淮北市HCV感染者基因亚型分布特征及1b型天然耐药突变分析  

Analysis of HCV genotype distribution and natural drug resistance mutation in Huaibei city

作　　者：木朝宇 张晓梅[1] 范德胜[1,2] 刘培明 姚慧琳[1] MU Chao-yu;ZHANG Xiao-mei;FAN De-sheng;LIU Pei-ming;YAO Hui-lin(Department of Laboratory Medicine,Huaibei Miners General Hospital,Huaibei Miners General Hospital of Bengbu Medical College,Huaibei Anhui 235000;Xuzhou Medical University,Xuzhou Jiangsu 221004,China)

机构地区：[1]淮北矿工总医院(蚌埠医学院附属淮北矿工总医院)检验科,安徽淮北235000 [2]徐州医科大学,江苏徐州221004

出　　处：《蚌埠医学院学报》2023年第2期260-263,共4页Journal of Bengbu Medical College

基　　金：蚌埠医学院自然科学研究重点项目(BYKY2019296ZD);安徽省淮北市科技计划项目(2021HK023);徐州医科大学优秀人才基金项目(XYFY2021049)。

摘　　要：目的:分析淮北市HCV感染病人基因亚型分布特征及1b型天然耐药突变情况,为HCV临床抗病毒治疗和感染防控提供依据。方法:选取2019-2022年就诊于淮北矿工总医院住院的HCV感染者(未经任何DAAs治疗)HCV-RNA阳性血清样本,抽提RNA后逆转录,采用巢式PCR扩增NS5B、NS5A及NS3/4A区域基因序列,产物送交测序公司测序。采用Mega11.0软件对测序结果进行序列比对分析。结果:结果HCV 1b型(68.63%)为主要亚型,2a型次之(29.41%),此外检出3a型2例(1.96%)。HCV亚型的分布与性别、年龄无明显相关(P>0.05),1b型多见于≥55岁年龄组中。RASs主要类型为:NS5B区C316N(100.00%);NS5A区Q54H(40.47%),Y93H(19.05%);NS3/4A区Q86P(30.88%),I71V+Q86P(19.12%),V170I+Q86P(14.71%)及T72I/A+Q86P(13.24%)。其中突变频率较高的RASs依次为:C316N(100.00%)、Q54H(60.00%)、Q86P(53.78%)、Y93H(33.33%)、I71V/S(15.97%)。结论:淮北市HCV以1b亚型为主,2a型次之,首次检出3a型。1b型天然耐药突变以NS3/4A区为主,NS5A区次之,NS5B区较单一。提示HCV感染者DAAs治疗前应进行亚型及RASs的检测。Objective:To analyze the distribution characteristics of HCV genotypes and natural resistance mutation of type 1b of patients with hepatitis C virus(HCV)infection in Huaibei city,so as to provide evidence for clinical antiviral treatment and infection prevention and control of HCV.Methods:The HCV-RNA positive serum of patients with HCV infection[without any direct antiviral agent(DAAs)treatment]who were treated in Huaibei Miners General Hospital from 2019 to 2022 were selected.The samples were extracted and reverse transcribed,nested PCR was used to amplify the gene sequences of the NS5B,NS5A and NS3/4A regions.The electrophoresis-positive products were sent to company for sequencing.Sequence alignment analysis was performed using Mega11.0 software.Results:The HCV 1b subtype(68.63%)was the main subtype,followed by type 2a(29.41%),and 2 cases of type 3a(1.96%)was detected.The distribution of HCV subtypes was not significantly correlated with gender and age(P>0.05),type 1b was more common in the age group≥55 years old.The main types of RASs were:C316N(100.00%)in NS5B region;Q54H(40.47%)and Y93H(19.05%)in NS5A region;Q86P(30.88%),I71V+Q86P(19.12%),V170I+Q86P(14.71%)and T72I/A+Q86P(13.24%)in NS3/4A region.The RASs with higher mutation frequency were:C316N(100.00%),Q54H(60.00%),Q86P(53.78%),Y93H(33.33%),I71V/S and(15.97%).Conclusions:HCV type 1b is the main epidemic genotype in Huaibei city,followed by 2a.Type 3a is detected for the first time.NS3/4A region is the main type of natural drug resistance mutation of type 1b,followed by NS5A,and NS5B was single.It is suggested that genotypes and RASs tests should be performed in HCV infected patients before DAAs.

关 键 词：丙型肝炎病毒感染 耐药相关突变 基因亚型 

分 类 号：R373.21[医药卫生—病原生物学] R512.62[医药卫生—基础医学]