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目的了解我国慢性丙型肝炎病毒(heptitis C virus,HCV)感染者中不同基因型/亚型HCV混合感染率以及影响因素,为制定适合我国国情的HCV预防和治疗政策提供科学依据。方法从全国各省(台湾省除外)的省会城市、直辖市(重庆市除外)和自治区(新疆除外)的三级甲等综合医院和传染病专科医院,随机收集2009-2011年HCV RNA阳性血浆(血清)标本1 450份,记录相应的年龄、性别、民族、籍贯、职业和病毒滴度等。分别以C/E1和NS5B为目的基因进行巢式PCR扩增并克隆测序。根据感染情况分为单独感染组和混合感染组,用χ2检验及t检验比较两组性别、年龄、民族和滴度等差异(P<0.05为差异有统计学意义)。结果 C/E1和NS5B两个基因PCR扩增均为阳性的标本1 159个,HCV混合感染者为11个,其余1 148个均为单独感染。不同基因型/亚型混合感染率为0.95%。混合感染的基因型涵盖了1b、2a和6a。1b+2a混合感染9个(2a占优势的6个,1b占优势的3个);6a+2a混合感染1个(6a占优势);6a+1b混合感染1个(6a占优势)。年龄、性别、民族和滴度等两组之间差异均无统计学意义。结论全国HCV不同基因型/亚型混合感染率为0.95%。混合感染的基因型涵盖了1b、2a和6a。6a基因型在中国慢性丙型肝炎患者的混合感染中首次被报道。
Objective To understand the prevalence of HCV in different genotypes / subtypes of HCV in Chinese patients with chronic hepatitis C virus (HCV) infection and its influencing factors, and to provide a scientific basis for the development of HCV prevention and treatment policies suitable for China’s national conditions. Methods From 2009-2011 HCV RNA-positive plasma (serums) were collected from Grade A General Hospital and Infectious Diseases Specialist Hospital of provincial capitals (excluding Chongqing) and autonomous regions (excluding Xinjiang) ) 1,450 specimens, record the appropriate age, gender, ethnic origin, occupation and virus titer. Respectively, C / E1 and NS5B for the purpose of the gene nested PCR amplification and sequencing. According to the infection status, the patients were divided into separate infection group and mixed infection group. Chi-square test and t-test were used to compare the gender, age, ethnicity and titer between the two groups (P <0.05 for the difference was statistically significant). Results There were 1 159 positive samples of C / E1 and NS5B amplified by PCR, 11 of them were infected by HCV and 1 148 were infected separately. The infection rate of different genotypes / subtypes was 0.95%. The genotypes of mixed infections cover 1b, 2a and 6a. 1 (6a dominant); 6a + 1b mixed infection 1 (6a dominant). There were no significant differences in age, gender, ethnicity and titer between the two groups. Conclusion The prevalence of HCV in different genotypes / subtypes in China is 0.95%. The genotypes of mixed infections cover 1b, 2a and 6a. The genotype 6a was first reported in mixed infections in patients with chronic hepatitis C in China.