广东深圳市乙型肝炎病毒基因型的检测及意义

目的 了解深圳市乙型肝炎病毒（HBV）基因分型情况．探讨HBV基因分型与抗病毒治疗疗效及预后的关系。方法 用单克隆抗体ELISA法（mAbsELISA）对143例乙型肝炎病毒感染的患者进行HBV基因分型。结果 143例患者中．B型67．8％．C型26．6％。B型多见于无症状乙型肝炎病毒携带者（ASC）（95．4％）；C型多见于肝硬化患者（LC）（64，7％）。年龄≤35岁及有乙型肝炎家族史的患者中B型均较C型多见（P〈0．05）。拉米夫定治疗的LC中．HBVDNA持续阴性者B型较C型多见（P〈0．05）。干扰素治疗的慢性乙型肝炎患者中．完全应答者B型较C型多见（P〈0．05）。25例重型乙型肝炎患者中，B型存活（94．1％）较C型存活（57．1％）高（P〈0．05）。结论 深圳地区HBV基因分型以B型为主，C型次之。B型多见于年轻患者。C型多见于年老患者．且C型肝硬化患者对拉米夫定疗效差。

Study of HBV genotype of Shenzhen and related clinical significance

Objective To study the condition of hepatitis B virus(HBV) genotype in Shenzhen and to analyze the relationship of HBV genotype,anti-virus therapeutic effect and prognosis.Methods The HBV genotyping of 143 patients with HBV were carried out with mAbs ELISA.Results Among 143 cases,97(67.8%) were type B,38(26.6%) were type C.Type B accounted for 95.4% in ASC group,but type C accounted for 64.7% in LC group(P<0.05).Among the patients younger than 35 and among the patients with family history of HBV,type B was more popular than type C(P<0.05).Twelve of 17 cases in group LC underwent lamivudine treatment,and 4 cases of type B but no case of type C were tested to be continuous HBV DNA negative(P<0.05).Among 20 cases of interferon treatment,11 cases of type B but no case of type C were found to be full response to interferon.Among 25 cases of severe HBV,17 were type B and 16 survived,but 7 were type C and 4 survived(P<0.05).Conclusion HBV genotype popularity in Shenzhen is classified as type B the first and type C the second.Type B,which is effective to interferon;Type C,which is prone to cirrhosis and less effective to lamivudine;HBV genotyping no relationship with HBeAg(+) or HBV DNA level.