贵州地区HCV感染者基因型分布特征

目的 探讨贵州地区丙型肝炎患者HCV基因型分布特征,为HCV感染的防控和个体化治疗提供临床依据。方法 选取2011年9月-2018年10月贵阳市公共卫生救治中心1211例HCV RNA阳性的丙型肝炎患者,采用PCR直接测序法,与GenBank中已知的HCV序列进行对比,获得HCV基因型及亚型,并分析其分布与性别、年龄、民族、地区、感染途径等因素的关系。计数资料组间比较采用χ2检验或Fisher确切概率法。结果 1211例HCV感染者共检出4种基因型和11种基因亚型,其中以1b型(26.84%)、3b型(27.17%)和6a型(24.28%)为主。不同HCV基因型在男女感染者中分布差异有统计学意义(χ2=15.428,P=0.009),其中男性以3b型为主(29.34%),女性以1b型为主(32.21%)。不同HCV基因型分布在各年龄组中差异有统计学意义(χ2=67.439,P<0.001),≤18岁组与≥60岁组以1b型为主(分别为66.67%、58.93%),而19~39岁组以3b型(28.93%)、6型(29.29%)为主,40~59岁组以1b型(29.54%)、3b型(27.33%)和6型(24.28%)为主。各种感染途径的HCV基因型分布差异有统计学意义(χ2=153.916,P<0.001),感染方式以静脉药瘾为主(57.97%),其次是性接触和有创美容(均为8.42%);经静脉药瘾、有创美容感染HCV者均以3b型为主(分别为31.48%、32.35%),性接触感染者多为HCV 6型(36.27%)。不同民族、贵州地区间HCV基因型分布差异均无统计学意义(P值均>0.05)。结论 贵州地区HCV基因型分布呈多样性,3b、1b、6a型为主要流行株,存在HCV 6型中的多种少见基因亚型,且在不同的年龄、性别、感染途径方面HCV基因型分布存在差异。

Distribution characteristics of hepatitis C virus genotypes in Guizhou,China

Objective To investigate the distribution characteristics of hepatitis C virus (HCV) genotypes in patients with hepatitis C in Guizhou, China, and to provide a basis for the prevention and individualized treatment of HCV infection. Methods A total of 1211 HCV RNA-positive patients with hepatitis C who were treated in Guiyang Public Health Clinical Center from September 2011 to October 2018 were enrolled. PCR direct sequencing was performed to obtain HCV sequences, which were then compared with the known HCV sequences in GenBank to obtain HCV genotypes and subgenotypes. The association of genotype distribution with sex, age, ethnic group, region, and route of infection was analyzed. The chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. Results A total of 4 genotypes and 11 subgenotypes were detected among the 1211 individuals with HCV infection, with the main genotypes of 1b (26.84%), 3b (27.17%), and 6a (24.28%). There was a significant difference in the distribution of HCV genotypes between the male and female individuals (χ2=15.428, P=0.009);29.34% of the male individuals had genotype 3b, and 32.21% of the female individuals had genotype 1b. There was a significant difference in the distribution of HCV genotypes between different age groups (χ2=67.439, P<0.001);genotype 1b was the main genotype in the individuals aged ≤18 years (66.67%) or ≥60 years (58.93%), genotypes 3b and 6 were the main genotypes in the individuals aged 19-39 years (28.93% and 29.29%, respectively), and genotypes 1b, 3b, and 6 were the main genotypes in the individuals aged 40-59 years (29.54%, 27.33%, and 24.28%, respectively). There was a significant difference in the distribution of HCV genotypes between the individuals with different routes of infection (χ2=153.916, P<0.001);the most common route of infection was intravenous drug addiction (57.97%), followed by sexual contact (8.42%) and invasive cosmetic surgery (8.42%);genotype 3b was the main genotype in the individuals with intravenous drug addiction (31.48%) or invasive cosmetic surgery (32.35%), and genotype 6 was the main genotype in the individuals with sexual contact (36.27%). There was no significant difference in the distribution of HCV genotypes between the individuals in different ethnic groups or from different regions of Guizhou (both P>0.05). Conclusion The distribution of HCV genotypes is diverse in Guizhou, and HCV strains with genotypes 3b, 1b, and 6a are the main epidemic strains. Several rare subgenotypes of HCV genotype 6 are observed. There is a significant difference in the distribution of HCV genotypes between the individuals with different ages, sexes, or routes of infection.