某市苗族、侗族及汉族乙型肝炎病毒基因分型及耐药基因检测

摘要

目的：研究凯里市苗族、侗族及汉族乙型肝炎病毒（HBV）的基因分型和耐药基因变异状况。方法采用荧光定量聚合酶链反应（PCR）和基因芯片反向斑点杂交技术检测凯里市苗族、侗族及汉族293例乙型肝炎患者基因型和对拉米夫定、阿德福韦耐药突变基因型。用试剂盒自带的阴性、阳性对照作为每次测定的质控，确保结果的准确性。结果（1）HBV 基因型检测到 B 型及 C 型，其中 B 型259例（88．4％），C 型25例（8．5％），无法分型9例（3．1％）。汉族 B 基因型比例低于苗族和侗族，C 基因型比例明显高于其他2个民族，其基因型分布与其他少数民族比较，差异有统计学意义（χ2＝15．55，P＜0．01）；（2）286例对拉米夫定敏感，7例对拉米夫定耐药；7例对拉米夫定耐药的突变基因中，为苗族和汉族患者，侗族未见拉米夫定耐药。但3个民族 HBV 耐拉米夫定变异检出率比较，差异无统计学意义（χ2＝3．20，P＞0．05）。所有293例患者均对阿德福韦敏感。结论凯里市 HBV 基因型以 B型为主；HBV 基因 B 型患者易对拉米夫定耐药，且以突变基因型以180M 和204V 为主。%Objective To research the genotyping and drug resistance gene mutation status of hepatitis Bvirus (HBV) among Miao ,Dong and Han nationalities in Kaili city of Guizhou province .Methods The quantitative PCR and reverse dot blot hybridization microarray technology were adopted to detect the HBV genotypes and lamivudine , adefovir resistant mutations genotypes in 293 cases (Miao ,Dong and Han nationalities ) of hepatitis B .The negative control and positive control of the reagent kit served as the quality control in each determination for ensuring the ac ‐curacy of the results .Results (1) 259 cases of genotype B (259/293 ,88 .4% ) and 25 cases of genotype C (25/293 , 8 .5% ) were detected ,and 9 cases(3 .1% ) were unable genotyping .A lower frequency of genotype B in Han popula‐tion was found compared to Miao and Dong population and a higher frequency was seen in genotype C ,resulting in statistical significance in genotyping distribution compared with other minorities (χ2 = 15 .55 ,P< 0 .01) .(2)286 cases were sensitive to lamivudine .7 cases showed lamivudine resistance ,and all these 7 cases were Miao or Han patients without lamivudine resistance in Dong population ,and lamivudine‐resistant HBV mutation detection rate had no sta‐tistically significant difference among the three ethnic groups (χ2 = 3 .20 ,P> 0 .05) .All 293 patients were sensitive to adefovir .Conclusion Genotype B is the dominant HBV genotype in Kaili city .HBV genotype B patients easily be‐come lamivudine‐resistant and the mutant genotype mainly are 180M and 204V .