新疆维吾尔族慢性乙型肝炎患者HBV基因型分布及其特点

目的探讨新疆维吾尔族慢性乙型肝炎患者HBV基因型分布及其特点。方法采用型特异性引物巢式PCR法对127例维吾尔族慢性乙型肝炎患者进行基因分型,并测序验证。结果基因D型占39．4%（50/127）,基因B型占22．0%（28/127）,基因C型占16．5%（21/127）,基因BD混合型占9．4%（12/127）,基因CD混合型占8．7%（11/127）,基因BCD混合型占3．9%（5/127）; HBeAg阳性与HBeAg阴性的维吾尔族慢性乙型肝炎患者基因型分布,差异无统计学意义（x^2= 6．033,P＞0．05）;不同年龄维吾尔族慢性乙型肝炎患者HBV基因型分布差异无统计学意义（x^2= 3．137,P＞0．05）;不同性别维吾尔族慢性乙型肝炎患者HBV基因型分布差异亦无统计学意义（x^2= 8．058,P＞0．05）。结论新疆维吾尔族慢性乙型肝炎患者HBV基因型以D型占优势,其次可见B、C型及BD、CD、BCD混合型。同一疾病谱的慢性HBV感染者基因型分布可能与宿主HBeAg状态、年龄、性别无明显关系。     

Distribution of hepatitis B virus genotypes among patients with chronic infection.

Hepatitis B virus (HBV) can be classified into at least eight genotypes, A-H. We evaluated the distribution HBV genotypes among patients with chronic infection. METHODS: We consecutively evaluated adult patients with chronic HBV infection from Salvador, Brazil. Patients were classified according to HBV infection chronic phases based on HBV-DNA levels and presence of serum HBV markers. HBV-DNA was qualitatively and quantitatively detected in serum by polymerised chain reaction (PCR). Isolates were genotyped by comparison of amino acid mutations and phylogenetic analysis. RESULTS: One-hundred and fourteen patients were evaluated. HBV-DNA was positive in 96 samples. HBV genotype was done in 76. Mean age was 36 +/- 11.3. In 61 of 76 cases subjects were classified as inactive HBsAg carriers. Their mean HBV serum level was 1760 copies/ml and 53 of 61 were infected with HBV genotype A, seven with HBV genotype F and one with genotype B. Twelve of the 76 patients had detectable hepatitis B e-antigen (HBeAg) in serum. Ten were infected with HBV genotype A and two with genotype F; most had increased alanine aminotransferase and high HBV-DNA levels. Three patients were in the immunotolerant phase, two were infected with HBV genotype A and one with genotype F. HBV subtyping showed subtypes adw2 and adw4. CONCLUSIONS: HBV genotype A adw2 and genotype F adw4 were the most prevalent isolates found. We could not find differences in genotype distribution according to HBV clinical phases and DNA levels. We did not detect HBV genotype D in contrast to a previous study in our center with acute hepatitis B. All inactive HBsAg carriers had low HBV-DNA levels.     

乙型肝炎病毒基因型对拉米夫定治疗早期血清乙型肝炎表面抗原水平变化的影响

目的了解血清乙型肝炎表面抗原（HBsAg）水平在拉米夫定治疗早期的变化特点及乙型肝炎病毒（HBV）基因型在其中的作用。方法乙型肝炎e抗原（HBeAg）阳性且拉米夫定为初始抗病毒治疗的慢性乙型肝炎患者87例,雅培HBsAg Architect方法定量检测治疗基线和第12周血清HBsAg水平;采用聚合酶链反应联合限制性片段长度多态性分析的方法确定HBV基因型。结果所有患者治疗第12周血清HBV DNA水平下降（中位数4．31log10拷贝／ml,P〈0．001）。总的血清HBsAg下降至基线的57．99％（P〈0．001）,但主要发生在HBV基因B型患者（43例,P〈0．001）,在HBV基因C型患者变化不明显（43例,P=0．378）。血清HBsAg和HBV DNA变化（基线和12周）之间的正相关关系仅存在于基因B型（Rs=0．577,P〈0．001）,而在C型患者中不明显（Rs=0．068,P=0．686）。基线HBsAg水平低（比数比值为0．387,95％可信区间为0．188～0．794,P=0．010）和HBV基因C型感染（比数比值为4．083,95％可信区间为1．362～12．236,P=0．012）是导致32．2％（29例）患者血清HBsAg水平未下降的主要因素。结论在拉米夫定治疗HBeAg阳性慢性乙型肝炎的早期,超过30％的患者血清HBsAg水平并没有随着HBV DNA复制水平下降而下降,HBV基因C型感染和基线HBsAg水平低是其主要因素。     

