云南省德宏州人民医院276例丙型肝炎病毒患者基因型分布

doi:10.16150/j.1671-2870.2018.03.018

摘要/Abstract

摘要： 目的：了解云南省德宏地区丙型肝炎病毒(hepatitis C virus, HCV ) 基因型的分布特征。方法：选取2014年1月至2017年3月在云南省德宏州人民医院诊治的 HCV RNA阳性患者276例,采集其血清样本,采用PCR反向点杂交法分析HCV基因型（1a、1b、2a、3a、3b和6型）;对不能确定型别的样本采用非结构蛋白5B（nonstructural protein 5B,NS5B）测序法进行分型。结果：276例患者的HCV基因型中,主要为6型120例（43.48%）、3b型80例（28.99%）,其次是1b型33例（11.96%）、3a型30例（10.87%）、1a型9例(3.26%)、2a型4例（1.45%）。其中德宏地区的患者有151例,主要为6型61例（40.40%）、3b型53例(35.10%),其次是1b型15例(9.93%)、3a型14例(9.27%)、1a型4例（2.65%）、2a型4例（2.65%）。将德宏地区151例基因分型分布结果与国内其他地区进行比较,结果提示差异有统计学意义,云南省德宏州地区的HCV 6型及3型（包括6n、6u、6a、6m、6型混合）所占百分比明显高于其他地区,而1a和2a型检出百分比较低（P<0.05）。结论：云南省德宏州地区的HCV基因亚型共检出9种,主要以3b型和6型为主,其次是1b型及3a型,与国内其他地区比较有显著差异,提示本地区HCV亚型有其独特性。

关键词: 丙型肝炎病毒, 基因型, 基因测序, PCR反向点杂交分析

Abstract: Objective: To explore the distribution of hepatitis C virus (HCV) genotypes in Dehong, Yunnan. Methods A total of 276 serum samples from out-and in-patients with positive HCV RNA in People's Hospital of Dehong Prefecture from January 2014 to March 2017 were collected, and PCR-reverse dot hybridization was used to determine the HCV genotypes, including genotypes of 1a, 1b, 2a, 3a, 3b and type 6. Those samples with uncertain results were further detected by NS5B (nonstructural protein 5B) sequencing typing. Results Of the 276 samples, 120 samples (43.48%) were identified as HCV subtype 6, 80 samples (28.98%), as 3b, 33 samples (11.96%) as 1b, 30 samples (10.87%) as 3a, 9 samples (3.26%) as 1a, and 4 samples (1.45%) as 2a. Among all the patients, 151 patients were local cases, 61 samples (40.40%) were identified as HCV genotype subtype 6, 53 samples (35.10%), as 3b 15 samples (9.93%) as 1b, 14 samples (9.27%) as 3a, 4 samples (2.65%) as 1a, and 4 samples (2.65%) as 2a, and distribution of genotyping was different from those in other places in China (P<0.05), with a higher prevalence of subtype 6 and 3 and lower prevalence of subtype of 1a and 2a. Conclusions A total of 9 subtypes of HCV gene are detected in Dehong, Yunnan province, and the main types are 3b and 6 (including 6n, 6u, 6a,6m, 6x), followed by 1b and 3a. When compared with other provinces of China, distribution of HCV genotype in Dehong has its unique characteristic.

Key words: Hepatitis C virus, Genotype, Gene sequencing, Polymerase chain reaction dot hybridization analysis

中图分类号:

R575.1

刘厚昌, 番云华, 张凯, 王水花. 云南省德宏州人民医院276例丙型肝炎病毒患者基因型分布[J]. 诊断学理论与实践, 2018, 17(03): 322-327.

LIU Houchang, PAN Yunhua, ZHANG Kai, WANG Shuihua. Genotypes of HCV among 276 patients with hepatitis C virus infection in People's Hospital of Dehong Prefecture, Yunnan Province[J]. Journal of Diagnostics Concepts & Practice, 2018, 17(03): 322-327.

