海南省IDUs和non-IDUs人群中HCV的基因型分布

目的 了解海南省静脉吸毒人群（inject drug users, IDUs）中HCV-Ab、HCV-RNA的情况,以及IDUs与非静脉吸毒人群（non-inject drug users, non-IDUs）中丙型肝炎病毒（Hepatitis C virus, HCV）亚型分布特点。方法 从海南省的美沙酮维持治疗门诊、戒毒所和海南省人民医院住院患者中选择HCV-Ab阳性者检测HCV-RNA,对HCV-RNA阳性者抽取血清进行RT-PCR及巢式PCR扩增Core-E1区并测定其核酸序列、确定其基因亚型。根据是否存在静脉吸毒行为分为IDUs组和non-IDUs组,然后并对两组的资料统计分析。结果 海南省802例美沙酮维持治疗门诊、戒毒所吸毒者中HCV-Ab阳性309例,HCV-Ab阳性率38.53%,其中215例HCV-RNA阳性,阳性率为69.58%。海南省人民医院就诊HCV-RNA阳性者251例,共466例HCV-RNA检测阳性 。466例HCV-RNA阳性者中448例样本成功测序和基因分型及具体如下： IDUs组（320例）中6a（58.75%）是最主要的基因型,其次是3b（16.88%）、3a（15.63%）、1a（4.38%）、1b（2.81%）和非6a（0.93%）;而non-IDUs组（128例）中最主要的基因亚型是1b（30.47%）,其次是6a（28.12%）、3b（10.16%）、3a（3.91%）、1a（7.03%）和非6a（14.84%）,两组亚型之间的差异具有统计学意义(P<0.01)。结论 海南省IDUs人群中HCV感染后自发清除率较高,其感染的主要亚型为6a,其次为3b;但有些地区的IDUs人群中存在其他亚型的小范围流行。

Genotype distribution of HCV among the populations of IDUs and non-IDUs in Hainan

Objective To define the main gene subtypes and HCV-Ab, HCV-RNA of hepatitis C virus (HCV) infectors among inject drug users (IDUs) and non-inject drug users (non-IDUs) in Hainan Province. Methods The HCV-RNA(s) of 581 samples, that were from Methadone Maintenance Treatment Clinics, drug treatment center and Hainan Provincial People's Hospital Infection Department, were extracted, amplified in the HCV Core-E1 region by RT-PCR and nested-PCR, and determine the HCV genotype distribution. Based on whether or not absence of intravenous drug abuse, the subjects were divided into IDUs group and non-IDUs group, statistical analysis was made on the demographic data. Results Among 802 methadone maintenance treatment outpatients and drug addicts in Hainan Province, 309 were HCV-Ab positive, with the HCV-Ab positive rate of 38.53%, and 215 were HCV-RNA positive, with the positive rate of 69.58%. And 251 patients tested HCV-RNA positive in Hainan People's Hospital, 466 patients tested positive for HCV-RNA. Of the 581 HCV-Ab positive cases, 466 of them HCV-RNA positive cases.And 448 out of the 466 sampleswere successfully sequenced and genotyped as follows,the subtypes and proportion among 320 IDUs were found as 6a (58.75%) in mainly, and followed by 3b (16.88%), 3a(15.63%), 1a (4.38%), 1b (2.81%) and non-6a (0.93%); 128 non-IDUs were 1b (30.47%), 6a (28.12%), 3b (10.16%), 3a (3.91%), 1a (7.03%) and non-6a (14.84%), the difference was statistically significant (P<0.01). Conclusion The spontaneous clearance rate of HCV infection in IDUs population was high in Hainan Province, 6a is the main subtype among IDUs, followed by 3b. There is a range transmission of HCV subtypes other than 6a in different regions.