慢性乙型肝炎患者HBV基因型和哑型分布调查

目的研究慢性乙型肝炎患者HBV基因型和亚型流行情况。方法应用HBV基因型和亚型特异性引物PCR法对北京、长春、大连、西安、石家庄、郑州和合肥7个城市660份HBV DNA阳性慢性乙型肝炎患者血清进行基因型和亚型分析。结果在660份HBV DNA阳性血清中,B基因型、C基因型和B／C混合感染分别为16．67％（110／660）、74．54％（492／660）和8．79％（58／660）;在C基因型中,C1亚型6例（1．22％）、C2亚型473例（96．14％）、C1／C2混合基因亚型13例（2．64％）;B基因型均为Ba亚型,B基因型和C基因型混合感染者均为Ba与C2亚型混合感染,未发现其他基因型和基因亚型;不同基因型感染患者HBeAg阳性率差异无统计学意义（P=0．153）;B基因型和C基因型患者之间血清HBV DNA水平差异无统计学意义（6．37±1．62lg copies／ml对6．29±1．76lg copies／ml）,但均高于B和C基因型混合感染患者（5．25±1．65lg copies／ml）。结论这7个城市慢性乙型肝炎患者以B基因型和C基因型感染为主,有部分B／C基因型混合感染。HBV亚型以Ba和C2亚型占优势。     

山东地区HBeAg阳性慢性乙型肝炎患者病毒基因型和亚型分布与临床

根据HBV全基因组序列差异≥8%或S基因序列差异≥4%,可将HBV分为A、B、C、D、E、F、G、H 8个基因型。目前已有报道,不同基因型可进一步分为不同的基因亚型。本研究对128例山东地区HBeAg阳性CHB患者HBV基因型、亚型及其临床意义进行了初步探讨。     

HBsAg疫苗冲击树突状细胞联合乙肝免疫球蛋白对慢性乙型肝炎及HBV携带者的疗效

目的:观察HBsAg疫苗冲击的树突状细胞与乙肝免疫球蛋白联合应用对慢性乙型肝炎的疗效．方法:慢乙肝患者66例每月1次注射HBsAg疫苗(106／次)冲击的树突状细胞,乙肝免疫球蛋白200 U／次,6次为1疗程,共2疗程,治疗结束后检查肝功能,HBV DNA定量及乙肝标志．结果:HBeAg阳性慢乙肝27例治疗后有7例显示完全应答,14例显示部分应答．HBeAg阴性的慢乙肝15例中有4例出现完全应答,8例显示部分应答．慢性HBV携带者13例中5例显示完全应答,2例表现为部分应答．11例非活动性 HBsAg携带者中2例出现完全应答．结论:HBsAg疫苗冲击的树突状细胞与乙肝免疫球蛋白联合可试用于慢乙肝的治疗．     

Spatial and chronological differences in hepatitis B virus genotypes from patients with acute hepatitis B in Japan

Genotypes of hepatitis B virus (HBV) were determined in 485 patients with acute hepatitis B from all over Japan. They were A in 92 (19%), Ba in 26 (5%), Bj in 32 (7%), C in 330 (68%) and D in 5 (1%). Sexual contacts were the main route of transmission in them. Overall, HBV persisted in only 5 of the 464 (1%) followed patients. Genotypes C accounted for more than 68% in northern as well as southern areas, contrasting with genotype A accounting for 34% in and around the Metropolitan areas. During 24 years from 1982 to 2005, genotype A increased from 5% to 33%, while genotype B gradually decreased from 26% to 8%. Fulminant hepatitis was significantly more frequent in infection with genotype Bj (41%) than those with the other genotypes (p < 0.01). The core-promoter double mutation (T1762/A1764) and precore stop-codon mutation (A1896) were more frequent in patients with fulminant than acute self-limited hepatitis (57% versus 15% and 58% versus 10%, respectively, p < 0.01 for both). In conclusion, genotype A distributes unevenly over Japan, prevails in younger patients through sexual transmission and has increased with years. Furthermore, fulminant outcome was more frequent in patients with genotype Bj than those with the other genotypes.     

