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目的了解静脉吸毒人群丙型肝炎病毒(HCV)感染者的基因亚型分布及影响因素,为防治静脉吸毒人群感染HCV提供依据。方法收集828份静脉吸毒人群样本,HCV抗体初筛用酶联免疫吸附试验(ELISA),有反应性的样本再用重组免疫印迹法(RIBA)进行补充试验,阳性的样本进行核酸检测;核酸阳性的样本先用HCV基因分型试剂盒进行分型,未通过分型试剂盒确定型别的样本,再用巢式聚合酶链式反应扩增HCV CORE区进行测序,以确定HCV基因型。结果 828份静脉吸毒人群样本中,HCV抗体阳性498份,核酸检测呈阳性反应的样本390份,通过HCV基因分型试剂盒确定型别的样本311份,经CORE区测序确定型别的样本70份,有9份未成功扩增出序列,共有381份样本确定了基因亚型。其主要基因亚型为3b、3a、1b、6n及6a五种型别,分别占38.6%(147/381)、20.5%(78/381)、18.6%(71/381)、10.8%(41/381)、8.7%(33/381);不同地区之间流行的HCV基因型别差异具有统计学意义(χ~2=282.23,P<0.01);男性和女性之间主要基因型不太一致;各年龄段间HCV基因亚型分布的差异无统计学意义(χ~2=40.93,P>0.05),但30~50岁感染者居多。不同基因型之间HCV核糖核酸含量的差异有统计学意义(F=5.85,P<0.01)。结论静脉吸毒人群HCV感染者的基因亚型主要为1b、3a、3b、6a及6n,基因型分布具有地域性差异,并且病毒载量与基因型的分布具有相关关系。
Objective To understand the distribution of genotypes and influencing factors of hepatitis C virus (HCV) infection in intravenous drug users and to provide evidence for prevention and control of HCV infection in the population. Methods A total of 828 samples of intravenous drug users were collected. HCV antibody screening by enzyme-linked immunosorbent assay (ELISA), reactive samples and then by Western blotting (RIBA) supplementation, positive samples for nucleic acid detection; nucleic acid positive Of the samples were genotyped by the HCV genotyping kit, but no genotyping kit was used for the genotyping kit. The HCV CORE region was amplified by nested PCR and sequenced to determine the HCV genotype. Results Among 828 intravenous drug addicts, 498 were positive for HCV antibody and 390 were positive for nucleic acid test. 311 samples were confirmed by HCV genotyping kit, and the other samples identified by CORE sequencing A total of 9 samples did not amplify the sequences, and 381 samples confirmed the genotypes. The major subtypes were 3b, 3a, 1b, 6n and 6a, accounting for 38.6% (147/381), 20.5% (78/381), 18.6% (71/381), and 10.8% / 381), 8.7% (33/381). The genotypes of HCV in different regions were statistically different (χ ~ 2 = 282.23, P <0.01). The major genotypes between males and females were not consistent There was no significant difference in the distribution of HCV genotypes between different age groups (χ ~ 2 = 40.93, P> 0.05), but most of the patients aged 30 to 50 were infected. The differences of HCV RNA content among different genotypes were statistically significant (F = 5.85, P <0.01). Conclusion The genotypes of HCV-infected patients are mainly 1b, 3a, 3b, 6a and 6n. The distribution of genotypes is regionally different, and the relationship between viral load and genotype distribution is also related.