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目的了解江苏省海门市高中生乙型肝炎感染情况及其HBV S基因的变异情况。方法采用整群抽样方法抽取江苏省海门市职业中心校的407名高三学生进行乙肝血清学调查;采用酶联免疫吸附法(ELISA)和巢氏聚合酶链式反应(PCR)扩增方法检测血清样本的乙型肝炎表面抗原(HBsAg)、乙型肝炎病毒表面抗体(抗-HBs)和乙型肝炎病毒(HBV)S基因并进行进化分析。结果 407名高中生中乙肝表面抗原(HBsAg)阳性率为6.39%;在家中、乡镇卫生院和县级及以上医院出生学生的HBsAg阳性率分别为11.76%、8.02%和2.27%,差异有统计学意义(P<0.05);抗-HBs滴度≥10U/L者占72.5%,且呈U形分布;不同乡镇、不同性别学生抗-HBs滴度差异有统计学意义(P<0.01);407名高中生HBV S基因均为C基因型,主要变异在蛋白疏水区,抗原决定簇a区未发生免疫原性改变。结论出生时接受的医疗水平对HBV感染有影响;海门市高中生HBV S基因受到正选择作用而出现变异,但未发生免疫原性改变。
Objective To understand the status of HBV infection and HBV S gene variation among high school students in Haimen City, Jiangsu Province. Methods A total of 407 high school students from Haimen Vocational School of Jiangsu Province were enrolled in the study. Serological tests of hepatitis B were carried out using cluster sampling method. Serum levels were detected by enzyme-linked immunosorbent assay (ELISA) and nested polymerase chain reaction (PCR) Samples were analyzed for hepatitis B surface antigen (HBsAg), hepatitis B virus surface antibodies (anti-HBs) and hepatitis B virus (HBV) S genes for evolutionary analysis. Results The positive rate of HBsAg in 407 high school students was 6.39%. In the home, the HBsAg positive rates of HBsAg among township hospitals and county-level hospitals were 11.76%, 8.02% and 2.27% respectively, with statistical differences (P <0.05). Anti-HBs titer≥10 U / L accounted for72.5% with U-shaped distribution. There was significant difference in anti-HBs titers between different towns and different sexes (P <0.01). 407 high school students HBV S gene are C genotype, the main variation in the protein hydrophobic region, antigenic region a immunogenicity did not change. Conclusion The medical level received at birth has an impact on HBV infection. The HBV S gene of high school students in Haimen City has a positive selection effect, but there is no change in immunogenicity.