论文部分内容阅读
背景丙型肝炎病毒(HCV)感染严重危害人类健康;HCV基因型与干扰素的应答关系密切,HCV基因型的分布随地理位置变化而不同。目的探讨广西地区不同传播途径的HCV感染者与HCV基因型的关系。方法收集2011年2月—2014年12月在广西医科大学第一附属医院感染性疾病科病房及门诊就诊的230例HCV RNA阳性患者的血清标本,记录患者HCV传播途径,包括输血、静脉药瘾、性途径、其他(如文身、打耳洞、口腔治疗等)、不明原因等。采用反转录巢式PCR扩增HCV NS5B区段后,将得到的PCR终产物进行测序,测序结果与Gen Bank中已注册的标准株全基因序列比对出基因型及基因亚型,分析传播途径与HCV基因型的关系。结果 NS5B区段PCR终产物琼脂糖凝胶电泳中目的条带为377 bp,电泳条带显示较清晰。230例样本中222例成功扩增并得出HCV基因型分型:1a亚型27例(12.16%),1b亚型102例(45.95%),2a亚型11例(4.95%),3a亚型15例(6.76%),3b亚型29例(13.06%),6a亚型34例(15.32%),6d亚型1例(0.45%),6e亚型1例(0.45%),混合型(1b+6c)2例(0.90%)。经输血途径传播者93例,经静脉药瘾途径传播者56例,经性途径传播者21例,经其他途径传播者36例,经不明原因途径传播者16例。经其他途径传播者HCV基因型构成比较,差异无统计学意义(P>0.05);经输血、静脉药瘾、性途径传播者HCV基因型构成比较,差异均有统计学意义(P<0.05);其中输血途径以1型多见;静脉药瘾途径以1型、3型、6型多见;性途径以1型、3型多见。结论随着传播途径的改变,HCV基因型的分布也发生变化,其中经输血途径传播的HCV基因型以1b亚型为主;静脉药瘾途径以1a、3b、6a亚型为主;性途径以1a、3b亚型为主。
Background Hepatitis C virus (HCV) infection seriously affects human health. The HCV genotype is closely related to the response to interferon. The distribution of HCV genotypes varies with geographical location. Objective To investigate the relationship between HCV genotypes and HCV infection among different routes of transmission in Guangxi. Methods Serum samples of 230 patients with positive HCV RNA from ward and outpatient department of Infectious Disease Unit of the First Affiliated Hospital of Guangxi Medical University were collected from February 2011 to December 2014. The HCV transmission routes including blood transfusion and intravenous drug addiction were recorded , Sexual way, other (such as tattoos, ear piercing, oral treatment, etc.), unexplained causes. The reverse transcriptional nested PCR was used to amplify the HCV NS5B segment, and the final PCR products were sequenced. The genotypes and genotypes were compared with those of the standard strains registered in Gen Bank. Pathway and HCV genotypes. Results The target band of PCR product of NS5B segment was 377 bp in agarose gel electrophoresis. The band of electrophoresis showed clearer. Of the 230 samples, 222 were successfully amplified and genotyped for HCV genotypes: 27 (12.16%) in subtype 1a, 102 (45.95%) in subtype 1b, 11 (4.95%) in subtype 2a and 3a (13.06%) in 3b subtype, 34 (6a) subtype in 34 cases (15.32%), 6 subtype in 1 case (0.45%) and 6e subtype in 1 case (0.45% (1b + 6c) 2 cases (0.90%). 93 cases were spread by blood transfusion, 56 cases were spread via intravenous drug addiction, 21 were sexually transmitted, 36 were transmitted by other means and 16 were transmitted by unknown reason. There were no significant differences in the HCV genotype distribution among other ways (P> 0.05). The HCV genotypes were significantly different among those who were transfused, intravenously drugged and sexually transmitted (P <0.05) Among them, the type of blood transfusion was more common than type 1; the route of intravenous drug addiction was more common in type 1, type 3 and type 6; the type 1 and type 3 were more common in sexual ways. Conclusion The distribution of HCV genotypes also changed with the change of route of transmission. The HCV genotypes transmitted by transfusion were mainly subtype 1b. The route of intravenous drug dependence was mainly subtype 1a, 3b and 6a. 1a, 3b subtype based.