丙型病毒性肝炎病毒基因型与病毒载量及疾病进展的相关性分析  

Relationship between hepatitis C virus genotype,virus load and disease progress

作　　者：熊陶[1] 胡爱荣[1] 蒋素文[1] 丁世雄[1] 梁晓岳[1] 胡耀仁[1] 

机构地区：[1]宁波市第二医院,浙江宁波315010

出　　处：《疾病监测》2015年第1期19-22,共4页Disease Surveillance

基　　金：宁波市自然科学基金(No.2010A610075);浙江省医坛新秀培养对象项目(No.2013-245)~~

摘　　要：目的分析丙型病毒性肝炎(丙肝)病毒(HCV)的基因型与病毒载量及肝脏疾病进展的相关性。方法选择2010年12月至2013年4月在宁波市第二医院北郊院区就诊的慢性HCV感染者,分别采用反转录-聚合酶链反应(RT-PCR)法和基因芯片法检测HCV RNA和HCV基因型。结果 107例标本中,共检出7种亚型,其中1a型4例(3.74%),1b型52例(48.60%),2a型15例(14.02%),3a型10例(9.35%),3b型9例(8.41%),6型16例(14.95%),1b+2a混合型1例(0.93%);男女慢性HCV感染均以1型为主要基因型,但男性6型的构成比高于女性(χ2=4.336,P=0.049);各年龄组间HCV基因型的构成及各基因型的年龄构成差异均无统计学意义;6型的病毒载量最高,其次为1型,2、3型的病毒载量明显低于6型和1型(P<0.01);终末期肝病患者和伴存免疫缺陷患者的病毒载量均高于慢性丙肝患者,且终末期肝病患者以基因1型(主要为1b)为主(P=0.016)。结论本地区HCV基因型同样以1b型为主,且1b型感染者的病毒载量较高,疾病进展较快;6型的感染率较高,应重视对基因6型HCV感染者的研究。Objective To understand the correlation between hepatitis C virus genotype, virus load and disease progress. Methods The retrospective analysis was conducted on the clinical data of 107 chronic hepatitis C patients seeking medical care in our hospital from December 2010 to April 2013. RT-PCR and gene chip methods were used to detect HCV RNA and identify HCV genotype respectively. Results Among the 107 samples collected from the patients, 7 genotypes were detected, i.e. genotype la in 4 patients （3.74%）, genotype lb in 52 patients （48. 60% ）, genotype 2a in 15 patients （14.02%）, genotype 3a in 10 patients （9.35%）, genotype 3b in 9 patients （8.41%）, genotype 6 in 16 patients （ 14. 95% ） and genotype 1b ＋2a in 1 patient （0. 93% ）. Genotype 1 was the most common genotype in both males and females, and genotype 6 was more common in males than in females （X^2= 4. 336, P = 0. 049）. There were no statistical significant differences in the distribution of HCV genotypes in different age groups and in specific genotype carrying ages of patients. The virus load of genotype 6 was highest, followed by genotype I. The virus lOads of genotype 2 and 3 were significantly lower than those of genotype 6 and 1 （P 〈0. 01 ）. The HCV RNA levels of the patients with end-stage liver disease and the patients accompanied with immunodeficiency were higher than that of patients with chronic hepatitis C. Genotype 1 （ especially lb） was the most common genotype in patients with end-stage liver disease （ P = 0. 016 ）. Conclusion HCV genotype lb is also the most common genotype in eastern Zhejiang. Patients infected with HCV genotype lb may have higher virus load and more serious liver diseases. The infection rate of HCV genotype 6 is relatively higher. We should attach importance to the study of infection of HCV genotype 6.

关 键 词：肝炎病毒 丙型 基因型 病毒载量 疾病进展 

分 类 号：R373.21[医药卫生—病原生物学]