乙型肝炎病毒基因分型及其临床意义

目的了解慢性乙型肝炎病毒(HBV)感染者HBV基因分型及其对慢性肝病的影响,为制定针对不同HBV基因型抗病毒的个体化方案提供分子病毒学依据。方法临床确诊的慢性乙型肝炎、乙型肝炎肝硬化及肝癌患者314例,采用RDB法对HBV进行基因分型检测。结果山西地区的200例慢性乙型肝炎患者所感染的HBV均为B和C基因型,分别占56%、26%,并存在混合感染(17%);C与B基因型患者相比,血清病毒载量高、肝脏损伤严重;混合感染的患者与单一基因型感染者相比病毒载量更高、肝损伤更严重;肝硬化患者感染的HBV主要为C基因型及B、C混合感染,且肝损害严重、病毒复制率高;肝癌患者中C基因型感染占42.19%,B、C混合感染占37.5%,B基因型感染可能与年轻患者肝癌的发生有关。结论B基因型HBV感染与C基因型及混合感染相比,病毒载量低、肝损害轻,但年轻患者应监测肝癌的发生;C基因型及混合感染的患者预后较差,肝硬化、肝癌发生率高,应进行积极有效的治疗,防止严重肝病发生。     

240例初治乙型肝炎患者的流行病学特征

目的 分析初治乙型肝炎患者的流行病学特征,着重阐明基因型分布与病毒标志物及临床自然转归的关系.方法 选择上海交通大学医学院附属第三人民医院2008年5月至2010年3月住院初治乙型肝炎患者共240例,既往均未进行抗病毒治疗.对其流行病学特征、肝功能、HBV血清标志物、HBV DNA载量等临床资料进行分析,并采用PCR-...     

Different pre-S deletion patterns and their association with hepatitis B virus genotypes

AIMTo investigate the associations of different types of pre-S deletions with hepatitis B virus (HBV) genotypes.METHODSThe sequences of the pre-S region, basal core promoter (BCP) mutation, and precore (PC) mutation were examined through direct DNA sequencing or clonal analysis and sequencing in 273 HBV carriers, namely 55 asymptomatic carriers, 55 carriers with chronic hepatitis (CH), 55 with liver cirrhosis (LC), 53 with liver cirrhotic hepatocellular carcinoma (LC-HCC), and 55 with noncirrhotic HCC. A total of 126 HBV carriers (46.2%) harbored pre-S deletions. The DNA sequences of pre-S deletion mutants from 43 age-matched genotype B (HBV/B)-infected carriers and 43 age-matched genotype C (HBV/C)-infected carriers were further examined, aligned, and compared.RESULTSNo significant difference was observed in the mean age distribution (P = 0.464), male sex (P = 0.805), viral load (P = 0.635), or BCP mutation (P = 0.117) between the HBV/B and HBV/C groups. However, the rate of PC mutation was significantly higher in the HBV/B-infected carriers than in the HBV/C-infected carriers (P = 0.003). Both genotypes exhibited a high rate of deletion in the C-terminal half of the pre-S1 region and N-terminus of the pre-S2 region (86.0% and 79.1% in the HBV/B group; 69.8% and 72.1% in the HBV/C group, respectively). Epitope mapping showed that deletion in several epitope sites was frequent in both genotypes, particularly pS1-BT and pS2-B2. Conversely, the rate of pS2-B1 deletion was significantly higher in the HBV/B group (72.1% vs 37.2%, P = 0.002), and the rate of pS2-T deletion was significantly higher in the HBV/C group (48.8% vs 25.6%, P = 0.044). Functional mapping showed that the rate of deletion in three functional sites (the nucleocapsid binding site, start codon of M, and site for viral secretion) located in the N-terminus of the pre-S2 region was significantly higher in the HBV/B group (P < 0.05). One type of N-terminus pre-S1 deletion mutant with deletion of the start codon of the L protein was frequently observed in the HBV/C group (20.9% vs 9.3%, P = 0.228), particularly in the LC patients (42.9% vs 12.5%). Different patterns of pre-S deletions were also found between the HBV/B and HBV/C groups according to different clinical outcomes. In CH patients, deletion in the site for polymerized human serum albumin was more frequent in the HBV/B group (88.9% vs 36.4%, P = 0.028). In the LC-HCC patients, the rate of deletion in the pre-S2 region was significantly higher in the HBV/B group than in the HBV/C group (P < 0.05).CONCLUSIONHBV/B- and HBV/C-infected carriers exhibit different patterns of pre-S deletion, which may be associated with the progression of liver diseases.     

