长春市702例HBV感染者的病毒基因分型及临床意义

袁野; 于雪娇; 卢念红; 张明威

doi:10.3969/j.issn.1001-5256.2016.11.019

长春市702例HBV感染者的病毒基因分型及临床意义

DOI: 10.3969/j.issn.1001-5256.2016.11.019

1. 吉林大学第一医院
2. 吉林大学第二医院

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中图分类号: R512.62
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出版历程
- 出版日期: 2016-11-20

HBV genotyping of 702 hepatitis B patients in Changchun,China and its clinical significance

摘要

摘要: 目的了解长春市HBV基因型的分布情况,分析不同基因型与病毒复制水平、血清标志物及肝损伤的关系及临床意义。方法收集2013年8月-2016年5月于吉林大学第一医院就诊的HBV感染者702例,采用real-time PCR法检测HBV基因型,并检测HBV DNA载量、血清标志物及肝功能,分析基因型与临床检测项目的相关性。计量资料组间比较采用独立样本t检验;计数资料组间比较采用χ2检验。HBV基因型在不同疾病中的分布选用Mann-Whitney U检验。结果 702例HBV感染者中成功分型664例,其中C基因型484例（72.9%）,B基因型168例（25.3%）,B+C基因型12例（1.8%）。HBV基因型分布无性别、年龄差异。C基因型感染者HBV DNA载量为（6.68±1.20）log10拷贝/ml,显著高于B基因型（5.15±1.37）log10拷贝/ml,差异有统计学意义（t=13.714,P<0.001）;C基因型HBsAg（+）+HBeAg（+）+抗-HBc（+）高于B基因型,差异有统计学意义（χ2=21.687,P<0.001）;但HBsAg（+）+抗-HBe（+...
- 肝炎病毒,乙型 /
- 基因型 /
- 生物学标记
Abstract: Objective To investigate the distribution of HBV genotypes in Changchun,China,as well as the association of genotypes with virus replication level,serum markers,and liver impairment and its clinical significance. Methods A total of 702 patients with HBV infection who visited The First Hospital of Jilin University from August 2013 to May 2016 were enrolled. Real- time PCR was used to determine HBV genotypes. HBV DNA load,serum markers,and liver function were measured,and the association between genotype and clinical test items was analyzed. The independent samples t- test was used for the comparison of means between groups,and the chi- square test was used for comparison of categorical data between groups. The Mann- Whitney U test was used to investigate the distribution of HBV genotypes in different diseases. Results Of all patients with HBV infection,664 underwent successful genotyping,among whom 484( 72. 9%) had genotype C,168( 25. 3%) had genotype B,and 12( 1. 8%) had genotype B + C. There were no differences in the distribution of HBV genotypes between patients with different sexes or ages. Compared with those with genotype B HBV infection,the patients with genotype C HBV infection had significantly higher HBV DNA load( 6. 68 ± 1. 20 log10 copies / ml vs 5. 15 ± 1. 37 log10 copies / ml,t = 13. 714,P < 0. 001) and HBsAg( +) + HBeAg( +) + anti- HBc( +)( χ2= 21. 687,P < 0. 001). There was no significant difference in HBsAg( +) + anti- HBe( +) + anti- HBc( +)between the two groups( χ2= 2. 124,P = 0. 145). The patients with genotype B had significantly higher levels of HBsAg and anti- HBe than those with genotype C( χ2= 28. 780,P < 0. 001). Compared with those with genotype B,the patients with genotype C had significantly higher levels of alanine aminotransferase( ALT) and aspartate aminotransferase( AST)( ALT: 307. 6 ± 113. 4 U / L vs 285. 8 ± 96. 2 U / L,t = 2. 229,P = 0. 026; AST: 211. 1 ± 96. 4 U / L vs 192. 7 ± 89. 2 U / L,t = 2. 172,P = 0. 030),as well as a significantly lower level of albumin( 37. 6 ± 9. 1 g/L vs 39. 9 ± 10. 6 g/L,t = 2. 701,P = 0. 007). Among the patients with genotype C HBV infection,264 progressed to chronic hepatitis,202 to liver cirrhosis,and 18 to liver cancer; among the patients with genotype B HBV infection,142 progressed to chronic hepatitis,20 to liver cirrhosis,and 6 to liver cancer. The patients with genotype C HBV infection had significantly greater liver injury compared with those with genotype B HBV infection( U = 28 894. 000,P < 0. 001). Conclusion Most of the patients with HBV infection in Changchun have genotype C,followed by genotype B. HBV genotype is not associated with sex or age. The patients with genotype C HBV infection have active HBV DNA replication and show greater association with the severity of liver injury compared with those with genotype B HBV infection.
- hepatitis B virus /
- genotype /
- biomarkers

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参考文献(16)

[1]LUO KX.Hepatitis B:Basic biology and clinical science[M].Beijing:People's Medical Publishing House,2001:7-9.(in Chinese)骆抗先.乙型肝炎基础和临床[M].北京:人民卫生出版社,2001:7-9.

