Department of Infectious Diseases, Southwest Hospital, Third Military Medical University of Chinese People's Liberation Army, Chongqing 400038, China.
J Clin Virol. 2009 Nov;46(3):230-3. doi: 10.1016/j.jcv.2009.08.003. Epub 2009 Sep 2.
The shift in the distribution of HCV genotypes could have a significant impact on practical medical issues.
To describe the recent distribution and evolution of HCV genotypes in southwest China.
HCV genotypes were determined by nucleotide sequencing of the CE1 regions followed by phylogenic analysis with the published HCV genotype. HCV genotype distribution was analyzed according to patients' age, risk exposure, and the first time of risk exposure.
Among the 371 cases, subtypes 1a (0.8%), 1b (42.0%), 2a (9.7%), 3a (12.1%), 3b (21.0%), 4a (0.3%), and 6a (14.0%) were found. Genotypes 3 and 6 were significantly more frequent (85.4%) among IDUs than among other subjects (32.5%, P<0.001), they were also more frequent among subjects aged 40 years or under (63.6%) than older patients (21.6%, P<0.001), among patients infected after 1997 (54.4%) than those infected before 1997 (27.3%, P=0.001). Age 40 years or under (P<0.001) and infection via IDU (P<0.001) were independently associated with genotypes 3 and 6 in the multivariate stepwise logistic regression analysis. IDU was detected as a cause of infection in 27.8% of HCV cases; it was more frequent among younger patients (40.4%) than older ones (7.1%, P<0.001), among patients infected after 1997 (40.3%) than those infected before 1997 (16.2%, P<0.001).
In southwest China, the relative prevalence of genotypes 3 and 6 has increased significantly, and that of genotypes 1b and 2a has declined significantly among young patients. This shift in distribution was associated with changes in the modes of HCV acquisition.
丙型肝炎病毒（HCV）基因型分布的转变可能对实际医学问题产生重大影响。
描述中国西南地区 HCV 基因型的最新分布和演变。
通过核苷酸测序确定 HCV 基因型，然后使用已发表的 HCV 基因型进行系统发育分析。根据患者的年龄、风险暴露和首次风险暴露情况，分析 HCV 基因型的分布。
在 371 例患者中，发现了 1a 型（0.8%）、1b 型（42.0%）、2a 型（9.7%）、3a 型（12.1%）、3b 型（21.0%）、4a 型（0.3%）和 6a 型（14.0%）。IDU 患者中基因型 3 和 6 的比例明显高于其他患者（32.5%，P<0.001），40 岁及以下患者中比例也明显高于老年患者（63.6%，P<0.001），1997 年以后感染者中比例也明显高于 1997 年以前感染者（54.4%，P=0.001）。多因素逐步逻辑回归分析显示，40 岁及以下年龄（P<0.001）和 IDU 感染（P<0.001）与基因型 3 和 6 独立相关。IDU 被检测为 HCV 感染的原因在 27.8%的 HCV 病例中；在年轻患者中更为常见（40.4%），而在老年患者中则较为罕见（7.1%，P<0.001），在 1997 年以后感染者中更为常见（40.3%），而在 1997 年以前感染者中则较为罕见（16.2%，P<0.001）。
在中国西南地区，基因型 3 和 6 的相对流行率显著增加，而基因型 1b 和 2a 的流行率在年轻患者中显著下降。这种分布的转变与 HCV 感染模式的变化有关。