Long-term clinical impact of occult hepatitis B virus infection in chronic hepatitis B patients

BACKGROUND/AIMS: Long-term clinical outcomes of occult hepatitis B virus (HBV) infection were studied. METHODS: Fifteen chronic hepatitis B patients were monitored for a median of 4.4 years (range 0.9-15.3) after hepatitis B surface antigen (HBsAg) seroclearance. Serum HBV DNA was measured by real-time detection polymerase chain reaction. Thirteen patients underwent liver biopsies at the end of follow-up and liver histology was evaluated by Ishak score. Liver HBV DNA was also measured for 12 patients. RESULTS: At the end of follow-up, HBV viremia was absent in 13 (87%) patients, and antibody titers to hepatitis B core antigen showed an inverse correlation with time from HBsAg seroclearance (r=-0.554; P=0.0040). However, all patients retained liver HBV DNA and tested positive for the covalently closed circular HBV DNA replicative intermediate. The hepatic HBV DNA loads had no relation to liver histology. Paired biopsies from 11 patients disclosed that each necroinflammatory score significantly improved after HBsAg seroclearance. Amelioration of liver fibrosis was also evident in eight (73%) patients (P=0.0391 by signed rank test). CONCLUSIONS: A long-standing but strongly suppressed HBV infection may confer histological amelioration after HBsAg seroclearance.     

广东省东莞地区慢性乙型肝炎患者HBV基因型分析

目的探讨东莞地区乙型肝炎患者HBV基因型的分布特点。方法采用PCR-微板核酸杂交-ELISA法检测HBVA—F基因型，采用荧光定量-聚合酶链反应法检测血清HBVDNA定量。结果在295例乙型肝炎患者中检出HBV基因型247例（83．7％），其中HBV基因C型占62．3％（154／247）、B型15．4％（38／247）、D型6．9％（17／247）、B／C混合型4．9％（12／247）、C／D混合型5．3％（13／247）、B／D混合型5．3％（13／247），48例未检出基因型；基因C型感染者之间无性别差异（x^2=0．043，P〉0．05）；各基因型患者血清HBVDNA水平无显著性相差，但与48例未检出基因型者比，后者HBVDNA水平明显降低（P〈0．01）。结论PCR-微板核酸杂交-ELISA法检测HBV基因型具有特异、敏感、简单和实用的特点，东莞地区乙型肝炎患者HBV基因型以C型为主，混合型比例相对较高，HBV复制强弱与病毒基因型无关。     

拉米夫定治疗无良好应答患者乙型肝炎病毒P区突变与基因型的关系

目的 观察拉米夫定治疗后无良好应答的慢性乙型肝炎患者HBV P区变异情况与基因型的关系.方法 对631例拉米夫定治疗后无良好应答的慢性乙型肝炎患者进行研究.通过荧光定量PCR或核酸测序确定HBV基因型,直接测序观察P区突变,实时荧光定量PCR方法检测患者病毒载量,比较不同基因型患者的HBV DNA水平及HBV P区变异情况.计量资料采用成组设计资料t检验,计数资料采用x~2检验或Fisher精确检验.结果 631例慢性乙型肝炎患者中,B基因型HBV感染者272例,C基因型感染者359例,C基因型感染者患者年龄为(39.1±11.4)岁,明显大于B基因型感染患者的(33.7±9.7)岁(t=-6.55,P<0.01).C基因患者病毒载量为(5.96±1.22)log_(10)拷贝/ml,高于B基因型患者的(5.58±1.21)log_(10)拷贝/ml,t=-2.01,P<0.05.A181V/T变异在C基因型的发生率高于B基因型(0.4%比5.3%,χ~2=12.23,P<0.01),M204I/V,L180M、T184A/G/I/S、S202G/I和V173L变异发生率在B、C基因型之间差异无统计学意义(P值均>0.05).M204I在B基因型的发生率为20.6%,高于C基因型的13.9%(χ~2=4.91,P<0.05);M204V和M201Ⅳ变异在B、C基因型中的发生率差异无统计学意义(χ~2值分别为1.70和2.21,P值均>0.05).拉米夫定耐药发生率在B、C基因型间差异无统计学意义(χ~2=0.00,P>0.05).结论 拉米夫定常见耐药位点在B、C基因型之间无明显差异,但是C基因HBV感染患者病毒载量高于B基因型HBV感染患者;M204I变异在B基因型中出现频率高于C基因型,拉米夫定加用或改用阿德福韦酯后可能会使A181V/T变异在C基因型出现的概率高于B基因型;年龄、免疫因素和非常见位点的变异或许是影响拉米夫定疗效的重要因素.     

