乙型肝炎病毒基因分型及其临床意义  

The clinical importance of hepatitis B virus genotyping

作　　者：邓志华[1] 王桂琴[2] 曹燕[1] 徐永群[1] 王琦[1] 

机构地区：[1]山西医科大学第二医院消化科,030002 [2]山西医科大学微生物与免疫研究室

出　　处：《肝脏》2007年第6期455-458,共4页Chinese Hepatology

摘　　要：目的了解慢性乙型肝炎病毒(HBV)感染者HBV基因分型及其对慢性肝病的影响,为制定针对不同HBV基因型抗病毒的个体化方案提供分子病毒学依据。方法临床确诊的慢性乙型肝炎、乙型肝炎肝硬化及肝癌患者314例,采用RDB法对HBV进行基因分型检测。结果山西地区的200例慢性乙型肝炎患者所感染的HBV均为B和C基因型,分别占56%、26%,并存在混合感染(17%);C与B基因型患者相比,血清病毒载量高、肝脏损伤严重;混合感染的患者与单一基因型感染者相比病毒载量更高、肝损伤更严重;肝硬化患者感染的HBV主要为C基因型及B、C混合感染,且肝损害严重、病毒复制率高;肝癌患者中C基因型感染占42.19%,B、C混合感染占37.5%,B基因型感染可能与年轻患者肝癌的发生有关。结论B基因型HBV感染与C基因型及混合感染相比,病毒载量低、肝损害轻,但年轻患者应监测肝癌的发生;C基因型及混合感染的患者预后较差,肝硬化、肝癌发生率高,应进行积极有效的治疗,防止严重肝病发生。Objective To study the effects of different hepatitis B virus（HBV） genotype on chronic hepatic disease and to provide an experimental basis for designing different therapeutic regimen. Methods RDB method was used to HBV DNA genotyping in 314 patients with chronic hepatitis, cirrhosis and hepatocellular careinoma（HCC）. Results Among 200 chronic hepatitis the HBV genotype was mainly B （56%） and C （26%） and B and C mixed infection. Genotype C compared with B had a high quatity of virus loading and serious liver impairing. B and C Mixed infection compared with single type virus infection appeared to have a heavier virus loading and serious liver damageing. Patients of liver cirrhosis infected mainly virus genotype C and B, C mixed and menifested with heavier virus loading and serious liver impairing. In HCC patients genotype C was 42.19% and B,C mixed was 37.5% . Genotype B showed some relationship with occurrence of HCC and developed young patients. Conclusion Genotype B infection compared with C and the B, C mixed had lower virus loading and mild liver impairing but might be related to HCC development in young patients. C and the B, C mixed infection had a worse prognosis with high rate of cirrhosis and HCC development.

关 键 词：乙型肝炎病毒 基因型 慢性乙型肝炎 

分 类 号：R450[医药卫生—治疗学]