01)。结论静脉吸毒人群HCV感染者的基因亚型主要为1b、3a、3b、6a及6n,基因型分布具有地域性差异,并且病毒载量与基因型的分布具有相关关系。     

河南部分地区HIV/HCV合并感染者HCV基因型的分布特征

目的了解河南部分地区艾滋病病毒(HIV)合并丙型肝炎病毒(HCV)感染者HCV基因型的分布特征。方法收集河南地区129例HIV/HCV共感染患者,119例单纯HCV感染患者,采取横断面调查的方法,收集研究对象的年龄、性别、职业、HIV传播途径等人口学资料,并进行HCV-核糖核酸(RNA)及HCV基因分型检测,结果录入数据库,用SPSS 23.0软件统计分析。结果该地区HIV/HCV合并感染者HCV基因亚型1b型最多,占54.3%(70例)。其次为2a型,占44.2%(57例)。单纯HCV感染者HCV基因亚型1b型最多,占70.6%(84例);其次为2a型,占26.1%(31例);3b和6a型各占0.8%(各1例)。两组患者间HCV基因型分布差异有统计学意义(χ2=10.578,P0.05),HIV/HCV合并感染者的HCV1b型所占百分比(54.3%)低于单纯HCV感染者(70.6%),而HCV 2a型所占百分比(44.2%)高于单纯HCV感染者(26.1%)。HIV/HCV合并感染者中,HCV1b型在经血感染中占92.9%(65/70),HCV2a型经血感染者中占98.2%(56/57)。结论河南部分地区HIV/HCV合并感染者的HCV基因分型以1b型为主,2a型次之,与单纯HCV感染者HCV基因型分布相似,经血感染是主要的传播途径。     

广西地区HIV合并HCV感染人群HCV基因型分布特征

目的了解广西地区艾滋病病毒(HIV)和丙型肝炎病毒(HCV)感染人群HCV基因型的分布特征。方法收集广西地区51例HCV RNA阳性HIV感染者的血清,通过对反转录巢式聚合酶链反应(RT nested-PCR)扩增HCV NS5B区段,所得终产物直接测序进行HCV基因分型。结果在51例样本中,HCV基因型以3b和6a型为主,各占23.53%(12/51),其次为1a型,占19.61%(10/51);3a型、1b型、6d型分别占13.73%(7/51)、9.80%(5/51)、1.96%(1/51),2a型、6e型各占3.92%(2/51)。分析表明,HIV合并HCV感染者的HCV基因在性别、年龄、感染途径分布差异没有统计学意义(P0.05)。结论广西地区HIV合并HCV感染者流行的HCV基因亚型至少有1a、1b、2a、3a、3b、6a、6d、6e共8种,3b和6a可能为流行的主要基因亚型,1a型次之。初步说明广西地区HIV合并HCV感染人群流行的HCV基因亚型呈多样性,同时它们与性别、年龄及感染途径无明显相关性。     

四川地区丙型肝炎病毒基因型分布特点

目的研究四川地区丙型肝炎病毒(HCV)的基因型分布特点。方法收集成都市公共卫生临床医疗中心2016年1月至2017年12月收治的376例慢性丙型肝炎患者的HCV基因分型、HCV-RNA及肝功能结果,并对其进行回顾性分析。结果 376例患者共检测出5种基因型,包括1b型264例(70.21%)、2a型17例(4.52%)、3型72例(19.15%)、3b型55例(14.63%)和6a型23例(6.12%)。不同HCV基因亚型在性别、年龄、HCV-RNA及肝功能指标等方面比较,差异有统计学意义(P0.05)。3a型、3b和6a型以男性患者为主;2a型患者年龄最大,HCV RNA载量亦高于其他亚型;而6a型患者年龄最小,ALT、AST及TBil水平均低于其他亚型。结论四川地区HCV感染以基因1b型和3b型为主,不同基因亚型HCV感染者的病毒载量和肝功能具有一定差异。     

