浙东地区乙型肝炎病毒基因型分布及临床意义

目的：了解浙江东部地区乙型肝炎病毒（HBV）基因型的分布、优势型及其与临床的相关性。方法：选择浙江东部地区HBVDNA阳性的HBV感染者100例，应用基因芯片对其进行基因分型，其中对7例优势基因型进行S基因序列同源性测序复核。结果：100例HBV阳性的血清标本分型率为96．0％，其中B基因型36例（36．0％），C基因型47例（47．0％），BC混合基因型11例（11．0％）及BCD混合基因型2例（2．0％），未分出型的4例（4．0％）。基因芯片分型与S基因序列同源性测序分型结果一致，乙型肝炎感染者检出的基因型以C、B型为主；重型肝炎与肝癌组中c型检出率分别为60％和55％，明显高于其他基因型（P〈0．05），C、B基因型与HBVDNA拷贝数、丙氨酸氨基转移酶水平及总胆红素在统计学上无显著差异（P〉0．05）。结论：HBV的基因型存在地区性差异，浙江东部地区的优势基因型为c、B型，与以往报道的结论不太一致。不同临床肝炎型与基因型存在一定的相关性，主要表现为重型肝炎和肝癌患者检出的基因型多为C型，提示C基因型患者预后较差。基因芯片分型方法可应用于HBV基因的分型，方便、快速。

Distribution of hepatitis B virus genotyping and its clinical significance in eastern Zhejiang

Objective:To investigate the distribution of hepatitis B virus genotyping,dominant genotype and its relation to clinical significance in eastern Zhejiang.Methods:One hundred HBV DNA-positive samples were genotyped with gene chips.S gene fragments in 7 dominant genotypes were re-checked with sequencing and homology analysis.Results:Ninety-six(96.0%) samples were successfully genotyped in 100 serum samples and 4 samples were unknown genotypes.The cases of B genotype,C genotype,BC mixed-genotype and BCD mixed-genotype were 36(36.0%),47(47.0%),11(11.0%) and 2(2.0%),respectively.The genotyping results with gene chips were consistent with genotyping with S gene fragments sequencing and homology analysis.C and B genotypes were dominant genotypes in HBV positive patients.C genotype accounted for 60% and 55% in severe hepatitis and liver cancer patients respectively(P<0.05).There was no statistical significance in C and B genotype,HBV DNA copy,level of alanine aminotransferase and total bilirubin(P>0.05).Conclusion:Regional difference is found in HBV genotype.C and B genotypes are dominant in eastern Zhejiang,which is different from previously reported.Correlation exists between clinical hepatitis and genotypes,i.e.,C genotype accounted for most of severe hepatitis and liver cancer patients,which suggests that patients with C genotype have worse prognosis.Gene chips could be used to rapidly genotype HBV.