[2]MELLO FC,FERNANDES CA,GOMES SD.Antiviral therapy against chronic hepatitis B in Brazil:high rates of lamivudine resistance mutations and correlation with HBV genotypes[J].Memorads Do Institato Oswaldo Cruz,2012,107(3):317-325.

[3]LEE JH,HONG SP,JANG ES,et al.Analysis of HBV genotype,drug resistant mutations,and pre-core/basal core promoter mutations in Korean patients with acute hepatitis B[J].J Med Virol,2015,87(6):993-938.

[4]ANDERNACH IE,HUNEWALD OE,MULLER CP.Bayesian inference of the evolution of HBV/E.[J].PLo S One,2013,8(11):e81690.

[5]BOUCKAERT R,ALVARADO-MORA MV,PINHO JR.Evolutionary rates and HBV:issues of rate estimation with Bayesian molecular methods.[J].Antiviral Therapy,2013,18(3):497-503.

[6]BOKHARAEI-SALIM F,KEYVANI H,MONAVARI SH,et al.Distribution of hepatitis B virus genotypes in azerbaijani patients with chronic hepatitis B infection.[J].Hepat Mon,2014,14(12):e25105.

[7] Chinese Society of Hepatology,Chinese Society of Infectious Diseases,Chinese Medical Association.The guideline of prevention and treatment for chronic hepatitis B(2010 version)[J].J Clin Hepatol,2011,27(1):Ⅰ-ⅩⅥ.(in Chinese)中华医学会肝病学分会,中华医学会感染病学分会.慢性乙型肝炎防治指南(2010年版)[J].临床肝胆病杂志,2011,27(1):Ⅰ-ⅩⅥ.

[8]LI YM,XU ZF,LIU R,et al.Study on hepatitis B virus genotypes distribution of China Heilongjiang Daqing and Xinjiang Aletai Region[J].J Mod Lab Med,2012,27(4):41-43.(in Chinese)李玉梅,徐志峰,刘然,等.中国黑龙江大庆与新疆阿勒泰地区乙肝病毒基因型分布规律研究[J].现代检验医学杂志,2012,27(4):41-43.

[9]LIU AQ,TANG SM,CHEN WB,et al.Research on hepatitis B virus genotyping and drug resistance in Shenzhen area[J].Int J Lab Med,2013,34(14):1787-1788.(in Chinese)刘艾芹,唐曙明,陈卫布,等.深圳地区乙肝病毒基因分型与耐药性研究[J].国际检验医学杂志,2013,34(14):1787-1788.

[10]WENG W,TANG JB,SONG XF,et al.Distribution and clinical correlation research of hepatitis B virus genotypes of patients in Tongling area[J].Lab Med,2014,29(7):701-704.(in Chinese)翁伟,唐吉斌,宋晓菲,等.铜陵地区乙型肝炎病毒基因型分布及其与临床的相关性研究[J].检验医学,2014,29(7):701-704.

[11]ZHANG B,LI SL,YAO ZY,et al.Correlation between patients with chronic hepatitis virus and HBV genotypes in Tangshan region[J].Chin J Nosocomiol,2016,26(5):982-984.(in Chinese)张宝,李世龙,么作义,等.唐山地区慢性乙型肝炎患者临床特征与HBV基因型的相关性研究[J].中华医院感染学杂志,2016,26(5):982-984.

[12]SUN YH,LEI XY,YUAN H.Clinical and pathological differences between children with various genotypes of hepatitis B virus-associated glomerulonephritis[J].Chin J Contemp Pediatr,2015,17(4):371-374.(in Chinese)孙永红,雷晓燕,袁宏.乙型肝炎病毒相关性肾炎不同基因型患儿间临床及病理特征的差异分析[J].中国当代儿科杂志,2015,17(4):371-374.

[13]SHEN J,LIU WL,WANG F.The correlation analysis of hepatitis B virus genotyping and clinical indexes in Taiyuan area[J].Chin J Health Lab Technol,2015,25(14):2383-2385.(in Chinese)申静,刘薇拉,王菲.太原地区乙肝病毒基因分型与临床指标的相关性分析[J].中国卫生检验杂志,2015,25(14):2383-2385.

[14]ZHANG B,LI SL,TIAN SH,et al.Comparative study on hepatitis B virus seven serum markers and hepatitis B virus dna quanti-tative of HBV patients in Tangshan area of Hebei province[J].Med Recapitulate,2014,20(20):3793-3794.(in Chinese)张宝,李世龙,田珊红,等.河北唐山地区乙肝患者血清标志物七项与乙肝病毒DNA定量的对比研究[J].医学综述,2014,20(20):3793-3794.

[15]PAPASTERGIOU V,KARATAPANIS S.Current status and emerging chal enges in the treatment of hepatitis C virus genotypes 4 to 6[J].World J Clin Cases,2015,3(3):210-220.

[16]MUKHERJEE R,BURNS A,RODDEN D,et al.Diagnosis and management of hepatitis C virus infection[J].J Lab Autom,2015,2(3):29-49.

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