Zhang Ai-Min, Wang Hui-Fen, Wang Hai-Bin, Hu Jin-Hua, He Wei-Ping, Su Hai-Bin, Chen Jing, Du Ning, Duan Xue-Zhang
Liver Failure Treatment and Research Center, 302nd Hospital of PLA, Beijing 100039, China.
Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi. 2010 Jun;24(3):178-80.
To explore the association between HBV genotype and chronic/severe liver disease with HBV infection in Chinese patients.
Serum samples were collected from 2922 patients with HBV infection. HBV genotyping was performed with type-specific primers polymerase chain reaction, and the virological and biochemical markers were detected, which differences in the genotypes between various clinical types of HBV infection and liver function and virological markers between various HBV genotyping were analyzed.
The genotype B, C, BC combinations, D of 2922 patients with HBV infection accounted for 15.9%, 83.5%, 0.41%, 0.21% respectively. The ratio of genotype B in acute hepatitis group was higher (P = 0.003), which the ratio of genotype C in the cirrhosis group and the hepatocellular carcinoma group was higher (P = 0.000, 0.000). The difference in ratio of genotype C was not statistically significant between acute-on-chronic liver failure group and chronic hepatitis group. HBeAg-positive rate, viral load and liver function markers of B, C genotype group in acute hepatitis group and chronic hepatitis group were not significant different. HBeAg-positive rates of genotype C in acute-on-chronic liver failure group, cirrhosis group, hepatocellular carcinoma group were higher than that of genotype B (P = 0.000, 0.024, 0.003). Viral load of genotype C in hepatocellular carcinoma group was higher than that of genotype B (P = 0.025). Cholinesterase levels of genotype C in the acute-on-chronic liver failure group and the hepatocellular carcinoma group was lower than that of genotype B (P = 0.0004, 0.02).
There were HBV genotype B, C, B/C combinations and D in Chinese patients with HBV infection, with genotype B and C being the major ones. Compared with HBV genotype B, genotype C in Chinese patients with HBV infection was more likely to chronic infection, evolved to cirrhosis and hepatocellular carcinoma, but genotype difference was not observed in occurrence of acute-on-chronic liver failure. Genotype was not significant effect in acute and chronic hepatitis B, but HBeAg-positive rate/viral load was higher and liver damage was more severe in severe and end-stage genotype C HBV infection patients.
探讨中国乙肝病毒（HBV）感染患者中HBV基因型与慢性/重型肝病之间的关联。
收集2922例HBV感染患者的血清样本。采用型特异性引物聚合酶链反应进行HBV基因分型，并检测病毒学和生化指标，分析不同临床类型HBV感染的基因型差异以及不同HBV基因分型之间的肝功能和病毒学指标差异。
2922例HBV感染患者中，基因型B、C、BC组合、D分别占15.9%、83.5%、0.41%、0.21%。急性肝炎组中基因型B的比例较高（P = 0.003），肝硬化组和肝细胞癌组中基因型C的比例较高（P = 0.000，0.000）。慢加急性肝衰竭组和慢性肝炎组之间基因型C的比例差异无统计学意义。急性肝炎组和慢性肝炎组中B、C基因型组的HBeAg阳性率、病毒载量和肝功能指标无显著差异。慢加急性肝衰竭组、肝硬化组、肝细胞癌组中基因型C的HBeAg阳性率高于基因型B（P = 0.000，0.024，0.003）。肝细胞癌组中基因型C的病毒载量高于基因型B（P = 0.025）。慢加急性肝衰竭组和肝细胞癌组中基因型C的胆碱酯酶水平低于基因型B（P = 0.0004，0.02）。
中国HBV感染患者中存在HBV基因型B、C、B/C组合及D，其中基因型B和C为主要类型。与HBV基因型B相比，中国HBV感染患者中的基因型C更易发生慢性感染，进展为肝硬化和肝细胞癌，但在慢加急性肝衰竭的发生中未观察到基因型差异。基因型在急性和慢性乙型肝炎中无显著影响，但在重型和终末期基因型C的HBV感染患者中，HBeAg阳性率/病毒载量更高，肝损伤更严重。
