广西乙型肝炎病毒基因型及基因亚型流行病学分布研究

摘要

目的:研究广西乙型肝炎病毒(HBV)基因型及基因亚型的流行病学分布特征,为广西乙肝防治提供理论依据.方法:采用巢式PCR的方法扩增广西东、南、西、北、中5个地区的乙肝病毒感染者血清HBV DNA S区,用直接测序法获取S区序列进行基因分型,构建系统进化树确定基因亚型.结果:379例标本中,C基因型占54.35％(206/379),B基因型占43.54％(165/379),G基因型占2.11％(8/379),未检测到其他基因型.各基因型在不同地区、年龄组分布差异有统计学意义(P=0.00、P=0.009),在性别上的分布差异无统计学意义(P=0.152).B基因型中有160例成功分型,其中B2亚型占96.25％(154/160),B4亚型占3.75％(6/160),B基因亚型在不同地区、年龄组及性别上的差异均无统计学意义(P=0.07、P=0,67、P=0.41).C基因型中有204例成功分型,其中C1亚型占72.06％(147/204),C5亚型占25.49％(52/204),C2亚型占2.45％(5/204),C基因亚型在不同地区的分布差异有统计学意义(P=0.00),而在不同年龄组及性别上的分布差异无统计学意义(P=0.23、P=0.49).结论:广西HBV基因型以C型为主,其次为B型,桂北、桂西地区以及40岁以下、60岁以上人群以B基因型为优势基因型,桂东、桂南、桂中以及40岁至59岁人群则以C基因型为优势基因型;基因亚型以B2、C1亚型为主.B2亚型主要分布在桂北,C1亚型主要分布在桂南.%Objective:To investigate the epidemiological characteristics of hepatitis B virus genotypes and subgenotypes in Guangxi.Methods:A nested polymerase chain reaction (nPCR) assay was used for amplification of the HBV DNA S region.Samples were collected from HBV infected person in Guangxi.Sequence analysis of S gene for genotyping and subgenotypes were determined by phylogenetic analysis.Results:54.35％(206/379) were genotype C,43.54％(165/379) were genotype B,and 2.11％(8/379) were genotype G.Any other genotype was not found.There were significant differences in the genotype distribution among different regions and age groups (P＜0.05),but no significant difference was observed between male and female (P＞0.05).96.25％ of the genotype B isolates was subgenotype B2,and 3.75％ was B4.There was no significant difference in the distribution of genotype B among different regions,age and gender groups (P＞0.05).Of the genotype C isolates,72.06％ was subgenoype C1,25.49％ was C5,and 2.45 ％ was C2.There was significant difference in the distribution of genotype C among different regions (P =0.00),but no significant differences were note among different age groups and gender (P ＞0.05).Conclusion:Genotype C is predominant in Guangxi,followed by genotype B.The predominant genotype among patients in the north,south and middle of Guangxi and aged 40-59 years old were genotype C,while genotype B was predominant genotype among patients in the east and west parts of Guangxi and ＜40 or ＞60 years old.B2 and C1 are the main subgenotypes.B2 is dominant in the north of Guangxi,while C1 is in the south.