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目的明确石家庄地区乙肝基因型/亚型分布特征,探索其与乙肝感染后疾病进展的相关性。方法采用型特异性引物多重聚合酶链反应(PCR)方法对270例乙肝表面抗原(HBsAg)阳性慢性乙肝、肝硬化和原发性肝癌患者血清标本进行HBV基因型/亚型检测,应用SPSS16.0进行统计描述和检验。结果基因型检测成功样本共233例,其中,C型占81.11%(189/233),B型占18.03%(42/233),D型占0.86%(2/233),基因亚型检测结果为:C2亚型占75.10%(175/233),B2亚型占16.74%(39/233),C1亚型占6.01%(14/233),B1亚型占1.29%(3/233);原发性肝癌、慢性乙肝患者中C基因型比例显著高于肝硬化(P=0.013,P=0.026);C基因型HBV感染者相对B型具有更高的HBe Ag阳性率和HBV DNA滴度(P=0.012,P=0.002);相对B型,C型HBV患者更易进展为肝硬化失代偿期(P=0.006),且具有显著更高的患癌风险(P=0.029)。结论石家庄地区流行HBV以C型和B型为主,其中C2、B2为主要亚型,HBV C型感染者更容易进展为失代偿肝硬化,发生肝癌的风险更高,但是需要更大样本量研究进行验证。
Objective To clarify the distribution of hepatitis B genotypes / subtypes in Shijiazhuang and to explore the relationship between HBV genotypes and disease progression after hepatitis B infection. Methods Serum samples of 270 patients with chronic hepatitis B, cirrhosis and primary hepatocellular carcinoma who were positive for hepatitis B surface antigen (HBsAg) were tested for HBV genotypes / subtypes using type-specific primer multiplex polymerase chain reaction (PCR) and SPSS16 was used. 0 for statistical description and test. Results A total of 233 cases were successfully genotyped, of which 81.11% (189/233) were type C, 18.03% (42/233) were genotype B, and 0.86% (2/233) were genotype D The subtype of C2 was 75.10% (175/233), the subtype of B2 was 16.74% (39/233), the subtype of C1 was 6.01% (14/233) and the subtype B1 was 1.29% (3/233). The proportion of C genotypes in patients with primary liver cancer and chronic hepatitis B was significantly higher than that in patients with cirrhosis (P = 0.013, P = 0.026). HBV genotypes had a higher HBe Ag positive rate and HBV DNA titer (P = 0.012, P = 0.002). Patients with type B and C HBV were more likely to progress to decompensated cirrhosis (P = 0.006) and had a significantly higher risk of cancer (P = 0.029). Conclusion The prevalence of HBV in Shijiazhuang is mainly C and B, with C2 and B2 as the major subtypes. Patients with HBV C infection are more likely to develop decompensated cirrhosis and have a higher risk of developing HCC, but larger samples are needed The amount of research to verify.