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。
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.
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