四川省自贡市159例慢性HBV感染者的HBV基因型分布及其与疾病进展关联研究
|
摘要
目的了解四川省自贡市慢性HBV感染者的HBV基因型分布情况,并探讨其与慢性乙肝患者病情进展的关系。方法收集2015年9月—2018年6月159例经本院确诊的慢性HBV感染者,且HBV-DNA水平含量在103IU/mL以上,根据疾病诊断将慢性HBV感染者分为三组:慢性乙型肝炎组(CHB)、乙肝相关性肝硬化组(LC)、乙肝相关性肝癌组(HCC)。采用多通道实时荧光探针PCR法检测乙肝病毒的3种基因型(B、C、D型),同时检测HBV-DNA及HBV的五项标记物。采用SPSS17.0软件对数据进行统计分析。结果本文研究显示B基因型115例(72.3%),C基因型43例(27.0%),B/C混合型1例(0.6%),D基因型0例;B基因型的HBV-DNA水平高于C基因型(P<0.05);慢性HBV感染患者中,男、女组均以B基因型为主,B基因型和C基因型分布在年龄、性别、HBeAg阳性率方面比较差异无统计学意义(P>0.05);乙肝相关性肝癌组(HCC)的C基因型比例明显高于CHB组和LC组(P<0.05)。结论自贡市HBV主要流行B基因型,其次是C基因型;B基因型和C基因型的慢性HBV感染患者进展为肝硬化或肝癌可能存在一定的差异。
Objective To investigate the prevalence and distribution of HBV genotypes in chronic HBV infection patients in Zigong area, and to explore the relationship between HBV genotypes and the progression of liver disease in chronic hepatitis B patients. Methods Totally 159 cases of chronic HBV infection with HBV-DNA level ≥103 IU/mL from September2015 to June 2018 were collected. According to the clinical diagnosis, chronic HBV infection patients were divided into three groups: chronic hepatitis B group(CHB), HBV related liver cirrhosis group(LC), HBV related hepatocellular carcinoma group(HCC). HBV genotype B, genotype C and genotype D were detected by multi-channel real-time fluorescence PCR, and five markers of HBV and HBV-DNA were detected at the same time. The data was analyzed by SPSS17.0 software for statistical description. Results The proportion of HBV genotype B, C, B/C and D was 72.3%(115/159), 27.0%(43/159), 0.6%(1/159)and 0%(0/159), respectively. HBV-DNA level of B genotype was higher than that of C genotype(P<0.05). In chronic HBV infection patients, the B genotype was dominant in male and female groups. There was no statistical significance in the distribution of B genotype and C genotype in terms of age, gender and HBeAg positive rate(P>0.05). The C genotype ratio of HCC group was significantly higher than that of CHB group and LC group(P<0.05). Conclusion In Zigong area, the main genotype of HBV was B genotype, followed by C genotype. There may be differences in the progression to liver cirrhosis and hepatocellular carcinoma between patients with chronic HBV infection with genotype B and genotype C.
Objective To investigate the prevalence and distribution of HBV genotypes in chronic HBV infection patients in Zigong area, and to explore the relationship between HBV genotypes and the progression of liver disease in chronic hepatitis B patients. Methods Totally 159 cases of chronic HBV infection with HBV-DNA level ≥103 IU/mL from September2015 to June 2018 were collected. According to the clinical diagnosis, chronic HBV infection patients were divided into three groups: chronic hepatitis B group(CHB), HBV related liver cirrhosis group(LC), HBV related hepatocellular carcinoma group(HCC). HBV genotype B, genotype C and genotype D were detected by multi-channel real-time fluorescence PCR, and five markers of HBV and HBV-DNA were detected at the same time. The data was analyzed by SPSS17.0 software for statistical description. Results The proportion of HBV genotype B, C, B/C and D was 72.3%(115/159), 27.0%(43/159), 0.6%(1/159)and 0%(0/159), respectively. HBV-DNA level of B genotype was higher than that of C genotype(P<0.05). In chronic HBV infection patients, the B genotype was dominant in male and female groups. There was no statistical significance in the distribution of B genotype and C genotype in terms of age, gender and HBeAg positive rate(P>0.05). The C genotype ratio of HCC group was significantly higher than that of CHB group and LC group(P<0.05). Conclusion In Zigong area, the main genotype of HBV was B genotype, followed by C genotype. There may be differences in the progression to liver cirrhosis and hepatocellular carcinoma between patients with chronic HBV infection with genotype B and genotype C.
