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作 者:李开文[1] 梁淑家[2] 陈钦艳 王学燕 杨庆利 何翔[4] 胡丽萍[2] 贾蕙华 Anna Kramvis 方钟燎[1,2,3] LI Kai-wen;LIANG Shu-jia;CHEN Qin-yan;WANG Xue-yan;YANG Qing-li;HE Xiang;HU Li-ping;JIA Hui-hua;Anna Kramvis;FANG Zhong-liao(School of Preclinical Medicine, Guangxi Medical University (Nanning,Guangxi 530021,China);Guangxi Center for Disease Prevention and Control (Nanning,Guangxi 530028);Guangxi Key Laboratory of Viral Hepatitis Research (Nanning ,Guangxi 530028);Guangdong Center for Disease Prevention and Control (Guangzhou Guangdong 511430);University of the Witwatersrand)
机构地区:[1]广西医科大学基础医学院,广西南宁530021 [2]广西壮族自治区疾病预防控制中心,广西南宁530028 [3]广西病毒性肝炎防治研究重点实验室,广西南宁530028 [4]广东省疾病预防控制中心,广东广州511430 [5]南非金山大学
出 处:《应用预防医学》2017年第2期113-118,共6页Applied Preventive Medicine
基 金:南非与中国国际科学技术合作国家研究基金会(NRF);广西医学高层次骨干人才培养"139"计划
摘 要:目的比较分析HBV/HIV共感染者与HBV单纯感染者肝癌相关HBV 1762T/1764A突变及前S基因缺失突变率。方法根据病例对照研究原理,收集未接受HBV及HIV抗病毒治疗的HBV/HIV共感染者和HBV单纯感染者血清标本,用分子生物学技术对血清HBV核心基因启动子(BCP)和前S基因进行分析。结果病例-对照共61对,平均年龄为(44.9±2.1)岁,共发现3个HBV基因型:基因型B、C和I。共感染者和单纯感染者的主要基因型均为B基因型,分别占63.4%(39/61)和50.8%(31/61)。共感染者肝癌相关HBV基因突变总率(52.5%)显著高于HBV单纯感染者(23.0%),差异有统计学意义(χ~2=11.307,P<0.05)。共感染者BCP的1762T/1764A双突变率(44.3%)显著高于HBV单纯感染者(χ~2=7.290,P<0.05)。同样,共感染者前S基因缺失率也显著高于HBV单纯感染者(χ~2=8.270,P<0.05)。随机从两组中各抽20例进行对比分析,结果显示共感染与高病毒载量有关,但是高病毒载量与肝癌相关HBV基因突变无关。肝癌相关HBV基因突变率不随CD_4^+细胞计数变化而变化。多因素分析结果表明,合并HIV感染与肝癌相关HBV基因突变(包括BCP双突变与前S缺失突变)有关。结论 HBV/HIV共感染可增加肝癌相关HBV基因突变率。Object To compare the prevalence of cancer related mutations1762T/1764A and PreS deletions in hepatitis B virus(HBV)isolated from HBV/HIV co-infected and HBV mono-infected adults.Methods According to case-control study,serum samples were collected from HBV/HIV co-infected and HBV mono-infected individuals,who were HBV and HIV drug-na?ve.The basic core promoter(BCP)and the preS/S regions of HBV isolated from61pairs of HBV/HIV co-infected and HBV mono-infected participants were analyzed.Results The study subjects consisted of sixty-one pairs.The mean age of both groups was44.9±12.1years.Three HBV genotypes,genotype B,C and I were identified in this study.Genotype B was the major genotype in both HBV/HIV co-infected(63.4%,39/61)and HBV mono-infected individuals(50.8%,31/61).The prevalence of the mutations in HBV/HIV co-infected group(52.5%)was significantly higher than that in the HBV mono-infected group(23.0%)(χ2=11.307,P<0.05).Individually1762T/1764A(44.3%)or preS deletions(23%)occurred more frequently in isolates from co-infected compared to mono-infected individuals(21.3%,4.9%,respectively)χ2=7.290,P<0.05;χ2=8.270,P<0.05).HBV/HIV co-infection was associated with higher viral loads but these higher viral loads were not associated with the higher prevalence of HCC-related HBV mutations.The prevalence of cancer related mutations did not vary with CD4cell counts.Multivariate analysis revealed that co-infection with HIV was associated with the development of both1762T/1764A and preS deletions.Conclusion Co-infection with HIV was associated with increased prevalence of HCC-related mutations in HBV isolates from Chinese patients.
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