福建省5个城市乙型肝炎病毒基因型分布及HBV基因型的临床意义

[Distribution of hepatitis B virus genotype in 5 cities of Fujian province and the clinical implications of HBV genotype].

作者信息

Hu Ying-ying, Jiang Jia-ji, Ou Wen-hu, Lin Guo-xian, Su Zhi-jun, Liu Jia-jun, Li Qin-guang, Yao Lü-feng, Lin Cai-wen, Li Dan, Chen Yi

机构信息

Fuzhou Municipal Hospital of Infection, Fuzhou 350025, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2004 Mar;25(3):251-5.

PMID:15200942

Abstract

OBJECTIVE

To study the prevalence of hepatitis B virus (HBV) genotype in 5 cities of Fujian province and the clinical implications of distinct genotypes in HBV-related liver diseases.

METHODS

HBV genotype was determined by the restriction fragment length polymorphism analysis in patients with chronic HBV infection in 5 cities of Fujian province. The relationship between HBV genotype and its clinical implications was studied by multinomal logistic regression and correspondence analysis.

RESULTS

Of the 431 HBV DNA positive patients detected by PCR, 275 (63.8%) belonged to HBV genotype B, 100 (23.2%) to genotype C, 51 (11.8%) to genotype D and D-mixed genotype. Genotype A, E and F were not found. Multinomal logistic regression showed that genotype B was more prevalent in Quanzhou and Sanming cities than in Fuzhou (P = 0.002, P = 0.006), and genotype B appeared significantly more common in asymptomatic carriers (ASC), chronic hepatitis B (CHB) and severe hepatitis (SH). Genotype C was most prevalent in patients with liver cirrhosis (LC) (47.0%) than in those with ASC (14.5%) and SH (14.7%) (P = 0.009, P < 0.001). The positive rate of hepatitis B e antigen was higher in patients with genotype C than in those with genotype B and genotype D (56.0% vs. 52.4%, P = 0.008, and 56.0% vs. 30.8%, P = 0.051, respectively). By correspondence analysis, genotype D and D-mixed genotype seemed to be correlated with hepatocellular carcinoma (HCC).

CONCLUSIONS

(1) The major popular genotypes of HBV were B, C and D in Fujian. (2) Data of our study suggested that the geographic distribution of genotype B and C might be different in some cities of Fujian. (3) Genotype B might have a tendency to lead to SH in younger patients with chronic hepatitis B and the development of LC might be associated with genotype C among the elder patients. (4) Genotype D appeared to associate with development of HCC, which called for further study to confirm.

摘要

目的

研究福建省5个城市乙型肝炎病毒（HBV）基因型的流行情况以及不同基因型在HBV相关肝病中的临床意义。

方法

采用限制性片段长度多态性分析方法，对福建省5个城市慢性HBV感染者的HBV基因型进行检测。通过多分类逻辑回归和对应分析研究HBV基因型与其临床意义之间的关系。

结果

在431例经聚合酶链反应（PCR）检测HBV DNA阳性的患者中，275例（63.8%）属于HBV B基因型，100例（23.2%）属于C基因型，51例（11.8%）属于D基因型和D混合基因型。未发现A、E和F基因型。多分类逻辑回归显示，B基因型在泉州市和三明市比在福州市更常见（P = 0.002，P = 0.006），且B基因型在无症状携带者（ASC）、慢性乙型肝炎（CHB）和重型肝炎（SH）中明显更常见。C基因型在肝硬化（LC）患者中最为常见（47.0%），高于ASC患者（14.5%）和SH患者（14.7%）（P = 0.009，P < 0.001）。C基因型患者的乙肝e抗原阳性率高于B基因型和D基因型患者（分别为56.0%对52.4%，P = 0.008；56.0%对30.8%，P = 0.051）。通过对应分析，D基因型和D混合基因型似乎与肝细胞癌（HCC）相关。