中国15个民族HBV基因型及基因亚型分布特征分析

目的 了解我国不同民族人群感染HBV的基因型及基因亚型分布特征。方法 利用多阶段分层整群随机抽样结合系统抽样的方法从2020年全国乙型肝炎血清流行病学调查HBsAg阳性样本库中抽取样本，利用巢式PCR扩增阳性样本HBV S区基因，构建系统发育树分析判定HBV基因型和亚型，结合社会人口学资料进行综合分析。结果 成功扩增15个民族的1 539份样本，检出B、C、D、I型和C/D重组型5种基因型。B型占比较高的民族包括汉（74.52%，623/836）、壮（49.28%，34/69）、彝（53.19%，25/47）、苗（94.12%，32/34）和布依族（81.48%，22/27）；C型占比较高的民族为瑶族（70.91%，39/55）；D型占比较高的民族为维吾尔族（83.78%，31/37）；C/D重组型占比较高的民族为藏族（92.35%，326/353）；检出I型11例中，8例来自于壮族。除藏族外，各民族的B型中B2亚型均>80.00%；在C型中，C2亚型占比较高的民族包括汉、藏、彝、维吾尔、蒙古、满、回和苗族8个民族，C5亚型占比较高的民族包括壮（55.56%，15/27）和瑶族（84.62%，33/39）；在D型中，彝族均为D3亚型，维吾尔和哈萨克族均为D1亚型。C/D1和C/D2亚型在藏族占比分别为43.06%（152/353）和49.29%（174/353）。I型均为I1亚型。结论 我国15个民族中发现HBV 5种基因型和15种基因亚型，不同民族的HBV基因型和基因亚型分布差异明显。

Epidemiological distribution of genotypes and sub-genotypes of hepatitis B virus in 15 ethnic groups in China

Objective To understand the distribution of genotypes and sub-genotypes of HBV in different ethnic groups in China. Methods The HBsAg positive samples were selected by stratified multi-stage cluster sampling from the sample base of national HBV sero-epidemiological survey in 2020 for the amplification of S gene of HBV by nested PCR. A phylogeny tree was constructed to determine the genotypes and sub-genotypes of HBV. The distribution of genotypes and sub-genotypes of HBV were analyzed comprehensively by using laboratory data and demographic data. Results A total of 1 539 positive samples from 15 ethnic groups were successfully amplified and analyzed, and 5 genotypes (B, C, D, I and C/D) were detected. The proportion of genotype B was higher in ethnic group of Han (74.52%, 623/836), Zhuang (49.28%, 34/69), Yi (53.19%, 25/47), Miao (94.12%, 32/34), Buyi (81.48%, 22/27). The proportions of genotype C were higher in ethnic groups of Yao (70.91%, 39/55). Genotype D was the predominant genotype in Uygur (83.78%, 31/37). Genotype C/D were detected in Tibetan (92.35%,326/353). In this study, 11 cases of genotype I were detected, 8 of which were distributed in Zhuang nationality. Except for Tibetan, sub-genotype B2 accounted for more than 80.00% in genotype B in all ethnic groups. The proportions of sub-genotype C2 were higher in 8 ethnic groups, i.e. Han, Tibetan, Yi, Uygur, Mongolian, Manchu, Hui and Miao. The proportions of sub-genotype C5 were higher in ethnic groups of Zhuang (55.56%, 15/27) and Yao (84.62%, 33/39). For genotype D, sub-genotype D3 was detected in Yi ethnic group and sub-genotype D1 was detected in both Uygur and Kazak. The proportions of sub-genotype C/D1 and C/D2 in Tibetan were 43.06% (152/353) and 49.29% (174/353). For all the 11 cases of genotype I infection, only sub-genotype I1 was detected.Conclusions Five genotypes and 15 sub-genotypes of HBV were found in 15 ethnic groups. There were significant differences in the distribution of genotypes and sub-genotypes of HBV among different ethnic groups.