中国慢性HBV感染者基因型分布及其临床意义Meta分析

摘要

目的 探讨中国乙型肝炎病毒(HBV)基因型分布及其临床意义.方法 在万方数据库和NCBI数据库检索有关中国HBV基因型分布的研究论文,将中国分为不同HBV感染流行区,分析不同地区、民族和肝脏疾病类型人群HBV基因A、B、C、B/C、D型和其他基因型(非A~D基因型和非B/C混合型)分布.采用Meta分析基因型分布特点及其临床意义.结果 在我国,HBV基因型主要以B基因型和C基因型为主,区域1(北部地区)HBV基因A、B、C、B/C、D型和其他型分别为0.1%、22.2%、69.1%、3.8%、0.5%和1.5%,其中C基因型比例显著高于其它区域(P<0.05);区域2(中部地区)HBV基因A、B、C、B/C、D型和其他型分别为0.2%、62.6%、27.4%、3.8%、0.5%和2.4%,其中B基因型比例显著高于其它区域(P<0.05);区域3(南部地区)HBV基因A、B、C、B/C、D型和其他型分别为0.6%、36.3%、49.4%、2.8%、2.6%和3.4%,其中C基因型比例显著高于区域2的27.4%(P<0.05);区域4(青藏高原)感染HBV B基因型、C基因型、D基因型和其他基因型分别为6.0%、22.5%、11.7%和59.3%,其中C/D混合型比例显著高于其他区域(P<0.05);藏族人群C/D混合型比例(49.3%)显著高于其他民族(P<0.05),哈萨克族D基因型比例(58.1%)显著高于其他民族(P<0.05);C基因型与慢性乙型肝炎、HBV相关性肝硬化和肝癌显著相关(OR=1.979、OR=3.888、OR=4.399,P<0.001).结论 不同地区和民族HBV基因型分布显著不同,B基因型可能是中国HBV起源基因,而感染C基因型更有可能引起严重的肝脏疾病.%Objective To uncover the characteristics of distribution of hepatitis B virus (HBV) genotypes in China. Methods Papers on study of HBV genotypes in China were searched in Wanfang and NCBI databases, and the epidemic zone were classified by different regions,ethnicity,and category of liver diseases. The data of these studies were analyzed by meta-analysis to observe the distribution of genotypes and related clinical significance in each classification. Results In China,the genotypes B and genotype C of hepatitis B virus were the main genotypes;The HBV A,B,C,B/C,D and other genotype infection in patients in area 1 (North area) were 0.1%,22.2%,69.1%,3.8%,0.5% and 1.5%,with genotype C significantly higher than patients in other areas (P<0.05);The HBV A,B,C,B/C,D and other genotype infection in patients in area 2 (Central area) were 0.2%, 62.6%,27.4%,3.8%,0.5% and 2.4%,with genotype B significantly higher than patients in other areas (P<0.05);In area 3 (South area),the HBV A,B,C,B/C,D and other genotype infection were 0.6%,36.3%,49.4%,2.8%, 2.6% and 3.4%,with genotype C significantly higher than patients in area 2(27.4%,P<0.05);In area 4 (Qinghai-Tibet plateau),the HBV B,C,D and other genotype infection were 6.0%,22.5%,11.7%,59.3%,with genotype C/D significantly higher than patients in other areas (all P<0.05);Additionally,genotype distribution among different nationalities was significantly different. Genotype C/D recombination(49.3%) in Tibetan population was significantly higher than patients in other nationalities (all P<0.05),and genotype D in Kazak was 58.1%,significantly higherthan patients in other nationalities (all P<0.05);Genotype C was significantly positively correlated with chronic hepatitis B,HBV related liver cirrhosis and hepatocellular carcinoma (Odds ratios:1.979,3.888, 4.399,respectively,all P<0.001). Conclusion The distributions of HBV genotypes in different regions and nationalities are significantly different,and thefindings of this study suggests that genotype B might be the original strain of Chinese HBV infection,and genotype C is more likely to cause severe liver damage.