广西地区不同传播途径的丙型肝炎病毒感染者与基因型的关系研究  

Correlation between Hepatitis C Virus Infectors of Different Transmission Routes and Distribution of Genotypes in Guangxi

作　　者：朱明月[1] 苏明华[2] 江建宁[2] 廖柏明[2] 韦智[2] 陈旭[2] 刘志红[2] 韦麒[2] 滕春玲[2] 何丽霞[2] ZHU Ming-yue SU Ming-hua JIANG Jian -ning LIAO Bai -ruing WEI Zhi CHEN Xu LIU Zhi -hong WEI Qi TENG Chun -ling HE Li -xia(Department of lnfectious Diseases, Beihai People＇s Hospital, Beihai 536000, Chin)

机构地区：[1]广西北海市人民医院感染性疾病科,536000 [2]广西医科大学第一附属医院感染性疾病科

出　　处：《中国全科医学》2016年第29期3534-3538,共5页Chinese General Practice

基　　金：广西教育厅基金资助项目(YB20140614);广西南宁市青秀区项目(2013ZH02)

摘　　要：背景丙型肝炎病毒(HCV)感染严重危害人类健康;HCV基因型与干扰素的应答关系密切,HCV基因型的分布随地理位置变化而不同。目的探讨广西地区不同传播途径的HCV感染者与HCV基因型的关系。方法收集2011年2月—2014年12月在广西医科大学第一附属医院感染性疾病科病房及门诊就诊的230例HCV RNA阳性患者的血清标本,记录患者HCV传播途径,包括输血、静脉药瘾、性途径、其他(如文身、打耳洞、口腔治疗等)、不明原因等。采用反转录巢式PCR扩增HCV NS5B区段后,将得到的PCR终产物进行测序,测序结果与Gen Bank中已注册的标准株全基因序列比对出基因型及基因亚型,分析传播途径与HCV基因型的关系。结果 NS5B区段PCR终产物琼脂糖凝胶电泳中目的条带为377 bp,电泳条带显示较清晰。230例样本中222例成功扩增并得出HCV基因型分型:1a亚型27例(12.16%),1b亚型102例(45.95%),2a亚型11例(4.95%),3a亚型15例(6.76%),3b亚型29例(13.06%),6a亚型34例(15.32%),6d亚型1例(0.45%),6e亚型1例(0.45%),混合型(1b+6c)2例(0.90%)。经输血途径传播者93例,经静脉药瘾途径传播者56例,经性途径传播者21例,经其他途径传播者36例,经不明原因途径传播者16例。经其他途径传播者HCV基因型构成比较,差异无统计学意义(P>0.05);经输血、静脉药瘾、性途径传播者HCV基因型构成比较,差异均有统计学意义(P<0.05);其中输血途径以1型多见;静脉药瘾途径以1型、3型、6型多见;性途径以1型、3型多见。结论随着传播途径的改变,HCV基因型的分布也发生变化,其中经输血途径传播的HCV基因型以1b亚型为主;静脉药瘾途径以1a、3b、6a亚型为主;性途径以1a、3b亚型为主。Background Hepatitis C virus（ HCV） infection did serious harm to human health. HCV genotypes had close relationship with response to interferon therapy. The frequency distribution of HCV genotypes varied according to different geographical regions. Objective To investigate the correlation between HCV infectors of different transmission routes and HCV genotypes in Guangxi. Methods Serum samples of 230 HCV RNA positive patients who admitted to Department of Infectious Diseases,First Affiliated Hospital of Guangxi Medical University were collected from February 2011 to December 2014. The transmission routes were recorded including blood transfusions,injection drug use（ IDU）, sexual contact, others（ such as tattoo,ears pierced, oral treatment etc.） and unknown, etc. The HCV NS5 B region was subjected to nested RT-PCR amplification and sequenced. The sequences were compared with the complete genome sequences of standard strains registered in Gen Bank to find out their exact genotypes and subtypes. The correlation between HCV transmission routes and genotypes were analyzed respectively. Results The PCR products amplified from the NS5 B region were separated by agarose gel electrophoresis and produced band of 377 bp. Electrophoretic bands appeared relatively clearly. The complete NS5 B region was successfully amplified and classified from 222 out of 230 samples. There were 27 cases（ 12. 16%） of subtype 1a,102 cases（ 45. 95%） of subtype 1b,11 cases（ 4. 95%） of subtype 2a,15 cases（ 6. 76%） of subtype 3a,29 cases（ 13. 06%） of subtype 3b,34cases（ 15. 32%） of subtype 6a,1 case（ 0. 45%） of subtype 6d,and 1 case（ 0. 45%） of subtype 6e,2 cases（ 0. 90%）of hybrid subtype 1b ＋ 6c. There were 93 patients with blood transmission,56 patients with IDU transmission,21 patients with sexual transmission,36 patients with other routes of transmission,16 patients with unknown transmission. There were no statistically significant difference among the genotypes with other routes of transmissio

关 键 词：肝炎病毒属 疾病传播 传染性 基因型 

分 类 号：R373.2[医药卫生—病原生物学]