西藏地区CHB抗病毒初治患者乙肝病毒基因分型及基因突变情况的分析  

Analysis of hepatitis B virus genotyping and gene mutations in CHB antiviral primary treatment patients in the Tibetan region

作　　者：钱花 张艳 温青萍 石荔[1] Qian Hua;Zhang Yan;Wen Qingping;Shi Li(Department of Infectious Diseases,Tibet Autonomous Region People's Hospital,Lasa,Tibet 850000,China)

机构地区：[1]西藏自治区人民医院感染性疾病科,西藏拉萨850000

出　　处：《西藏医药》2024年第1期48-50,共3页Tibetan Medicine

摘　　要：目的 分析西藏地区CHB抗病毒初治患者乙肝病毒基因型及其突变情况。方法 选取2021年12月~2022年12月在我院感染门诊就诊的慢性乙型肝炎(CHB)初始抗病毒治疗患者共48例,采用Sanger测序法检测HBV的9个基因型(即A-I),同时检测HBV核苷类似物耐药相关的22个位点,比较不同基因型组HBV-DNA定量水平、HBeAg阳性率、肝硬化或肝癌发生率、基因突变率的情况,根据基因突变情况指导临床抗病毒药物选择及预测疾病预后。结果HBV基因分型:HBV B基因型2例(4.2%),C基因型33例(68.7%),D基因型13例(27.1%);B型均为HBeAg阴性感染且基因突变率100%,C型与D型HBeAg阳性率分别为78.8%、84.6%,基因突变率为18.2%、30.8%;C型肝硬化或肝癌发生率为9.1%,D型为15.4%。结论 通过CHB患者的HBV基因分型及耐药突变检测分析,为临床抗病毒治疗药物选择提供参考依据,可预测患者的预后。Objective:To analyze hepatitis B virus genotypes and their mutations in primary antiviral treatment patients with CHB in Tibet to predict disease prognosis.Methods:A total of 48 patients on initial antiviral therapy for chronic hep⁃atitis B(CHB)attending the Infection Clinic of our hospital from December 2021 to December 2022 were selected,and nine genotypes(i.e.,A-I)of HBV were detected by Sanger sequencing,and 22 loci related to HBV nucleoside analog re⁃sistance were detected at the same time The quantitative level of HBV-DNA,positive rate of HBeAg,the incidence of liv⁃er cirrhosis or liver cancer and gene mutation rate of different genotypes were compared to guide the selection of clinical antiviral drugs and predict the prognosis of the disease according to the gene mutation.Results:There were 2 cases of HBV B genotype(4.2%),33 cases of C genotype(68.7%),and 13 cases of D genotype(27.1%);all of the B types were HBeAg-negative infections with a 100%gene mutation rate,while the rates of HBeAg positivity in the C type and the D type were 78.8%and 84.6%,and the rates of gene mutation were 18.2%and 30.8%,respectively;the rates of liver cirrho⁃sis or hepatocellular carcinoma in the C type were 9.1%,and type D was 15.4%.Conclusions:The analysis of HBV geno⁃typing and drug-resistant mutation detection in CHB patients provides a reference basis for the selection of clinical antivi⁃ral therapeutic drugs and can predict the prognosis of patients.

关 键 词：乙型肝炎病毒 基因型 突变 

分 类 号：R512.62[医药卫生—内科学]