云南地区丙型肝炎病毒基因亚型及RNA载量在丙型肝炎进展中的变化

目的 检测云南地区慢性丙型肝炎、丙肝相关性肝硬化、丙肝相关性肝癌患者中丙肝病毒 (HCV) 的基因亚型及RNA载量在疾病进展过程中的变化.方法 通过收集2016年1月至2017年4月昆明医科大学第一附属医院及云南省传染病医院收治的患者241例, 其中丙型肝炎组患者169例, 丙肝相关性肝硬化组56例, 丙肝相关的肝癌组16例作为研究对象.采用PCR荧光探针法检测血清中丙肝病毒基因亚型以及HCV RNA载量.结果 在丙型肝炎患者中3b型最多 (27.81%) ;在丙肝相关性肝硬化患者中1b型最多 (30.36%) ;在丙肝相关性肝癌中3 b型最多 (31.25%) .3组患者基因亚型比例无显著差别 (P>0.05) .慢性丙型肝炎、丙肝相关性肝硬化、丙肝相关性肝癌组患者的HCV RNA载量分别为 (332±114) Copies/m L、 (189±73) Copies/m L、 (152±56) Copies/m L.3组患者HCV RNA载量的差异显著 (P<0.01) , 慢性丙型肝炎组高于其他2组 (P<0.01) , 但丙肝相关性肝硬化组与丙肝相关性肝癌组患者HCV RNA载量没有明显差别 (P>0.05) .结论 云南地区丙型肝炎中以3b型为主, 丙肝相关性肝硬化中以1b型为主, 丙肝相关性肝癌中3b型为主.在慢性丙型肝炎进展过程中HCV RNA载量减低.

The Changes of Hepatitis C Virus Gene Subtypes and RNA Loads in the Development of Chronic Hepatitis C Patients in Yunnan

Objective To investigate the changes of hepatitis C virus (HCV) gene subtypes and RNA loads in chronic hepatitis C, HCV-related liver cirrhosis and HCV-related hepatocellular carcinoma patients in Yunnan. Me thods 241 patients were enrolled at the First Affiliated Hospital of Kunming Medical University (Yunnan, China) from January 2016 to April 2017. Among them, 169 patients were with chronic hepatitis C, 56 patients with HCV-related liver cirrhosis and 16 patients with HCV-related hepatocellular carcinoma. HCV gene subtype and RNA loads were measured using the Polymerase Chain Reaction-fluorescence probe method. Re s ults In the chronic hepatitis C group, there were 47 subtype 3 b cases (27.81%) . 17 cases of HCV-related liver cirrhosis were subtype 1 b (30.36%) ;5 patients with HCV-related hepatocellular carcinoma were subtype 3 b (31.25%) .There was no statistical difference distribution of the genotype among the three groups (P>0.05) .The HCV RNA loads of the chronic hepatitis C group, HCV-related liver cirrhosis group and HCV-related hepatocellular carcinoma group were (332±114) copies/m L, (189±73) copies/m L and (152±56) copies/m L respectively.The difference among three groups were significant (P <0.01) .The chronic hepatitis C group was significantly higher than the other two groups, and the differences were statistically significant (P<0.01) . But no significant difference of HCV RNA loads was found between HCV-related liver cirrhosis and HCV-related hepatocellular carcinoma group (t = 0. 65, P<0.05) . Conclus ion In Yunnan, 3 b was main genotype in chronic hepatitis C patients and 1 b was main genotype in HCV-related liver cirrhosis, 3 b was main genotype in HCV-related hepatocellular carcinoma. HCV RNA loads tend to decrease in the progress that chronic hepatitis C develops into HCV-related liver cirrhosis and HCV-related hepatocellular carcinoma.