安徽省戊型肝炎基因分型及临床特征研究

目的研究安徽省戊型病毒性肝炎的基因型及其分布特点,为预防和控制戊型病毒性肝炎和疫苗的研制提供科学依据。方法按照戊型病毒性肝炎诊断标准及处理原则（GB17011-1997）于2006年12月～2007年12月从安徽省的4家综合性三甲医院收集戊型病毒性肝炎132例,分析临床特征,其中采集血清50份,用RT-nPCR法检测戊型肝炎病毒基因型。结果HEV RNA阳性率为22%（11/50）,经测序证实为戊型肝炎病毒（Hepatitis Evirus,HEV）的基因序列;用DNA STAR软件分析,11例的病毒株中2例为HEVⅠ型,9例为HEVⅣ型。Ⅳ型中又有ⅣA型3例和ⅣD型6例。结论安徽省急性散发性戊型肝炎的病毒基因型以HEVⅣ型为主,Ⅰ型次之,而Ⅳ型又有不同的亚型,主要为ⅣA和ⅣD型。

Study on clinic characteristics and genotype of hepatitis E in Anhui Province

Objective This study was aimed to know the epidemiological characteristics and genotype of hepatitis E in Anhui Province by studying the molecular epidemiological characteristics of isolation clusters of the virus of acute scattered hepatitis E. The results would help to research the bacterin of hepatitis E. Methods The data of acute hepatitis E patients from the department of contagious diseases of four general hospitals in Anhui Province were collected from December 2006 to December 2007. On the basis of clinical diagnosis, the antigens and antibodies including HAV IgM, HBsAg, HBsAb, HBeAg, HBeAb, HBcAb, HCVAb, HEV lgM and IgG were tested by ELISA method. According to the diagnosis standards established by GB 17011-1997, once HEV IgM and IgG are positive combined with the symptoms and dysfunction of liver, then the patient should be diagnosed acute hepatitis E. The HEV RNA in the serum of 50 acute hepatitis E patients was examined by the method of RT-nPCR, and also cloning HEV was conducted to measure the sequence of HEV RNA and analyze the genotype of HEV by DNA STAR software for gene analysis, Results Among 50 serum tests, 11 of them were PCR positive, and they were approved as HEV gene sequence. The positive rate of HEV RNA was 22 % , 2 cases were HEV type I and 9 were HEV type IV in which 3 were type IVA and 6 were type IVD. The positive rate of HEV RNA was related to the time of test and the severity of liver dysfunction. Conclusions The symptoms are typical. The major gene type is type IV, and it has two subtypes.