江苏省泰州地区乙肝病毒基因型与基因变异的研究

目的　研究江苏省泰州地区乙肝病毒 (HBV)基因型分布和基因变异情况及其临床意义。方法　选择江苏省泰州地区HBV感染者 15 8例 ,其中乙肝携带者 2 9例 ,急性肝炎 (AC) 18例 ,慢性轻、中度肝炎 (CH) 5 6例 ,重型肝炎 (FHF) 2 2例 ,肝硬化 (LH) 2 1例 ,肝细胞癌 (HCC) 12例 ,采用基因芯片法进行基因分型和基因变异检测。结果　 15 8例乙肝患者中B型 3 5例( 2 1 1% ) ,C型 12 1例 ( 76 6% ) ,B/C混合型 2例 ( 1 3 % )。 15 8例乙肝感染者中发生前C区基因 1896变异的 95例( 60 1% ) ,发生C基因启动子 (BCP) 1762变异的 93例 ( 5 8 9% ) ,发生HBV聚合酶 (P)基因区YMDD变异的 11例 ( 7 0 % )。结论　江苏省泰州地区存在乙肝病毒基因型B和基因型C ,其中C型占优势 ;乙肝患者基因组可有多种变异 ,BCP 1762变异、前C区 1896变异与肝病的严重程度有关 ;部分乙肝患者在拉米夫定治疗过程中产生耐药 ,可能和HBV(P)基因区YMDD变异有关

Study on hepatitis B virus genotype and gene mutation in Taizhou area

Objective: To study the distribution and mutation of hepatitis B virus (HBV) genotype in Taizhou area and their clinical significance. Methods: HBV genotype and its mutation were determined with genomic chip method in 158 patients in Taizhou area, of whom 29 cases were asymptomatic HBV carriers,18 suffered fromacute hepatitis, 56 chronic mild or moderate hepatitis, 22 fulminant hepatic failure, 21 liver cirrhosis and 12 hepatocellular carcinoma. Results: Of 158 patients, 35(21.1%) were genotype B, 121 (76.6%) were genotype C, 2(1.3%) were genotype B and C; 95(60.1%) had precore 1896 mutation, 93(58.9%) core promotor 1 762 mutation, 11(7.0%) polymerase gene YMDD mutation. Conclusions: Genotypes B and C are found in Taizhou area. Genotypes C is the major genotype in this area. Gene mutation exists in HBV genotypes. BCP 1 762 mutation and pre、C 1 896 mutation are associated with the degree of severe liver disease. The development of resistance to lamivudine in HBV cases may be related to YMDD mutation in HBV P gene region.