北京地区乙型肝炎病毒基因型与其感染临床表型的相关性

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目的:探讨HBV不同基因型感染患者转归的关系.方法:北京佑安医院住院及门诊1321例肝硬化患者、慢性乙型肝炎患者、慢性乙型肝炎病毒(HBV)携带者和乙型肝炎病毒自限性感染者四组人群进行HBV血清免疫学指标检测、HBVDNA检测、HBV基因型的分析,用HBV特异性基因型引物进行聚合酶链反应(PCR),丙烯酰胺凝胶电泳分析HBVDNA基因型,应用酶联免疫吸附实验方法检测HBV血清免疫学指标.结果:1321例血清标本中804例(60.1%)HBVDNA阳性,HBV基因型分别为A型0.25%、B型20.77%、C型69.53%、B+C混和型9.44%.自限性感染者组14/245例(5.71%)HBVDNA阳性,其中9例C基因型、4例B基因型、1例BC混和基因型;慢性HBV携带者组128/300例(42.67%)HBVDNA阳性,其中88例C基因型、36例B基因型、4例BC混和基因;慢性肝炎患者组608/668例(91.11%)HBVDNA阳性,其中2例A基因型、121例B基因型、417例C基因型、68例B/C混和基因型;肝硬化患者组54/108例(50%)HBVDNA阳性,B型6例、C型45例、B+C混和型3例.肝硬化患者组C基因型为83.33%,分别高于自限性感染者组、慢性HBV携带者组和慢性肝炎患者组(64.29%、68.75%、68.58%,均为P<0.05).年龄,性别与感染HBV基因型无关,HBV感染后病情发展与HBV基因型有关.结论:北京地区乙型肝炎病毒基因型以C型为主,B型次之,其它基因型较少见;肝硬化患者组C基因型分别高于隐性感染者组、慢性乙型肝炎表面抗原携带者组和慢性肝炎患者组;提示乙型肝炎病毒基因型与肝炎病情发展有一定关系. Objective: To investigate the relationship between the prognosis of patients with different genotypes of HBV infection.Methods: 1321 inpatients and outpatients with cirrhosis in Beijing You’an Hospital, patients with chronic hepatitis B, chronic hepatitis B virus carriers and hepatitis B virus Self-limited HIV infection in four groups of HBV serum immunological tests, HBVDNA detection, HBV genotype analysis using HBV-specific genotype primers for polymerase chain reaction (PCR), acrylamide gel electrophoresis analysis of HBVDNA genotype , HBV immunological indexes were detected by enzyme-linked immunosorbent assay.Results: Of the 1321 serum samples, 804 (60.1%) were positive for HBV DNA, HBV genotypes were 0.25% for type A, 20.77% for type B and 69.53% , And 9.44% in B + C mixed type.HIVV DNA was positive in 14/245 (5.71%) patients with self-limited infection, including 9 C genotypes, 4 B genotypes and 1 BC genotype. Chronic HBV carriers HBVDNA was positive in 128/300 cases (42.67%), including 88 cases of C genotype, 36 cases of B genotype and 4 cases of BC mixed gene. In 608/668 cases (91.11%) of chronic hepatitis patients, HBVDNA was positive, of which 2 cases 121 cases of B genotype, 417 cases of C genotype, 68 cases of B / C mixed genotypes; patients with cirrhosis 54/108 cases (50%) were positive for HBVDNA, 6 cases were type B, 45 cases were type C and 3 cases were mixed with B + C. The genotype C of patients with cirrhosis was 83.33%, which were higher than those of self- Chronic HBV carriers and chronic hepatitis patients (64.29%, 68.75%, 68.58%, both P <0.05) .No age, gender and HBV genotype infection, HBV infection after the disease progression and HBV genotype.Conclusion: The genotypes of hepatitis B virus in Beijing were mainly genotype C and genotype B followed by other genotypes. The genotypes of C in patients with cirrhosis were significantly higher than those in patients with latent infection and carriers of chronic hepatitis B surface antigen Group and chronic hepatitis patients group; suggesting that hepatitis B virus genotypes and hepatitis progression have a certain relationship.
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