参考文献

[1] Thrift AP, El-Serag HB, Kanwal F.Global epidemiology and burden of HCV infection and HCV-related disease[J]. Nat Rev Gastroenterol Hepatol,2017,14(2):122-132.
[2] 项丽芬, 唐仁海, 杨跃诚, 等. 云南省德宏州社区居民丙型肝炎病毒感染率及影响因素研究[J]. 中国初级卫生保健,2013,27(5):80-82.
[3] 吴勤, 孟繁平, 马雪梅, 等. 丙型肝炎肝硬化患者HCV基因型与血清白细胞介素17、白细胞介素6及维生素D的关系[J]. 临床肝病杂志,2015,31(11) :1849-1852.
[4] Pawlotsky JM.Hepatitis C virus genetic variability: pathogenic and clinical implications[J]. Clin Liver Dis,2003,7(1):45-66.
[5] Zhou YB, Liang S, Wang QX, et al.The geographic distribution patterns of HIV-, HCV- and co-infections among drug users in a national methadone maintenance treatment program in Southwest China[J]. BMC Infect Dis,2014,14:134.
[6] Tanaka Y, Agha S, Saudy N, et al.Exponential spread of hepatitis C virus genotype 4a in Egypt[J]. J Mol Evol,2004,58(2):191-195.
[7] 张淑琼, 汪亚玲, 李晓非, 等. HIV/HCV合并感染者HCV基因分型特点及流行情况分析[J]. 国际检验医学杂志,2014,35(7):920-922.
[8] 唐维, 苏明华, 江建宁, 等. 广西地区丙型肝炎病毒的基因型分布与流行病学特征[J]. 世界华人消化杂志,2014,22(9):1300-1306.
[9] 陈敏, 马艳玲, 罗红兵, 等. 昆明市静脉注射吸毒人群丙型肝炎病毒基因型分析[J]. 中华流行病学杂志,2015,36(9):994-997.
[10] 陶钧, 刘勇, 童毅, 等. 贵州吸毒人群丙型肝炎病毒感染者的基因分型研究[J]. 中华病毒病杂志,2012,2(2):117-122.
[11] 李威, 曾艳丽, 刘俊平, 等. 河南地区慢性丙型肝炎患者丙型肝炎病毒基因型分布研究[J]. 中华实用诊断与治疗杂志,2015,29(6):538-539.
[12] 刘义庆, 田文君, 渠腾, 等. 山东地区153例汉族丙型肝炎患者HCV基因分型研究[J]. 检验医学与临床杂志,2014,11(19):2649-2650.
[13] 戎霞, 郑英, 熊华平, 等. 广东地区临床患者和献血者HCV感染者HCV基因分型比较[J]. 中华输血杂志,2014,27(6):593-596.
[14] 熊陶, 胡爱荣, 蒋素文, 等. 浙江省东部地区丙型肝炎病毒基因分型的研究[J]. 中华医院感染学杂志,2015, 25(22):5139-5141.
[15] 刘涛, 陈兆云, 张朝霞. 新疆地区维族与汉族丙型肝炎患者HCV基因分型研究[J]. 中华医院感染学杂志,2015,25(18):4122-4124.
[16] Rao H, Wei L, Lopez-Talavera JC, et al.Distribution and clinical correlates of viral and host genotypes in Chinese patients with chronic hepatitis C virus infection[J]. J Gastroenterol Hepatol,2014,29(3):545-553.
[17] 张艳红, 解莹, 谢晨, 等. 鞍山中心医院丙型肝炎病毒亚型的分布状态[J]. 大连医科大学学报,2015,37(4):358-360.
[18] 李媛, 冯悦, 夏雪山, 等. 云南省丙型肝炎病毒基因型和基因亚型的分布与流行特点[J]. 山东医药,2013,53(9):91-92.
[19] 陈倩倩. 云南省德宏州HCV分子流行病学研究及黑猩猩SAMHD1表达载体的构建与真核表达[D]. 江苏:江苏大学,2014:15-16.
[20] Clausen LN, Weis N, Ladelund S, et al.Genetic variants in the apoptosis gene BCL2L1 improve response to interferon-based treatment of hepatitis C virus genotype 3 infection[J]. Int J Mol Sci,2015,16(2):3213-3225.
[21] Fried MW, Shiffman ML, Reddy KR, et al.Peginterferon alfa-2a plus ribavirin for chronic hepatitis C virus infection[J]. N Engl J Med,2002,347(13):975-982.
[22] Chevaliez S, Pawlotsky JM.Hepatitis C virus: virology, diagnosis and management of antiviral therapy[J]. World J Gastroenterol,2007,13(17):2461-2466.
[23] Hadziyannis SJ, Sette H Jr, Morgan TR, et al.Peginterferon-alpha2a and ribavirin combination therapy in chronic hepatitis C: a randomized study of treatment duration and ribavirin dose[J]. Ann Intern Med,2004,140(5):346-355.
[24] Hasan F, Asker H, Al-Khaldi J, et al.Peginterferon alfa-2b plus ribavirin for the treatment of chronic hepatitis C genotype 4[J]. Am J Gastroenterol,2004,99(9):1733-1737.
[25] He CL, Wu QX, Kuang XM, et al.Clinical efficacy of pegylated interferon plus ribavirin therapy for patients infected with hepatitis C virus genotype 6: a retrospective study[J]. J Third Mil Med Univ,2015,37(12):1252-1255.
[26] 颜学兵. 抗HCV是否步入以DAA为主的特异性治疗时代?[J]. 世界华人消化杂志,2016,24(13):1943-1951.
[27] 邱艳, 王金立, 凌世淦. HCV基因分型研究进展[J]. 国外医学病毒学分册,2002,9(3):93-95.