云南省德宏傣族景颇族自治州中国与缅甸籍吸毒人员的丙型肝炎病毒基因型分析  

Comparison of genotypes of hepatitis C virus between Chinese and Burmese drug users living in Dehong Prefecture, Yunnan Province

作　　者：王译葵 冯凯迪 王继宝 张志敏[2] 唐仁海 叶润华 张静娜[2] 杨跃诚 邱茂锋[2] 段松 

机构地区：[1]云南省德宏傣族景颇族自治州疾病预防控制中心性病艾滋病防制科,芒市678400 [2]中国疾病预防控制中心性病艾滋病预防控制中心

出　　处：《中华预防医学杂志》2016年第11期959-965,共7页Chinese Journal of Preventive Medicine

基　　金：国家重点地区艾滋病防治项目

摘　　要：目的分析云南省德宏傣族景颇族自治州（德宏州）中国和缅甸籍吸毒人员的丙型肝炎病毒（HCV）基因型分布特征。方法于2015年1—9月间，选取德宏州内各戒毒所和美沙酮门诊吸毒人员为研究对象，共7545名，对其进行问卷调查并采集血浆样本。其中HCV抗体阳性的样本为752份，采用随机数字表法抽取血浆量为200μl以上的样本共139份（中国籍和缅甸籍样本分别75和64份）进行核酸提取和HCV核酸扩增、测序，采用MEGA6．06软件建立系统进化树，并对不同的基因亚型进行分组后计算样本间的平均基因离散率。采用Fisher确切概率法比较不同特征研究对象HCV亚型分布情况，采用方差分析比较CE1和NS5B区不同亚型基因离散率差异。结果64份缅甸籍样本扩增成功43份（67％），其中CE1和NS5B区分别成功扩增31和38份；75份中国籍样本扩增成功52份（69％），其中CE1和NS5B区分别成功扩增43和45份。成功扩增的样本中，中国籍和缅甸籍的吸毒人员HCV基因亚型均以3b和6n为主，中国籍中分别占27％（14份）和37％（19份），缅甸籍中分别占28％（12份）和33％（14份）；其他亚型中（6u、3a、1a、1b型），中国籍样本分别占14％（7份）、19％（10份）、2％（1份）、2％（1份），缅甸籍样本分别占16％（7份）、5％（2份）、16％（7份）、2％（1份），1a亚型缅甸籍高于中国籍（P=0．015），3a亚型中国籍高于缅甸籍（P=0．031）。CE1区1a、1b、3a、3b、6n和6u亚型的基因离散率分别为0．048±0．007、0．091±0．013、0．074±0．008、0．061±0．006、0．136±0．009、0．031±0．005（F=516．26，P〈0．001），NS5B区1a、1b、3a、3b、6n和6u亚型的基因离散率分别为0．032±0．006、0．065±0．012、0．058±0．008、0．041±0．005、0．059±0．008、0．045±0．006（F=45．11，P〈0．001）。结论德宏州吸毒人员中HCV存在6种亚型，6n�Objective To analyze the distribution of hepatitis C virus （HCV） genotypes among Chinese and Burmese drug users in Dehong Prefecture, Yunnan Province. Methods Plasma specimens and relevant epidemiological data were collected from 7 545 drug users attending rehabilitation centers and methadone clinics in Dehong Prefecture from January to September in 2015, of which 752 were positive for HCV antibodies. HCV RNA was then extracted from 139 random specimens （64 Burmese and 75 Chinese） and the CE1 and NS5B regions were amplified by nested PCR. The sequences of these HCV genes were aligned, a phylogenetic tree was constructed using MEGA 6.0.6 and the average genetic discrete rate of each subtype group was calculated. We used Fisher＇s exact test to compare distribution of HCV subtypes from different people, using analysis of variance to compare the discrete rates of different CE1 and NS5B subtypes. Results While we successfully amplified RNA from 43 specimens provided by Burmese patients （67%）, including 31 with CE1 region and 38 with NS5B region, 52 from Chinese patients （69%） were successfully amplified including 43 with CEI region and 45 with NS5B region. We found that 3b and 6n were the predominant subtypes and were found in 27%（n=14） and 37%（n=19） of Chinese and 28%（n=12） and 33%（n=14） of Burmese specimens. Subtypes 6u, 3a, la and lb were present in 14%（n=7）, 19%（n=10）, 2% （n=1） and 2%（n=1） of Chinese specimens and 16%（n=7）, 5%（n=2）, 16%（n=7） and 2%（n=1） of Burmese specimens respectively. While the prevalence of subtype la was higher among samples from Burmese patients than Chinese patients （P=0.015）, the presence of subtype 3a was higher among the latter （P=0.031）. The discrete rates of CE1 region subtypes la, lb, 3a, 3b, 6n and 6u were 0.048±0.007, 0.091±0.013, 0.074±0.008, 0.061±0.006, 0.136±0.009 and 0.031±0.005 （F=516.26, P〈0.001）. The discrete rates for NS5B region subtypes la, 1b, 3a, 3b, 6n and 6u, meanwhile, were 0.032±0

关 键 词：丙型肝炎病毒 吸毒人员 基因型 中国 缅甸 

分 类 号：R749.64[医药卫生—神经病学与精神病学] R512.63[医药卫生—临床医学]