200例乙型肝炎患者HBV基因型分布及临床意义

目的探讨200例武汉地区乙型肝炎病毒（HBV）感染者病毒基因型的分布及其与肝病严重程度的相关性。方法采用半巢式PCR对200例来自武汉地区的乙肝病毒感染者血浆HBV进行扩增后，Sanger测序法进行基因分型。结果200例HBV血浆样本的基因型分布为B型142例（71．0％），C型55例（27．5％），D型1例（O．5％）和B／C混合型1例（O．5％），B／F／G混合型1例（O．5％）。在基因型B和基因型C中，无症状携带HBV患者、轻中度慢性乙肝患者、重度肝炎及肝硬化患者、肝癌患者的构成比分别为：37．32％，44．37％，14．08％，4．23％和23．64％，36．36％，21．82％，18．18％，两种基因型在肝病严重程度中的构成比差异有统计学意义（P〈O．05）。结论分离的200例HBV样本基因型以B，C为优势基因型，且基因型与HBV感染者发生肝病的严重程度有显著相关性。

Distribution and Clinical Significance of Hepatitis B Virus Genotype in Wuhan

Objective To investigate the distribution of hepatitis B virus （HBV） genotypes in 200 samples and its association with the severity of the liver disease. Methods 200 plasma HBV from patients infected with HBV in Wuhan were amplified by semi-nested PCR,and then genotyped by Sanger DNA sequencing. Results B and C were the most widely distributed genotypes among the 200 strains of HBV. Among the 200 individuals, 142 cases were genotype B （71.0%）,55 cases were genotype C （27.5%）, 1 case was genotype D （0.5%）, 1 case was B/C Nixed -genotype （0. 50//oo） and 1 case was B/F/G mixed-genotype （0. 5 %）. The proportion ratio of asymptomatic carriers （ASC）,slight and moderate chronic hepatitis B, se- vere hepatitis B,liver cirrhosis （LC） and hepatocellular carcinoma （HCC） were 37.32% ,44. 37% ,14. 08% ,4. 23~ for gen- otype B and 23.64% ,36.36% ,21.82M and 18.18% for genotype C respectively. There was statistical significance between these two dominant genotypes in the proportion ratio of the severity of liver disease （P〈0. 05）. Conclusion B and C were the dominant genotypes in 200 samples separated from Wuhan,and the genotype of HBV had an significant influence on the severity of the liver disease of the HBV-infected patients.