慢性丙型肝炎患者病毒基因分型与血清HCV RNA水平的关系探讨

目的研究HCV基因型的分布,以探讨不同基因型感染者血清HCV RNA载量的差异。方法采用PCR法检测218例慢性丙型肝炎患者血清HCV RNA;采用ELISA法检测抗-HCV抗体;使用全自动生化分析仪测定丙氨酸氨基转移酶;采用化学发光免疫分析法测定血清肝纤维化指标;采用基因芯片法进行HCV基因分型。结果在218例HCV RNA阳性血清中共检出9种基因型,分别是lb、2a、3a、3b、6型单基因型共208例和lb+2a、lb+3b、lb+6型、2a+3a共10例四种混合基因型,其中以lb型168例(77.1%)、2a型19例(8.7%)为主;在208例HCV单基因型感染患者中发现不同基因型感染者血清HCV RNA载量无统计学差异(F=0.932,P>0.05);在168例1b基因型和40例非lb基因型感染者,性别差异无统计学意义(x2=0.857,P>0.05),两型感染者之间肝纤维化指标差别比较也无统计学意义。结论我国HCV基因型以lb型为主,基因型与HCV RNA载量及ALT水平之间无相关性。     

长春地区出入境人员感染丙型肝炎病毒的基因分型研究

目的研究长春地区出入境人员感染丙型肝炎病毒(HCV)的基因型分布。方法收集42例丙型肝炎阳性者的血清标本,采用基因测序法进行HCV基因型检测和分析。结果 42份HCV阳性血清基因分型分别为1b、1a、2a,其中基因1型21份(占50%),1b亚型13份(占30.95%),1a亚型8份,2a亚型9份。HCV基因型性别、年龄分布差异无统计学意义(P0.05)。结论长春地区出入境人员感染的HCV以1b型为主,2a型次之。     

合肥地区丙型肝炎病毒基因分型分布特征

目的了解合肥地区丙型肝炎病毒(HCV)基因型分布特点。方法收集251例HCV患者的临床流行病学资料和外周静脉血,采用sanger测序法检测HCV基因型。结果合肥地区HCV患者中共检出4种基因型,8种基因亚型,以1b型最多占68.12%,其次2a、2i型占12.75%、10.36%,3a、3b、6a、6n、6v均有分布。各基因型在不同性别中的比较差异无统计学意义(P0.05);不同年龄段基因型相比较,差异有统计学意义(P0.05),在30～60岁年龄组,基因型分布最为广泛;在时间分布上,早期HCV基因型较为单一,主要以1b和2a型为主,近年来基因1b型逐渐减少,2i、3a、3b、6a基因型逐渐增多,总的基因类型增多。经输血、血液透析、母婴传播感染患者基因型主要为1b、2a及2i型,性转播、其他途径(拔牙、纹身、纹眉、穿耳、职业暴露等)传播以基因1b型为主,2a、2i、3a、3b型均有分布,而静脉吸毒患者基因型分布较为广泛,1b、2a、2i、3a、3b、6a、6n、6v均有分布。结论合肥地区的HCV基因分型呈多样化,以1b型为主,其次为2a、2i型,同时存在3a、3b、6a、6n、6v基因型。     

广东省单纯丙型肝炎病毒及其与人类免疫缺陷病毒共感染者丙型肝炎病毒的基因亚型分析

目的 了解广东省人类免疫缺陷病毒(HW) /HCV共感染者与单纯HCV感染者的感染途径、HCV的基因亚型分布及其遗传特征,为丙型肝炎病毒感染的治疗与预防提供依据. 方法采用巢式逆转录-聚合酶链反应扩增广东省95例HIV/HCV共感染者及99例单纯HCV感染者HCVNS5B基因区域,扩增产物测序后进行HCV基因亚型分析,遗传分析利用MEGA4软件.不同种基因亚型型内基因距离以碱基置换率表示.结果 HIV/HCV共感染者HCV有5种基因亚型,其中6a型占53.7％ (51/95)、3a型占17.9％ (17/95)、1b型占15.8％ (15/95)、3b型占11.6％ (11/95)、1a型占1.0％(1/95);1b亚型内基因距离为6.30％±1.27％,高于其他基因亚型.HIV/HCV共感染者主要通过静脉注射毒品感染(75/95,78.9％),其基因亚型主要为6a型,占60.0％ (45/75).单纯HCV感染者HCV有7种基因亚型,其中1b型占67.7％ (67/99)、6a型占17.2％(17/99)、3a型占6.1％ (6/99)、2a型占5.％(5/99)、3b型占2.0％(2/99)、4a型占1.0％ (1/99)、5a型占1.0％(1/99);1b亚型内基因距离为5.17％±1.03％,高于其他基因亚型.单纯HCV感染者主要通过输血或血液制品感染(80/99,80.8％),其HCV基因亚型主要为1b型,占76.2％ (61/80).结论 广东地区HIV/HCV共感染者及单纯HCV感染者HCV基因亚型呈现多样性,HIV/HCV共感染者与单纯HCV感染者主要感染途径不同,HCV主要基因亚型也不同.     

