乙肝病毒基因型与患者临床预后关系的研究

研究不同HBV基因型感染者临床特征的异同。选取慢性HBV感染者297例,用特异性引物PCR法测定其HBV基因型,并比较不同基因型者在临床各方面表现有何异同。297例样本中B型占12．8％,C型占87.2％, 未发现其他基因型。B型者与C型者相比,年龄≤35岁者较多,血清ALT、AST水平较低,两组的血清HBVDNA水平无明显差异。B型在慢性HBsAg携带者、慢性肝炎、肝硬化及肝癌患者中所占比例逐步下降,而C型所占比例则逐步上升。B型者HBeAg阳性率低,HBeAg血清学转换率高。B型、年龄小者及女性者容易呈慢性HBsAg携带者状态。在17例死于肝病者中,B型者死亡时感染HBV时间较长。B型者对抗病毒治疗应答比C型者好。C型HBV 感染与严重肝脏疾病的发生有关,感染B型HBV者临床预后较好,对抗病毒治疗的应答较好。

Research of relationship between HBV genotype and prognosis of patients infected with HBV

To clarify the "genotype- related differences in the clinical characteristics. PCR using type - specific primers was conducted in 297 chronic HBV carriers and then compare the clinical characteristies of different genotypes. In the 297 cases, 12.8% were genotype R while 87.2% were genotype C. Other genotypes were not detected in our cases. Patients younger than 35 years old were more frequent in genotype B than in genolype C. Higher levels of serum ALT and AST were observed in genotype C than in genotype B. No statistical difference was observed in serum HBVDNA level between patients with genotype B and C. The distribution of genotype B showed a decreasing trend from ASC, CHB and LC to the HCC group; in contrast, the distribution of genotype C showed an increasing trend in the same order. HBeAg - negative and HBeAg - seroconversion were more common in patients infected with genotype B. In patients infected with genotype B and younger, female patients, asymptomatic HBsAg carrier state was more common. Among the 17 patients died of liver cirrhosis or hepatocellular carcinoma, the average persistent HBV infection period of genotype B were longer than genotype C. HBV genotype B, compared to genotype C, is associated with a higher response rate to antiviral therapy. We drew preliminary conclusions that genolype C was associated with the development of severe liver diseases and genotype B has a relative good prognosis and is associated with a higher response rate to antiviral therapy.