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目的调查贵州省4城市乙型肝炎病毒(HBV)感染者的病毒基因型及其与临床的关系。方法选择贵阳、遵义、凯里、都匀4城市慢性HBV感染患者共786例,其中无症状携带者(ASC)346例,慢性肝炎(CH)313例,肝硬化(LC)77例,肝细胞肝癌(HCC)50例。用S基因限制性片段长度多态性确定基因型,直接测序分析B基因亚型,比较主要基因型地区分布及临床特征。结果786例中,B基因型497例(63．23%),C型275例(34．99%),A型7例(0．89%),D型7例(0．89%),未发现E、F型。B型的分布：凯里市最高(96．04%),遵义、都匀市其次(78．79%、64．52%),贵阳市最低(53．14%)。C型的分布,贵阳(45．84%)高于都匀(34．41%)、遵义(13．13%)及凯里市(3．96%),差异有统计学意义(P＜0．05或P＜0．01)。94例B型感染者中,93例为Ba(98．94%)、1例为Bj亚型。从ASC、CH、LC到HCC组,B型的分布逐渐降低,而C型在各组的分布逐渐增高。与B型相比,C型感染者年龄较大；ALT水平较高(P＜0．05)；HBeAg阳性较低(P＜0．025)。结论贵州省存在A、B、C、D 4种HBV基因型,但以B型为主,C型其次,A、D型极少。B型中又以Ba亚型为主。B、C基因型在贵州省4城市的分布有一定差异。
Objective To investigate the genotype of hepatitis B virus (HBV) in 4 cities of Guizhou Province and its relationship with clinical manifestations. Methods A total of 786 cases of chronic HBV infection in Guiyang, Zunyi, Kaili and Duyun 4 cities were selected. There were 346 cases of asymptomatic carriers (ASC), 313 cases of chronic hepatitis (CH), 77 cases of liver cirrhosis (LC) Liver cancer (HCC) in 50 cases. Genotypes were determined by restriction fragment length polymorphism of the S gene and the B subtype was directly sequenced. The regional distribution and clinical characteristics of the major genotypes were compared. Results Among the 786 cases, 497 (63.23%) were genotype B, 275 (34.99%) were C, 7 (0.89%) were A, 7 Did not find E, F type. Type B distribution: the highest in Kaili (96.04%), Zunyi, Duyun followed (78.79%, 64.52%), the lowest in Guiyang (53.14%). (45.84%) were higher than Duyun (34.41%), Zunyi (13.13%) and Kaili (3.96%), the difference was statistically significant (P <0 .05 or P <0.01). Among the 94 cases of type B infection, 93 were Ba (98.94%) and 1 was Bj subtype. From ASC, CH, LC to HCC group, the distribution of type B gradually decreased, while the distribution of type C in each group increased gradually. Compared with type B, those with type C infection were older; ALT levels were higher (P <0.05); HBeAg was lower (P <0.025). Conclusion There are 4 HBV genotypes of A, B, C and D in Guizhou Province, but type B is the major genotype, followed by type C, followed by Type A and D genotypes. B-type in Ba subtype again. There are some differences in the distribution of B and C genotypes in 4 cities in Guizhou province.