山东地区慢性HCV感染者病毒的基因型分布

目的明确山东地区慢性丙型肝炎及丙肝肝硬化患者感染丙型肝炎病毒(HCV)的基因型分布,探讨HCV基因型与肝脏疾病严重程度及感染途径之间的关系。方法根据HCV 5′非编码区(NCR)设计基因芯片,对山东地区慢性HCV感染者(慢性丙型肝炎128例,丙肝肝硬化42例)应用基因芯片法检测HCV基因型,并对其中22份标本进行测序,比较慢性丙型肝炎、肝硬化病人HCV基因型分布以及不同途径感染的病HCV人基因型分布的差别。结果 168例患者标本可以分型,HCV基因型分别为:1b型106例,2a型48例,1a及3b型均为2例,1b+2a混合型9例,1a+1b混合型1例;对22例患者标本测序,1b型12例,2a型9例,3b型1例,与基因芯片法检测结果完全一致;肝硬化和慢性肝炎病人的HCV基因型分布差异无统计学意义(χ2=1.82,P>0.05),有输血史者和无输血史者HCV基因型分布差异无统计学意义(χ2=7.63,P>0.05)。结论山东地区HCV主要流行株是基因1b型,其次为2a型,同时有少量的1a、3b型以及混合感染,HCV基因型与疾病的进展及感染途径无关。     

静脉吸毒致获得性免疫缺陷病毒-1型感染者合并丙型肝炎病毒亚型的分析

目的了解静脉吸毒致获得性免疫缺陷病毒1型(HIV1)感染者混合HIV感染丙型肝炎病毒(HCV)亚型的分布情况。方法采用abbott公司的MurexHCVSerotyping16Assay检测12例单纯HCV感染者及25例静脉吸毒导致HIV1感染者(其中重叠HCV感染的患者12例)HCV不同亚型的抗体,确定HCV的基因亚型。结果12例单纯HCV感染者中HCV1型7例(58.3%),3型2例(25%),4 6型1例(8.33%),6型(包括重叠4型)2例(16.67%)。12例静脉吸毒者中HCV1型7(58.33%),6型4例(33.3%),1 3型1例(8.33%),3型(包括重叠1型)3例(25%)。结论单纯HCV感染者和合并HIV1感染的HCV感染者体内HCV以1型为主,并且均存在2种亚型共感染的现象。     

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。     

Virological characteristics of HCV infection in Japanese haemophiliacs

It has been found that almost all haemophiliacs treated with pooled concentrates of clotting factor VIII or IX before 1985/6 have been infected with hepatitis C virus (HCV). In order to clarify the characteristics of HCV infection in Japanese haemophiliacs, we investigated the HCV genotype and HCV-RNA level in 80 patients with haemophilia who had been confirmed to be positive by a second-generation HCV antibody test. HCV-RNA was detected in 60 (75.0%) individuals and various HCV genotypes were found. Although 80% (48/60) of the patients had genotype 1b, the frequency of each genotype was quite different from that in HCV-infected non haemophiliac Japanese. Particularly, multiple HCV genotypes were observed in 27 (46.7%) patients. The mean (± SD) level of HCV-RNA was 5.3 × 10⁵ ±  1.1 × 10⁶ copies mL⁻¹. The viral load in patients with genotype 2a was significantly less common than those with genotype 1a ( P = 0.0007), genotype 1b ( P = 0.0009) and combined genotype 1a/1b ( P = 0.0019). In patients co-infected with human immunodeficiency virus (HIV), the HCV-RNA level was significantly higher ( P = 0.05) than in those without co-infection. However, there was no significant difference ( P = 0.25) in the HCV-RNA level with HCV/HIV co-infection among the 40 patients with group 1 genotypes. We conclude that this biased distribution of HCV genotypes in Japanese haemophiliacs reflects their specific mode of HCV infection. Moreover, these results suggest that super-infection with HIV does not greatly influence the HCV load in patients with no marked immunological deterioration.     

