西藏自治区某医院体检人群乙型肝炎病毒感染状况及病毒S区氨基酸变异特征分析  

Characterization of hepatitis B virus infection status and amino acid variations in the S region of the virus in a hospital population undergoing physical examination in Tibet

作　　者：徐琳莉 袁筱婕 张维璐[1] 李红燕 吉兆华[1] 王玉华 李怡君 王月梅 邵中军[1] XU Linli;YUAN Xiaojie;ZHANG Weilu;LI Hongyan;JI Zhaohua;WANG Yuhua;LI Yijun;WANG Yuemei;SHAO Zhongjun(Department of Epidemiology,School of Public Health,Fourth Military Medical University,Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment,Xi′an 710032,China;Fukang Hospital Affiliated to Tibet University,Lhasa 850000,China)

机构地区：[1]第四军医大学预防医学系流行病学教研室,特殊作业环境危害评估与防治教育部重点实验室,西安710032 [2]西藏大学附属阜康医院,拉萨850000

出　　处：《中华疾病控制杂志》2024年第11期1270-1274,1294,共6页Chinese Journal of Disease Control & Prevention

基　　金：陕西省自然科学基础研究计划资助项目(2023-JC-QN-0987)。

摘　　要：目的描述西藏自治区某医院体检人群乙型肝炎病毒(hepatitis B virus,HBV)感染状况,分析HBV基因型分布特征和S区氨基酸变异特点。方法选择2022年5月—2023年7月在西藏自治区某医院的健康体检人群作为研究对象,采用随机抽样方法对体检人群进行问卷调查和血清学检测。根据乙型病毒性肝炎(简称乙肝)血清标志物检测结果,对乙型肝炎表面抗原(hepatitis B surface antigen,HBsAg)、乙型肝炎e抗原(hepatitis B e antigen,HBeAg)、乙型肝炎核心抗体(hepatitis B core antibody,抗-HBc)阳性样本进行S区基因扩增及氨基酸变异分析。结果共纳入3970名研究对象,乙肝血清标志物检测结果显示,HBsAg、乙型肝炎表面抗体(antibody to hepatitis B surface antigen,抗-HBs)和抗-HBc共检出8种血清标志物组合模式。HBV感染率和单项抗-HBc阳性率在不同年龄、性别、职业、婚姻状况和地区之间差异均有统计学意义(均P<0.001)。48例样本扩增出S区序列,分型结果显示D型39例、C型8例和B型1例,其中13例在S区的主要亲水区(major hydrophilic region,MHR)发生氨基酸突变。结论西藏自治区为乙肝高流行地区,HBV基因型主要是D型,HBV S区的MHR氨基酸序列存在多个位点的变异,需积极开展成人的乙型肝炎疫苗防疫措施。Objective To probe the status of hepatitis B virus infection in the physical examination population of the Tibet Autonomous Region and to clarify the distribution characteristics of hepatitis B virus genotypes and the amino acid variants in the S region.Methods The health check-up population in a hospital in Tibet from May 2022 to July 2023 was selected as the study population,and questionnaires and serologic tests were conducted on the check-up population using random sampling method.According to the results of hepatitis B serologic markers,hepatitis B surface antigen(HBsAg),hepatitis B e antigen(HBeAg),hepatitis B core antibody(anti-HBc)positive samples were subjected to S region gene amplification and amino acid variation analysis.Results A total of 3970 medical examiners were included,and eight combinations of serum markers were detected for HBsAg,antibody to hepatitis B surface antigen(anti-HBs),and anti-HBc.Differences in the prevalence of HBV infection and the positive rate of single anti-HBc were statistically significant across varing groups including age,gender,occupation,marital status and region(all P<0.001).The S region sequences were amplified from 48 samples,and the typing results were 39 cases of genotype D,8 cases of genotype C and 1 case of genotype B,of which 13 cases had amino acid mutations in the major hydrophilic region(MHR)of the S genetic region.Conclusions The Tibet Autonomous Region is a highly endemic area for hepatitis B.The HBV genotype is mainly genotype D and the amino acid sequence of the major hydrophilic region in the S region of HBV has mutations at several sites,so it is necessary to actively carry out vaccination measures against hepatitis B in adults.

关 键 词：乙型肝炎病毒 血清学模式 变异分析 

分 类 号：R183[医药卫生—流行病学]