HIV/HCV混合感染者与HCV感染者感染HCV基因型分析*

目的 使用二代测序技术检测广州地区人类免疫缺陷病毒（HIV）/丙型肝炎病毒（HCV）混合感染者和HCV感染者HCV基因型,了解本地区HCV基因型的流行特点。方法 在233例HCV感染者中,包括95例HIV/HCV混合感染者和138例HCV感染者,使用Illumina Miseq平台PE300模式对HCV Core和NS5B片段进行测序,采用生物信息学分析确定HCV基因型,对测序结果提示混合基因型感染的样本,使用NS5A基因型特异引物进行验证。结果 HIV/HCV混合感染者静脉吸毒感染构成比显著高于HCV感染者（77.7%对19.6% P<0.001）,HCV感染者输血感染的构成比显著高于HIV/HCV混合感染者（48.6%对3.2% P<0.001）;HIV/HCV混合感染者HCV Core基因片段平均数据量为（15456±6689） reads,HCV感染者为（14323±5321） reads,两组无显著差异（P>0.05）;HIV/HCV混合感染者HCV NS5B基因片段平均数据量为（16432±3467） reads,HCV感染者为（17611±5632） reads,也无显著差异（P>0.05）;本组228例（97.9%）HCV感染者为单一HCV基因型感染,HIV/HCV混合感染者HCV 6a型和3b型感染率显著高于HCV感染者（分别为47.4%对26.8%,P=0.001和13.7%对3.6%,P=0.005）,HCV 1b型感染率显著低于HCV感染者（20.0%对59.4%,P<0.001）;在233例入组的HCV感染者中,发现5例（2.1%）为混合基因型感染,其中4例为HIV/HCV混合感染者,1例为HCV感染者。结论 广州地区HIV/HCV混合感染者与HCV感染者感染HCV基因型构成比存在差异,其临床意义还需要探讨。

Comparison of HCV genotypes in patients with HIV/HCV co-infection and HCV mono-infection in Guangzhou

Objective To investigate the distribution of HCV genotypes between patients with HIV/HCV co-infection and with HCV mono-infection in Guangzhou. Methods A total of 233 patients with chronic hepatitis C were enrolled in this study,including 95 patients with HIV/HCV co-infection and 138 patients with HCV mono-infection. The HCV core and NS5B gene fragments were used for genotyping by using Illumina Miseq platform PE300 model,and for the samples which the NGS data contained mixed HCV infection（more than 1% reads mapping to other genotypes）,the NS5A genotypes specific primers were used to validate the mixed HCV infection. The data was compared by x2 test,fisher’s exact test,t-Student and Mann-Whitney U test. Results The percentage of intravenous drug users（IDUs） in patients with HIV/HCV co-infection was significantly higher than in patients with HCV mono-infection（77.7% vs. 19.6%,P<0.001）,and the percentage of blood transfusion history in patients with HCV mono-infection was much higher than in those with HIV/HCV co-infection（48.6% vs. 3.2%,P<0.001）;the average reads of HCV core gene in patients with HIV/HCV co-infection were（15456±6689） reads,no significantly different as compared to（14323±5321） reads in patients with HCV mono-infection,and th e average reads of HCV NS5B gene in patients with HIV/HCV co-infection were（16432±3467） reads,also no significantly different compared to（17611±5632） reads in patients with HCV mono-infection（P>0.05）;228 patients （97.9%） in our series were infected with single HCV genotypes,and HCV genotype 6a and 3b infections were more prevalent in patients with HIV/HCV co-infection than in with HCV mono-infection （47.4% vs. 26.8%,P=0.001 and 13.7% vs. 3.6%,respectively,P=0.005） and HCV genotype 1b infection was more prevalent in patients with HCV mono-infection than in patients with HIV/HCV co-infection （59.4% vs. 20.0%,P<0.001）;5 patients （2.1%） were found with mix HCV genotype infection,including 4 patients with HIV/HCV co-infection and 1 patient with HCV mono-infection. Conclusion The prevalence of infected HCV genotypes in patients with HIV/HCV co-infection and in with HCV mono-infection might be different,which worth further investigation.