海府地区慢性HBV感染不同免疫状态患者基因分型、病毒变异研究

摘要

目的 了解海府地区慢性HBV感染不同免疫状态患者基因分型、病毒变异及其相互之间的关联性.方法 入选对象为海府地区慢性HBV感染患者,依照HBV感染自然史分为4组:慢性无症状HBV携带组、HBeAg(+)CHB组、HBsAg-IaC组、HBeAg(-)CHB组,各50例,PCR-RELP、PCR-反向点杂交法检测所有样本基因型、病毒变异.结果 ①4组患者B基因型感染分布比率分别为:60％、56％、62％、60％;C基因为:38％、38％、34％、32％;D基因为:2％、6％、0、6％;B+C基因为:0、0、4％、2％.各型基因在4组患者中感染同比分布差异无统计学意义(P＞0.05).4组之间优势基因均为B、C基因,尤以B基因感染为主.②4组患者均存在PC、BCP区变异,其中HBeAg(-)CHB组患者变异比例最高,其次为HBeAg(+)CHB组,与HBsAg-IaC组相较,差异有统计学意义(x2=24.73、18.32、6.78、3.84;P=6.59E-07、1.87E-05、0.009、0.049).③B、C型基因感染患者均存在PC、BCP区变异.PC、BCP区变异结果中C基因型发生比例较B基因型高,分别为:43.66％比15.97％、33.80％比10.92％,两者相较差异有统计学意义(x2=17.59、14.84,P=2.74E-05、0.000).结论 海府地区慢性HBV感染优势基因为B、C基因,尤以B基因为主,4种免疫状态均存在PC、BCP区变异.C基因型感染患者及HBeAg(-)CHB患者存在高PC、BCP区变异,可能更易引起严重的肝细胞炎症、坏死和纤维化修复、病毒的高复制及流行,因此,对患者基因分型及病毒变异进行有效监控,将为海府地区慢性HBV感染者的管理开辟新的途径,具有很高的临床实用价值.%Objective To study the correlation between genotype,viral variation and their interrelationships among patients with chronic HBV infection in haifu area.Methods We selected patients in Haifu area with chronic HBV infection as researching objects,then divided them into four groups based on their natural infected history:with chronic asymptomatic HBV carry group,HBeAg (+) CHB group,HBsAg-IaC group,and HBeAg (-) CHB group,with 50 cases for each group.We then used PCR-RELP,PCR-reverse dot hybridization methods to detect all samples' genotype and virus mutations.Results ①The probability of B genotype infection was 60％,56％,62％ and 60％ respectively.Also C genes:38％,38％,34％,32％;D genes:2％,6％,0,6％;B + C genes:0,0,4 percent,2 percent.There were no significant differences in the number of genes among the four groups (P ＞ 0.05).Each of the four groups had a B and C gene,especially B.② All 4 groups' patients had a PC,BCP area variation,including HBeAg (-)has the highest percentage of patients with CHB group variation,followed by HBeAg (+) CHB group.Compared with HBsAg-IaC group,the difference was statistically significant (x2 =24.73,18.32,6.78,18.32;P =6.59 E-07,E-05 1.87,1.87,0.049).③Patients with type B and C have a variation in PC and BCP.PC,BCP area variation results in C genotype ratio was higher than B genotype,with 43.66％ to 15.97％,33.80％ to 10.92％.Both differences were statistically significant (x2 =17.59,14.84,P =17.59 E-05,0.000).Conclusion The main gene of HBV infection in Haifu area are B and C gene,especially gene B.And 4 immune states have variation in PC and BCP.C genotype infection and HBeAg (-) in patients with CHB have high PC,BCP area variations,may be more likely to cause severe inflammation of the liver cells,necrosis and fibrosis repair,high replication of the virus and migration,therefore,performing patient genotyping and virus monitoring,and the management of sea house area chronic HBV infection in new ways,have high clinical practical values.