Hepatitis C virus genotypes and associated risk factors in the state of Pará, Northern Brazil

BackgroundDespite the emergence of more effective therapies, hepatitis C virus (HCV) infection remains a serious public health problem at the global level. Currently, this virus is classified into seven genotypes and 67 subgenotypes, which in turn are distributed heterogeneously in Brazil and worldwide. Studies have shown that this genetic divergence results in differences in the progression of chronic disease associated with HCV infection and its treatment.ObjectiveThe aim of this study was to report the frequency of HCV genotypes in the state of Pará, Northern Brazil, and to assess the association between genotype and different clinical and laboratory characteristics, as well as risk factors for infection.MethodData from 85 medical records of untreated patients who had chronic hepatitis C infection were analyzed; the patients were evaluated at two hospitals in Belem, Pará, Brazil.ResultsCirculation of genotypes 1 and 3 was detected, with a higher prevalence of genotype 1 (75.3%) than genotype 3 (24.7%). In addition, there was a predominance of subgenotype 1b (60.34%) compared to 1a (20.69%) and 3a (18.97%). Reuse of needles and/or glass syringes was significantly associated with infection by HCV genotype 1 than genotype 3; however, the small number of patients infected with genotype 3 may have biased the results. No associations between genotype and the evaluated clinical and laboratory characteristics were observed.ConclusionThis study reinforces the differences in the distribution of HCV genotypes in Brazil and showed no association between HCV genotype and progression of chronic hepatitis C in the studied group.     

Hepatitis C virus infection among HIV-1 infected individuals from northern Mexico

Aims: The prevalence of hepatitis C virus (HCV) infection, risk factors and HCV genotypes in 140 HIV-1 infected individuals from northern Mexico was determined. Methods: Hepatitis C infection was confirmed by the detection of anti-HCV antibodies and HCV-RNA in sera, and genotyping was performed by the InnoLiPA-HCV genotype assay. Results: Seventeen (12.1%) out of 140 HIV-infected individuals were found to be HCV-positive. Coinfected individuals were more likely to be male (87%). The most frequent genotype was 1a (41%), followed by 1b (29.4%), 2a/c (17.6%), 2b (5.9%) and 3 (5.9%). Serum transaminase concentrations (AST and ALT) were higher in coinfected patients. Among the risk factors for coinfection: sexual transmission was the most frequently observed (men who have sex with men (MSM); 64.7% and bisexual behavior; 64.7%) followed by intravenous drug users (IVDU) (53%). There was no association of the HCV genotypes with the age and risk factors for HIV-1 and HCV infection observed in the studied patients. Conclusion: The results suggest that the prevalence of HIV-1/HCV coinfection in Mexico is lower than in other American countries.     

Relationship between genotypes of hepatitis C virus and histopathological manifestations in chronic hepatitis C patients

OBJECTIVE: The aim of this study was to assess the relationship between HCV genotype and histological liver injury. DESIGN: Prospective study on a cohort of patients with biopsy proven chronic hepatitis C. SETTING: University medical centre. PARTICIPANTS: Enrolled were 324 consecutive patients (male 197, median age 52 years, range 19-68; chronic hepatitis, 224; cirrhosis, 100). METHODS: HCV genotype was determined by the INNO LiPA assay and HCV RNA levels by the bDNA assay. The histological features were scored according to the histology activity index. RESULTS: The distribution of HCV genotypes was 1a, 4.6%; 1b, 52.4%; 2a/c, 27%; 3a, 8%; 4, 2%; mixed, 6%. Serum HCV RNA levels were similar for all genotypes. There was no difference in the distribution of HCV genotypes between patients with chronic hepatitis and those with cirrhosis. Patients with genotype 1b and those with type 2a/c showed a similar prevalence of cases of cirrhosis (33% versus 31%, respectively). In addition, in a subgroup of 102 patients with an established date of infection, the progression to cirrhosis occurred with a similar length of time for HCV type 1b and 2a/c (median 16 versus 15 years, respectively). Patients with HCV genotype 2a/c or mixed genotype showed a higher histology activity index than those with type 1b (P< 0.01), whereas there was no difference in the fibrosis score for the different genotypes. Patients with genotype 3a showed a significantly higher prevalence of steatosis compared to those infected with other genotypes. Alanine aminotransferase (ALT) values were higher in patients with HCV type 2a/c, 3a and mixed genotype than those with type 1 (P < 0.002). CONCLUSIONS: The data indicate that there is no association between a particular HCV genotype and the progression to cirrhosis, and that specific genotypes are associated with distinct histopathological and biochemical manifestations although none of them is correlated with an increase of the fibrosis stage.     