聚乙二醇干扰素α-2a治疗慢性乙型肝炎合并脂肪肝的临床疗效

目的探讨慢性乙型肝炎(CHB)合并脂肪肝对聚乙二醇干扰素α-2a(PEG-IFNα-2a)临床疗效的影响。方法选择2006年6月-2012年6月于广西科技大学第一附属医院住院的CHB并脂肪肝患者248例,根据脂肪肝程度分为轻度组173例、中度组55例、重度组20例,分析脂肪肝的危险因素,观察3组患者12个月时的病毒学应答、生化学应答、完全应答情况。另选取同期单纯CHB患者82例作为对照组。结果 4组患者在男性构成比、年龄、CHO、TG、ALT、HBV DNA载量、BMI、胰岛素水平差异均有统计学意义(P均0.05),而病程差异无统计学意义(P0.05);CHB患者合并脂肪肝与患者性别、年龄、CHO、TG、ALT、HBV DNA载量、BMI、胰岛素水平密切相关(P0.05);对照组患者HBV DNA转阴、病毒学应答与3个脂肪肝组差异无统计学意义(P0.05),但ALT复常率、完全应答率明显高于3个脂肪肝组,且随着脂肪肝病变严重程度的增加而降低(P0.05)。结论肝细胞脂肪病变不会影响PEG-IFNα-2a治疗CHB患者的病毒学应答,但会影响ALT复常率、完全应答率,在采用PEG-IFNα-2a治疗CHB过程中,采取相应的治疗措施提高患者ALT复常率及完全应答率,提高临床疗效,改善患者生存质量。     

Evaluation of hepatosteatosis in patients with chronic hepatitis B virus infection

Background and study aimsThe current study aimed to investigate the frequency of hepatic steatosis in chronic hepatitis B (CHB) patients and determine the possible risk factors associated with its presence.Patients and methodsThis cross-sectional study retrospectively evaluated the medical records of 255 adult CHB patients visiting an infectious disease outpatient clinic. Patients with hepatitis B surface antigen positivity for >6 months and those who did not receive antiviral therapy were included in the study. The presence and stage of hepatic steatosis were determined through hepatobiliary ultrasonography.ResultsThe mean age of the patients was 40.6 ± 12.7 years. Hepatic steatosis was detected in 44.4 % of the patients through ultrasound imaging. Our findings showed that the detected steatosis prevalence in our patients with CHB was significantly higher compared to the highest prevalence of non-alcoholic steatohepatitis found in the general Turkish population (19.9 %) [RR 2.23 (1.75–2.86), p < 0.001]. CHB patients with steatosis had significantly higher age, triglyceride, and gamma-glutamyl transferase levels than those without steatosis (p < 0.05). No significant association was found between the presence of steatosis, sex, liver function test results, and platelet, alkaline phosphatase, cholesterol, alpha fetoprotein, or HBV-DNA levels. No significant relationship was found between aspartate aminotransferase (AST)/platelet ratio index (APRI) and steatosis was examined (p > 0.05). Post-hoc analysis showed a significant relationship between HBV-DNA levels and ALT, AST, and APRI scores.ConclusionOur data showed that hepatic steatosis is more common in CHB patients than in the general population. Older age and high triglyceride levels increased the risk of hepatic steatosis in CHB patients, consequently increasing GGT levels, which are indicative of liver damage, in these patients.     

不同疗程干扰素治疗慢性乙型肝炎随访3年的临床研究

目的比较长疗程和短疗程干扰素治疗慢性乙型肝炎的治疗效果。方法在HBsAg和HBeAg、HBV DNA均为阳性的慢性乙型肝炎病人235例中,应用干扰素-α2b5MU肌肉注射,隔日1次,一组（153例）患者以12个月为一个疗程,另一组（82例）患者以6个月为一个疗程,两组病人于治疗结束后均随访36个月。结果两组患者HBsAg阴转率和近期应答率无明显差别（P〉0.05）;长疗程组的ALT复常率、HBeAg阴转率、HBeAb阳转率和HBV DNA阴转率均高于短疗程组（P〈0.05）;短疗程组的复发率高于长疗程组（P〈0.05）,其持续应答率低于长疗程组（P〈0.01）。结论长疗程干扰素治疗慢性乙型肝炎的疗效优于短疗程治疗。     

Evaluation of hepatosteatosis in patients with chronic hepatitis B virus infection

