湘潭地区乙型肝炎病毒基因型与YMDD基因区序列突变及BCP区突变关系探讨

【目的】对湘潭地区HBV感染者的基因型、YMDD基因区序列突变及BCP区突变情况及关系进行探讨。【方法】对952例不同类型的HBV感染者的样本同时进行基因型、YMDD基因区序列突变及BCP区突变检测和分析。【结果】湘潭地区HBV各种基因型分布比例为：B型占73．32％，C型占12．08％，B、C型混合感染14．60％。YMDD基因区序列突变结果显示：YMDD野生型，占88．66％，其余为YMDD突变型。BCP区突变结果显示：1762A／1764G（野生型）占70．59％，1762T／1764A（突变型）占19．75％，其余为混合型。基因型、相关性分析显示：HBVB型和C型YMDD基因区序列突变率无显著性差异（P〉0．05），序列突变类别存在显著性差异（P〈0．05），HBVC型YVDD突变率要高于B型。C型BCP区突变率要高于B型（P〈0．01）。HBV YMDD野生型和突变型的BCP区突变率存在显著性差异（P〈0．01），HBV YMDD突变型标本BCP区突变率与YMDD野生型相比无差异，但YVDDBCP区突变率要高于其他类别。【结论】①湘潭地区流行的HBV基因型主要为B型和C型，其中B型为优势基因型，具有南方地区的特点。②拉米夫定治疗前通过HBV基因型检测来预测抗病毒应答可能并无实际意义。③HBV基因分型、YMDD基因区序列突变、BCP区突变检测的应用，将有助于临床上对乙肝患者的预后和转归进行正确评价。

Research on the Relationship Between HBV Genotypes and YMDD Motif Mutations or Basic Core Promoter Mutations in Xiangtan

Objective]To investigate the relationship between HBV genotypes and YMDD motif mutations or basic core promoter（BCP） mutations in Xiangtan. Methods]HBV genotypes, YMDD motif mutations and BCP mutations were analyzed in 952 patients with different types of HBV infection by using reverse dot blot. Results] HBV genotyping results showed that HBV type B and C accounted for 73.32% and 12.08%, respectively. The rest（14.60%）were genotype 13 and C mixed infection（B＋C）. YMDD motif mutations results showed that YMDD wild-type accounted for 88.66% and the remainders were YMDD mutation types. BCP mutation results showed that 1762A/1764G accounted for 70.59% and 1762T/1764A accounted for 19.75%. The rest were mixed infection. The correlation analysis of genotypes showed that the YMDD mutation rate had no significant difference between HBV type B and C（ P 〉0.05）, while mutation types had significant difference（ P 〈0.05）. The YVDD mutation was more commonly seen in genotype C than in genotype B. The BCP mutation rate showed that genotype C was more frequent than genotype B（ P 〈0.01）. The BCP mutation rate showed no significant difference between YMDD wild-type and YMDD mutation type（ P〉0.05）, but most of BCP mutations were YVDD. Conclusion] ①The predominant HBV genotypes in Xiangtan are genotype B and genotype C. The major genotype is genotype B. The results display the characteristics of Southern China. ②Determination of HBV genotypes before lamivudine therapy is probably not an important pretreatment investi gation to predict antiviral responses. ③Detection of HBV genotypes, YMDD motif mutations ＆ BCP muta tions in clinic will contribute to correctly evaluate the prognosis of HBV patients.