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目的分析湖北地区丙型肝炎病毒(HCV)基因型分布及其流行病学特征。方法收集2013年5月至2016年3月在华中科技大学同济医学院附属同济医院接受HCV基因分型检查的丙肝患者血清及相关流行病学资料。采用实时荧光定量PCR对HCV RNA进行测定;采用巢式RT-PCR对HCV RNA阳性样本的核心区(core-e1)进行扩增并测序;对所测序列进行基因分型和进化树分析,并对各基因型相关的危险因素进行综合分析。结果共有HCV RNA阳性310例,测序223例,测序结果显示湖北地区存在5种基因型,1b型178例(79.82%),2a型32例(14.35%),6a型8例(3.59%),3b型4例(1.79%),3a型1例(0.45%)。1b、2a型主要见于1997年以前的有偿供血者和输血者;2a还多见于通过性接触传播的人群;6a、3b和3a型仅见于静脉注射毒品者。结论湖北地区HCV基因型分布呈现多样性且与传播途径密切相关,有关各方应予以关注及干预。
Objective To analyze the distribution and epidemiological characteristics of hepatitis C virus (HCV) genotypes in Hubei Province. Methods Serum and related epidemiological data of hepatitis C patients who underwent HCV genotyping at Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology from May 2013 to March 2016 were collected. Real-time fluorescence quantitative PCR was used to detect HCV RNA; nested RT-PCR was used to amplify and sequence core-e1 of HCV RNA positive samples; Genotyping and phylogenetic tree analysis were performed on the tested sequences Comprehensive analysis of the risk factors associated with each genotype. Results A total of 310 cases of HCV RNA were positive and 223 were sequenced. Sequencing results showed that there were 5 genotypes in Hubei Province, including 178 cases of type 1b (79.82%), 32 cases of type 2a (14.35%), 8 cases of type 6a (3.59% Four cases (1.79%) of type 3b and one case of type 3a (0.45%). 1b, 2a are mainly seen in paid blood donors and transfusters before 1997; 2a is more common in people who have sexually transmitted; and types 6a, 3b and 3a only occur in intravenous drug users. Conclusion The distribution of HCV genotypes in Hubei Province is diverse and closely related to the route of transmission. All parties concerned should pay attention to and intervene.