摘要：
目的:探讨海府地区慢性HBV感染者病毒基因型与BCP/PC区变异的特点.方法:选取2013年1月至2015年12月期间海口市人民医院住院治疗的200例慢性HBV感染者作为研究对象,依照HBV感染自然史分为慢性HBV携带组、HBeAg(+)慢性乙型肝炎组、非活动性HBsAg携带组和HBeAg(-)慢性乙型肝炎组,各50例.PCR-RELP法检测HBV基因型和PC/BCP变异.比较4组患者HBV基因型的分布情况及HBV变异类型的比率.结果:①4组患者HBV基因型的分布情况均以B型为主,差异无统计学意义(P＞0.05).②PC变异发生于基因型B,BCP变异发生于基因型C,随着HBV感染自然史的进展,PC变异的比率并未出现太大变化(37.50％ vs 48.65％ vs 39.40％ vs35.48％),差异无统计学意义(P＞0.05);但BCP变异的比率却逐渐增高(30.00％vs 61、65％ vs 76.47％vs 89.47％),差异具有统计学意义(P＜0.05).结论:海府地区慢性HBV感染进程的4个阶段(免疫耐受期、免疫清除期、免疫不全期和再活动期)均以B型基因为主,但是随着HBV感染自然史的进展,BCP变异比率均逐渐增高,表明BCP变异可能是肝细胞癌进程中的重要事件.%Objective:To investigate the genotype and BCP/PC variability in patients of chronic HBV infection in Hainan area.Methods:200 patients with chronic HBV infection who were hospitalized in Haikou People's Hospital from January 2013 to December 2015 were selected as the subjects.According to the natural history of HBV infection,the patients were divided into chronic asymptomatic HBV carrying group,HBeAg (+) chronic hepatitis B Hepatitis group,inactive HbsAg carrying group and BeAg (-) chronic hepatitis B group,50 cases in each group.HBV genotype and PC/BCP mutation were detected by PCR-RFLP.P16 mRNA was detected by RT-PCR.The distribution of HBV genotypes in different immunized states of chronic HBV infection were compared.The rates of HBV variants in the different immune status groups of each chronic HBV infection were compared.Results:① The distribution of HBV genotype in different immunized states of chronic HBV infection was mainly B type (P ＞ 0.05),which was not statistically significant.② PC mutation occurs in genotype B,and BCP mutation in genotype C.With the progression of natural history of chronic HBV infection,the ratio of PC mutation did not show much difference (37.50％ vs 48.65％ vs 39.40％ vs 35.48％) (P ＞ 0.05),which was not statistically significant,but the ratio of BCP mutation was gradually increased (30.00％ vs 61.65％ vs 76.47％ vs 89.47％) (P ＜ 0.05),which was statistically significant.Conclusion:The four stages of chronic HBV infection in Hainan (immune tolerance period,immune clearance period,immunological inexhaustion period and recurrence period) are mainly B-type genes,with the progress of natural history of chronic HBV infection,BCP mutation ratio Were gradually increased,indicating that BCP mutation may be an important event in the process of hepatocellular carcinoma.