山东地区丙型肝炎病毒的基因型及血清学分型的研究

探索山东地区丙型肝炎病毒(HCV)的基因型及血清学分型的分布,了解HCV基因型与感染途径的关系.对96例抗HCV阳性患者的血清进行HCV RNA检测,HCV RNA阳性者,应用限制性片段长度多态性分析(RELP)进行基因分型;同时应用Murex Serotyping HCV 1-6血清学分型试剂进行血清学分型.基因非2(1b)型79例,占83.16%,2(2a)型为16例占16.84%,44份血清标本的血清学分型可分型率为90.91%,与基因分型的符合率为90.00%.不同的感染途径之间,基因型分布没有差异(P=0.15).山东地区丙型肝炎病毒流行株为基因非2(1b)和2(2a)型,非2(1b)型为优势株,基因分型与血清学分型结果基本一致,基因型与丙型肝炎的感染途径无关.     

Changing pattern of clinical epidemiology on hepatitis C virus infection in southwest china

Background

The changing pattern of hepatitis C virus (HCV) infection could have a significant impact on future medical prevention practices and therapies.

Objectives

The purpose of this study was to describe the changing pattern of HCV infection in southwest China using clinical epidemiology, and to assess the association between the genotypes distribution and certain potential risk factors.

Patients and Methods

A retrospective analysis which included 1208 subjects with chronic HCV registered at the Southwest Hospital (Chongqing, Southwest China) was performed. The information was reviewed and the data collected from clinical records and short telephone interviews when necessary. HCV genotypes were determined by nucleotide sequencing of the CE1 regions followed by phylogenic analysis with the published HCV genotype. HCV genotype distribution was analyzed according to the patients'' age, gender, risk exposure, and the initial risk exposure.

Results

Among the 1 208 patients, the HCV subtype 1b was the most prevalent (32.9%), followed by subtype 3b (18.9%), 6a (18.0%), 3a (12.8%) and 2a (10.4%), while subtypes 1a and 6k accounted for cases of HCV infection in only 9 and 3 cases respectively. Individuals older than 40 years were mainly infected with subtypes 1b and 2a, whereas younger patients were predominantly infected with genotypes 3 and 6. Subtypes 1b and 2a were observed more frequently among 44.4% and 16.0% patients respectively, with a history of invasive operations. Subtypes 3b and 6a constituted the majority of HCV infections among intravenous drug users (IDUs) (28.7% and 34.9%, respectively). A significant difference (P < 0.001) was observed between the HCV genotype distributions, according to the potential route of infection.

Conclusion

In southwest China, the most common remaining subtype is the 1b genotype, but this has declined significantly among young patients. This is followed by subtype 3b and 6a which has increased significantly, especially among young patients. The distribution of such genotypes was also variable according to gender and age. The changing pattern of HCV infection was associated with changes in the modes of HCV acquisition, which raises an alarm signal concerning the major steps that need to be taken in order to reduce such infections in southwest China.     

Chronic hepatitis C in Sweden: genotype distribution over time in different epidemiological settings.

Hepatitis C virus (HCV) strains are divided into 6 genotypes and several subtypes. Recent studies reported a change in the relative frequency of genotypes within certain regions. We studied the HCV genotype in 312 Swedish patients with chronic hepatitis C, using a core region primer-specific PCR, and grouped the patients according to parenteral risk factors. The date of infection could be estimated in 127 cases. Genotypes 1a (35%) and 3 (31%) were the most common genotypes, followed by genotype 2 (17%), while only 6% had genotype 1b. Genotype 3 was relatively more frequent among subjects infected sexually or by intravenous drug use. The genotype distribution was different from that in studies from other parts of the world, with a lower frequency of genotype 1 (especially 1b) and a higher frequency of genotype 3. The frequency of genotype 1b has decreased and genotype 3 increased over time. The reasons for a different distribution of genotypes in Sweden, compared with other countries, might be a relatively recent introduction of HCV into the population, or a different pattern of transmission.