摘要
目的 了解广西乙型肝炎病毒 (HBV)基因型流行情况及其临床意义。方法 用套式PCR扩增检测广西南部和北部 [桂南和桂北 ]的各型乙型肝炎患者和慢性无症状HBV携带者共 16 1份血清HBVDNA ,阳性者用限制性片段长度多态性 (RFLP)方法、直接测序法或克隆测序法进行基因分型。结果 广西HBV各种基因型分布比例 :基因型A占 3 7% ,基因型B 2 1 7% ,基因型C 72 7%、基因型D 1 2 % ;未发现基因型E、F、G和H。基因型C在慢性肝炎、肝硬化和原发性肝癌患者组中流行呈增加趋势 ,基因型B的流行与基因型C比较呈相反趋势 (主要在慢性无症状HBV携带者和急性肝炎流行率相对较高 ) ;基因型C组的HBeAg阳性率显著高于基因型B组 ,而基因型C组抗 HBe阳性率显著低于基因型B组。在基因型C组的肝脏损伤 (ALT)比基因型A和B组更为严重 ;而在慢性无症状HBV携带者组中 ,基因型C在桂南的流行率显著高于桂北 ,基因型B的情况则相反。结论 ①广西主要流行的HBV主要为基因型B和C ,桂南主要为HBV基因型C ,桂北则主要为HBV基因型B ,提示广西HBV基因型由于其流行分布的不同与广西肝癌发病率桂南高于桂北有关。②基因型C与较严重的肝脏疾病如肝癌的发生有关。③首次发现广西的急性肝炎、慢性肝炎存在少量的HBV基因型A型、D型和B +C的混合型的?
Objective To understand the distribution of hepatitis B virus genotype in Guangxi and its clinical significance Methods Nested polymerase chain reaction (nPCR) was used for amplification of HBV DNA in sera of asymptomatic carrier (ASC) of hepatitis B virus (HBV) and patients with different liver diseases from southern and northern Guangxi Specimens from 161 subjects were positive for HBV DNA and HBV genotype was determined by using restriction fragment length polymorphism analysis, direct sequencing or cloning sequencing Results The prevalence of genotype A was 3 7% in all samples and that of genotype B, C and D was 21 7%,72 7% and 1 2%, respectively No other genotypes (such as genotype E, F, G, H) were found The prevalence of genotype C showed an increasing trend in ASC,chronic hepatitis, liver cirrhosis and hepatocellular carcinoma(HCC) group; in contrast, the prevalence of genotype B showed an opposite trend, although no statistically significant difference was observed, except between ASC and HCC ( P =0 05) The HBeAg positive rate was higher, and the anti HBe positive rate was lower in patients with chronic genotype C infection than in those with genotype B ( P <0 05 for both) Liver function test (ALT) abnormality was more severe in genotype C group than in genotypes A and B groups having acute or chronic infection ( P <0 01 for all comparisons) The prevalence of genotype C in southern Guangxi was higher than that in northern Guangxi In contrast, the prevalence of genotype B in southern Guangxi was lower than that in northern Guangxi Conclusion ① The predominant HBV genotypes in Guangxi were genotypes B and C The major genotype in southern Guangxi was genotype C; while that in northern Guangxi was genotype B, which implied that the distribution of HBV genotype C was cinsistent with the incidence of HCC in Guangxi ② Genotype C maybe associated withdevelopment of severe liver diseases including HCC ③Genotype A,D and B+C were mostly found in acute, hepatitis and chronic hepatitis group
出处
《中华实验和临床病毒学杂志》
CAS
CSCD
北大核心
2003年第2期174-179,共6页
Chinese Journal of Experimental and Clinical Virology