引文
[1]CHOI J W,AHN S H,PARK J Y,et al.Hepatitis B e antigen-negative mutations in the precore and core promoter regions in Korean patients[J].J Med Virol,2009,81(4):594-601.
[2]王金霞,赵玉良,马景臣.乙型肝炎病毒基因型研究进展[J].实用预防医学,2017,24(12):1539-1542.
[3]KAO J H,CHEN P J,LAI M Y,et al.Basal core promoter mutations of hepatitis B virus increase the risk of hepatocellular carcinoma in hepatitis B carriers[J].Gastroenterology,2003,124(2):327-334.
[4]CASTELAIN S,DESCAMPS V,BROCHOT E,et al.High association of T1858-G1896 precore mutations with impaired base pairing and high hepatitis B virus DNA levels in HBeAg-negative chronically infected patients[J].Arch Virol,2017,162(7):1913-1920.
[5]董绍斌,王富珍,张爽,等.原发性肝癌合并HBV感染者的HBV基因特征分析[J].中华实验和临床病毒学杂志,2017,31(2):92-97.
[6]TAN A,YEH S H,LIU C J,et al.Viral hepatocarcinogenesis:from infection to cancer[J].Liver International,2008,28(2):175-188.
[7]许军,王齐欣,蒋栋,等.乙型肝炎病毒基因型与病情轻重的关系[J].中华肝脏病杂志,2003(1):11-13.
[8]中华医学会肝病学分会,中华医学会感染病学分会.慢性乙型肝炎诊断标准(2015年版)[J].中西医结合肝病杂志,2015,25(6):384.
[9]丛文铭,步宏,陈杰,等.原发性肝癌规范化病理诊断指南(2015年版)[J].解放军医学杂志,2015,21(11):833-839.
[10]LI H M,WANG J Q,WANG R,et al.Hepatitis B virus genotypes and genome characteristics in China[J].World J Gastroenterol,2015,21(21):6684-6697.
[11]谢佳新,张海谱,高秋菊,等.石家庄地区乙肝病毒基因型分布及其与疾病进展关联研究[J].现代预防医学,2017,44(7):1161-1165.
[12]李东,张苏晗,杨秀惠,等.福建地区乙型肝炎病毒基因型分布及特征[J].中国热带医学,2017,17(1):27-31,40.
[13]胡章勇,杨军,许颖,等.成都地区HBV基因型分布及临床意义[J].四川医学,2009,30(2):227-228.
[14]卢亦路,王玲,张发强,等.成都地区HBV基因型分布研究[J].中华微生物学和免疫学杂志,2007,27(6):546-548.
[15]LIN C L,KAO J H.Hepatitis B virus genotypes and variants[J].Cold Spring Harbor Perspectives in Medicine,2015,5(5):a021436.
[16]徐龙,车达平,吕定英,等.江西地区乙型肝炎病毒基因型分布与临床的相关性[J].中华肝脏病杂志,2006,14(2):147-148.
[17]申旭霞,周燕,赵超芬,等.荧光定量聚合酶链反应分型法检测乙型肝炎病毒B、C基因型的研究[J].医学综述,2013,19(15):2819-2820,2823.
[18]谢佳新,丁一波,蒲蕊,等.乙肝病毒Enh∏/BCP/PC基因变异与肝硬化的相关性研究[J].公共卫生与预防医学,2017,28(6):1-5.
[19]李清,冯麟.HBV-DNA载量测定联合HBsAg定量分析在慢性HBV感染诊疗中的作用[J].热带医学杂志,2018,18(4):488-493.
[20]KAO J H,CHEN P J,LAI M Y,et al.Hepatitis B genotypes correlate with clinical outcomes in patients with chronic hepatitis B[J].Gastroenterology,2000,118(3):554-559.
[21]TSENG T C,LIU C J,YANG H C,et al.Higher proportion of viral basal core promoter mutant increases the risk of liver cirrhosis in hepatitis B carriers[J].Gut,2015,64(2):292-302.
