温州地区乙型肝炎病毒基因型分布调查及意义

目的调查乙型肝炎病毒(HBV)感染者的HBV基因型分布,探讨HBV基因型与临床的相关性。方法用SP-nPCR法检测469例HBV感染者的HBV基因型,用荧光定量PCR法检测HBVDNA载量,用ELISA法检测HBV血清学标志物。结果469份标本分出基因型430例,HBV基因型分布为:A型2.6%(11/430),B型34.9%(150/430),C型49.8%(214/430),B/C型12.8%(55/430),未检出D、E、F基因型;无症状携带者(ASC)和慢性乙肝患者(CH)以C、B基因型为主,肝硬化(LC)和肝癌(HCC)以C基因型占绝对优势。基因型分布与性别无关。30岁以下人群感染以B基因型为主,30岁以上则以C基因型为优势。结论SP-nPCR法适用于慢性HBV感染者(病人和携带者)的基因分型和流行病学调查。HBV感染以C、B基因型为主,存在B/C混合基因型和A基因型。C基因型感染与肝硬化和肝细胞癌相关。

Distribution and clinical significance of hepatitis B virus genotypes in Wenzhou population

Objective To investigate the clinical significance of hepatitis B virus (HBV) genotypes. Methods HBV genotypes from 469 serum samples were examined by nested polymerase chain reaction based on type specific primers(SP-nPCR). Serum HBV DNA levels were tested by real time polymerase chain reaction, while serum markers were detected by ELISA. Results 430 HBV genotypes among 469 samples were successfully identified. Genotype A was 2.6% (11/430), with 34.9% (150/430) of genotype B, 49.8% (214/430) of genotype C, 12.8%(55/430) of combined genotype B/C, while genotype D, E and F were not detected out. The results showed that the distribution of HBV genotypes was not related with sex, and genotype B was predominant in people under 30 years old, while genotype C was major in those of over the age of 30 years. Genotype C and B was predominant in asymptomatic HBV carriers(ASC) and chronic hepatitis (CH), while Genotypes C was the most in liver cirrhosis (LC) and hepatocellular carcinoma (HCC). Conclusions The SP-nPCR is convenient for HBV genotype detection in clinical and epidemiologic survey. Genotype B and C of HBV were predominant, then mixed genotype B/C and genotype A. Genotype C may play a role in ingressiveness to LC and HCC.