摘要
目的探讨梅州地区客家人群乙型肝炎病毒(HBV)基因型分布,比较不同基因型感染患者拉米夫定、阿德福韦酯耐药突变位点及病情。方法梅州地区客家慢性HBV感染患者525例,采用磁珠法提取HBV核酸后在实时荧光定量PCR仪进行核酸扩增;采用HBV分型检测芯片进行HBV基因分型检测;采用HBV耐药突变位点检测芯片进行核苷(酸)类似物(拉米夫定、阿德福韦酯)耐药突变位点检测。采用生化法检测血清肝功能指标,化学发光免疫法检测血清甲胎蛋白(AFP),并统计HBV不同基因型慢性感染者肝硬化、肝癌病例数。结果525例梅州地区客家慢性HBV感染患者中,HBV B基因型463例(88.19%),HBV C基因型59例(11.24%),HBV B+C基因型、HBV B+D基因型和HBV D基因型各1例,各占0.19%。525例HBV慢性感染者中,位点突变475例(90.48%),其中HBV B基因型421例、HBV C基因型54例;437例对拉米夫定耐药,18例对阿德福韦酯耐药,20例为多重耐药。对拉米夫定耐药的437例HBV慢性感染者中,以B基因型HBV耐药位点rt180M+rt204V最常见,耐药患者所占比例为72.89%。对阿德福韦酯耐药的18例患者中,以B基因型HBV耐药位点rt236T最常见,耐药患者所占比例为45.45%。HBV B、C基因型慢性感染患者血清谷丙转氨酶(ALT)水平比较,P<0.05。HBV C基因型慢性感染者肝硬化、肝癌比例(分别为57.63%和28.81%)高于B基因型(分别为25.92%和14.47%)(P均<0.05)。结论梅州地区客家人群HBV基因型有B、C、B+C、B+D、D型,以B基因型为主。HBV B基因型慢性感染者拉米夫定耐药位点以rt180M+rt204V最为多见,阿德福韦酯耐药位点以rt236T最为多见。HBV B基因型慢性感染患者病情轻于C基因型。
Objective To investigate the distribution of hepatitis B virus(HBV)genotypes in Hakka population of Meizhou and to compare lamivudine and adefovir dipivoxil resistant mutation sites and disease conditions in different genotypes.Methods Totally 525 cases of chronic HBV infection in Hakka population of Meizhou were selected.Nucleic acid was extracted by magnetic beads and amplified by quantitative real-time PCR.HBV genotyping was detected by HBV genotyping chip;HBV resistance mutation detection chip was used to detect nucleoside(acid)analogues(lamivudine,adefovir dipivoxil)resistance mutation sites.We used biochemical technology to detect serum liver function indexes,and chemiluminescence immunoassay to detect serum alpha-fetoprotein(AFP),and counted the number of cases of cirrhosis and liver cancer in patients with different genotypes of chronic infection.Results Among 525 Hakka patients with chronic HBV infection in Meizhou,HBV genotype B was found in 463(88.19%)cases,HBV genotype C in 59(11.24%)cases,HBV genotype B+C in 1(0.19%)case,HBV genotype B+D in 1(0.19%)case,and HBV genotype D in 1(0.19%).Of 525 patients with chronic HBV infection,475(90.48%)had site mutations,including 421 cases of HBV genotype B and 54 cases of HBV genotype C;437 were resistant to lamivudine,18 to adefovir dipivoxil,and 20 to multidrug resistance.As for the 437 patients with chronic HBV infection resistant to lamivudine,the HBV genotype B resistance site rt180M+rt204V accounted for the highest proportion(72.89%).As for the 18 patients with adefovir dipivoxil resistance,the HBV genotype B resistance site rt236T accounted for the highest proportion(45.45%).Significant difference was found in the serum alanine transaminase(ALT)level between patients with chronic HBV genotypes B and C(P<0.05).The proportion of liver cirrhosis and liver cancer(57.63%and 28.81%)in patients with chronic HBV genotype C infection was higher than that in patients with genotype B(25.92%and 14.47%,respectively)(P<0.05).Conclusion The HBV genotypes of Hakka populati
作者
郑志远
吴和明
李仲坚
ZHENG Zhiyuan;WU Heming;LI Zhongjian(Meizhou People′s Hospital,Meizhou 514000,China)
出处
《山东医药》
CAS
2020年第15期36-39,共4页
Shandong Medical Journal
基金
梅州市医药卫生科研课题(2014-B-50)。