[22]周晨浩,任宁.乙型肝炎病毒基因分型与肝细胞癌发生发展的研究进展[J].世界华人消化杂志,2016,24(11):1688-1694.2018-12-24
[2]王金霞,赵玉良,马景臣.乙型肝炎病毒基因型研究进展[J].实用预防医学,2017,24(12):1539-1542.
[3]KAO J H,CHEN P J,LAI M Y,et al.Basal core promoter mutations of hepatitis B virus increase the risk of hepatocellular carcinoma in hepatitis B carriers[J].Gastroenterology,2003,124(2):327-334.
[4]CASTELAIN S,DESCAMPS V,BROCHOT E,et al.High association of T1858-G1896 precore mutations with impaired base pairing and high hepatitis B virus DNA levels in HBeAg-negative chronically infected patients[J].Arch Virol,2017,162(7):1913-1920.
[5]董绍斌,王富珍,张爽,等.原发性肝癌合并HBV感染者的HBV基因特征分析[J].中华实验和临床病毒学杂志,2017,31(2):92-97.
[6]TAN A,YEH S H,LIU C J,et al.Viral hepatocarcinogenesis:from infection to cancer[J].Liver International,2008,28(2):175-188.
[7]许军,王齐欣,蒋栋,等.乙型肝炎病毒基因型与病情轻重的关系[J].中华肝脏病杂志,2003(1):11-13.
[8]中华医学会肝病学分会,中华医学会感染病学分会.慢性乙型肝炎诊断标准(2015年版)[J].中西医结合肝病杂志,2015,25(6):384.
[9]丛文铭,步宏,陈杰,等.原发性肝癌规范化病理诊断指南(2015年版)[J].解放军医学杂志,2015,21(11):833-839.
[10]LI H M,WANG J Q,WANG R,et al.Hepatitis B virus genotypes and genome characteristics in China[J].World J Gastroenterol,2015,21(21):6684-6697.
[11]谢佳新,张海谱,高秋菊,等.石家庄地区乙肝病毒基因型分布及其与疾病进展关联研究[J].现代预防医学,2017,44(7):1161-1165.
[12]李东,张苏晗,杨秀惠,等.福建地区乙型肝炎病毒基因型分布及特征[J].中国热带医学,2017,17(1):27-31,40.
[13]胡章勇,杨军,许颖,等.成都地区HBV基因型分布及临床意义[J].四川医学,2009,30(2):227-228.
[14]卢亦路,王玲,张发强,等.成都地区HBV基因型分布研究[J].中华微生物学和免疫学杂志,2007,27(6):546-548.
[15]LIN C L,KAO J H.Hepatitis B virus genotypes and variants[J].Cold Spring Harbor Perspectives in Medicine,2015,5(5):a021436.
[16]徐龙,车达平,吕定英,等.江西地区乙型肝炎病毒基因型分布与临床的相关性[J].中华肝脏病杂志,2006,14(2):147-148.
[17]申旭霞,周燕,赵超芬,等.荧光定量聚合酶链反应分型法检测乙型肝炎病毒B、C基因型的研究[J].医学综述,2013,19(15):2819-2820,2823.
[18]谢佳新,丁一波,蒲蕊,等.乙肝病毒Enh∏/BCP/PC基因变异与肝硬化的相关性研究[J].公共卫生与预防医学,2017,28(6):1-5.
[19]李清,冯麟.HBV-DNA载量测定联合HBsAg定量分析在慢性HBV感染诊疗中的作用[J].热带医学杂志,2018,18(4):488-493.
[20]KAO J H,CHEN P J,LAI M Y,et al.Hepatitis B genotypes correlate with clinical outcomes in patients with chronic hepatitis B[J].Gastroenterology,2000,118(3):554-559.
[21]TSENG T C,LIU C J,YANG H C,et al.Higher proportion of viral basal core promoter mutant increases the risk of liver cirrhosis in hepatitis B carriers[J].Gut,2015,64(2):292-302.
[22]周晨浩,任宁.乙型肝炎病毒基因分型与肝细胞癌发生发展的研究进展[J].世界华人消化杂志,2016,24(11):1688-1694.2018-12-24