Background and study aimsThe current study aimed to investigate the frequency of hepatic steatosis in chronic hepatitis B (CHB) patients and determine the possible risk factors associated with its presence.Patients and methodsThis cross-sectional study retrospectively evaluated the medical records of 255 adult CHB patients visiting an infectious disease outpatient clinic. Patients with hepatitis B surface antigen positivity for >6 months and those who did not receive antiviral therapy were included in the study. The presence and stage of hepatic steatosis were determined through hepatobiliary ultrasonography.ResultsThe mean age of the patients was 40.6 ± 12.7 years. Hepatic steatosis was detected in 44.4 % of the patients through ultrasound imaging. Our findings showed that the detected steatosis prevalence in our patients with CHB was significantly higher compared to the highest prevalence of non-alcoholic steatohepatitis found in the general Turkish population (19.9 %) [RR 2.23 (1.75–2.86), p < 0.001]. CHB patients with steatosis had significantly higher age, triglyceride, and gamma-glutamyl transferase levels than those without steatosis (p < 0.05). No significant association was found between the presence of steatosis, sex, liver function test results, and platelet, alkaline phosphatase, cholesterol, alpha fetoprotein, or HBV-DNA levels. No significant relationship was found between aspartate aminotransferase (AST)/platelet ratio index (APRI) and steatosis was examined (p > 0.05). Post-hoc analysis showed a significant relationship between HBV-DNA levels and ALT, AST, and APRI scores.ConclusionOur data showed that hepatic steatosis is more common in CHB patients than in the general population. Older age and high triglyceride levels increased the risk of hepatic steatosis in CHB patients, consequently increasing GGT levels, which are indicative of liver damage, in these patients.     

慢性乙型肝炎多重病毒感染临床特征研究

目的慢性乙型肝炎多重病毒感染临床并不多见，可使肝炎的病程变得较为复杂，预后相对较差，国内外相关的文献报道较少。分析慢性乙型肝炎多重病毒感染的病原学类型并研究其临床特征。方法共有慢性乙型肝炎多重病毒感染88例，其中三重感染74例，四重感染14例；用日期随机法抽取同期单纯乙型肝炎100例作为对照组。结果乙型肝炎多重病毒感染患者中合并丁肝病毒（HDV）、巨细胞病毒（CMV）、甲肝病毒（HAV）与戊肝病毒（HEV）者较多，分别为84．1％、43．2％、33．0％、26．1％。多重病毒感染患者的肝功能损害明显较单纯感染者重，疗效差，住院时间长。结论与慢性乙型肝炎单纯感染相比，慢性乙型肝炎多重病毒感染肝功能损害严重，疗效较差。     

乙肝病毒基因型与肝脏病理改变的关系

目的:探讨乙型肝炎病毒基因型与慢性乙型肝炎患者肝脏病理变化的关系.方法:应用乙肝病毒型特异性引物采用巢式聚合酶链反应(PCR)和荧光定量聚合酶链反应(FQ-PCR),对北京佑安医院住院92例慢性乙型肝炎患者进行乙型肝炎病毒基因型及亚型分析,参照2000年《病毒性肝炎防治方案》对慢性肝炎进行病理分级、分期诊断.结果:92例慢性乙型肝炎患者中HBV基因型分布为B型17例(B2亚型),B/C混合型17例(B2/Ca亚型),C型58例(Ca亚型).17例HBV B型感染患者中病理诊断肝脏炎症活动分级为G1-G3期分别为35.29%,58.82%,5.88%;肝脏纤维化程度分级为S1-3级分别为58.82%,29.41%,11.76%,17例HBV B/C型感染患者中病理诊断肝脏炎症活动分级为G1-G3期35.29%,52.94%,11.76%;肝脏纤维化程度分级为S1-3级23.52%,52.94%,23.52%,58例HBV C型感染患者中病理诊断肝脏炎症活动分级为G1-G4期31.03%,24.14%,36.21%,8.62%;肝脏纤维化程度分级为S1-4级25.86%,39.66%,5.17%,29.31%;HBV三组不同基因型的慢性乙型肝炎患者肝组织病理检查有统计学意义(x~2=15.13,P<0.01).HBV B型与B/C型感染患者年龄在21-30岁组58%-76%,31-40岁组17.6%-29.4%,C型感染患者年龄在21-30岁组25%,31-40岁组46.6%,40岁以上有24.24%;不同HBV基因型感染患者的年龄分布有显著性差异(x~2=9.54,P<0.05).结论:慢性乙型肝炎患者HBV基因型中C型比例明显高于B型与B/C型.HBV C型患者肝脏病理变化较B型与B/C型严重.不同HBV基因型感染患者的年龄分布不同.