乙型肝炎病毒基因型检测及其临床应用

目的:探讨HBV基因型的检测及其在临床上的应用.方法:用微板核酸分子杂交-ELISA方法检测468例HBV DNA阳性的慢性乙型肝炎患者血清HBV基因型.分析HBV基因型与病毒复制、基本C基因启动子(BCP)变异、肝病病情轻重、干扰素疗效的关系.结果:深圳地区HBV基因型以B和C基因型为主,分别占25.0%和64.9%;C基因型的HBeAg阳性率(68.8%)高于B基因型的HBeAg阳性率(35.0%)(P＜0.01);C基因型的血清HBV DNA水平也明显高于B基因型(1g 6.74 copies/ml vs. 1g 5.44 copies/ml, P＜0.01);轻中度慢性肝炎以B基因型为主,而重度慢性肝炎以C基因型为主;B基因型对干扰素的有效应答率为47.2%,C基因型的有效应答率为28.9%,两组比较差异有显著性意义(P＜0.05).结论:HBV基因分型有助于临床判断病情、估计预后及抗病毒治疗疗效预测.

Detection of the Genotypes of HBV and Its Clinical Implication

Objective:To study the detection of HBV genotypes and its clinical significance.Methods:HBV genotypes were determined by PCR micro-plate hybridization-ELISA assay. The relationship between HBV genotypes and HBV viral replication, basic core promoter(BCP) mutation, severity of liver disease and the antiviral response to Interferon therayp was investigated. Results:HBV genotype B and C were predominant in Shenzhen area, with a 25.0% and 64.9% proportion, respectively. The positive rate of HBeAg in genotype C group was significantly higher than that in genotype B group (68.8% vs. 35.0%,P<0.01). HBV DNA levels in genotype C group was much higher than those in genotype B group (1g 6.74 copies/ml vs. 1g 5.44 copies/ml,P<0.01).Genotype B of HBV was predominant in patients with mild and moderate chronic hepatitis.While genotype C was common in patients with severe chronic hepatitis. The response rate to Interferon therapy in patients with genotype B HBV infection was significantly higher than those with genotype C HBV infection (47.2% vs. 28.9%,P<0.05).Conclusion:[WTBZ]HBV genotypes may be correlated to HBV viral replication, severity of liver diseases and antiviral response to Interferon. The results suggest that genotyping of HBV may help predict severity of liver damage, prognosis and the efficacy of Interferon therapy in patients with chronic HBV infection.