HBV感染免疫状态与HBV基因型关系研究思路

HBV感染免疫状态不同,临床意义不同;HBV基因型不同,导致病毒致病性、变异、抗病毒等临床疗效及预后不同.HBV感染临床意义的不同,是宿主与病毒共同作用的结果.将HBV感染免疫状态与HBV基因型结合在一起研究,探索广西桂北地区不同免疫状态下基因型的分布情况及HBV感染免疫状态与基因型的关系,并希期望能针对宿主免疫状态、病毒特性,为每一位HBV感染患者制订最好的治疗方案.     

乙型肝炎病毒基因型与免疫复合物型治疗性乙肝疫苗应答相关性的研究

目的 研究对免疫复合物型治疗性乙肝疫苗不同应答乙肝患者的乙肝病毒基因型有无差别。方法 收集67例经60 ug HBsAg-HBIG (YIC) 治疗的慢性乙肝患者血清, 用S基因聚合酶链反应-限制性片段长度多态性分析(PCR-RFLP)法对其进行HBV基因分型,并结合患者对YIC治疗的不同应答进行分析。结果67例感染乙肝病毒（HBV）患者中,HBV B基因型22例,C基因型43例,未确定者2例。感染HBV B, C 两种基因型的患者对YIC免疫治疗的病毒学与HBeAg的血清转换应答差异无统计学意义. 结论HBV B或C基因型不影响慢性乙肝患者对YIC的治疗应答。     

太原地区乙肝患者HBV基因分型与细胞免疫功能研究

了解太原地区乙肝病毒基因型分布情况,研究不同基因型乙肝病毒致病性与细胞免疫功能关系。选择慢性乙肝、乙肝肝硬化及乙肝病毒相关肝癌等乙肝病毒感染患者,采用PCR技术检测患者血清HBV-DNA和HBV基因型,用流式细胞仪直接免疫荧光法(FCM)检测患者外周血T淋巴细胞亚群百分率,分析不同病毒基因型与乙肝病程关系以及不同基因型病毒感染患者细胞免疫功能状态。检测136例乙肝病毒感染患者,其中B基因型感染38例,占总数27.9%;C基因型感染93例,占总数70.6%;B/C混合型感染3例,占总数2.2%;D基因型感染2例,占总数1.5%。B型与C型乙肝病毒感染患者的HBsAg水平无区别,B型患者血清HBeAg(+)%高于C型乙肝病毒感染者,慢性无症状乙肝携带者、慢性乙肝、乙肝肝硬化和乙肝病毒相关的原发性肝细胞癌各组中乙肝病毒基因型的分布无差异,但乙肝肝硬化患者与慢性无症状乙肝携带者、慢性乙肝患者的基因型有差异(P<0.01),C基因型感染者HBV-DNA水平、HBeAg阳性率、CD4+细胞和CD4+/CD8+T淋巴细胞比值低于B基因型感染者。太原地区临床乙肝病毒感染患者以C基因型为主,C基因型感染者比B基因型的肝脏功能损害严重,可能与细胞免疫功能降低HBV-DNA水平和HBeAg阳性率高有关。     

慢性乙型肝炎患者血清HBV基因分型

为了解长春市慢性乙型肝炎患者血清中的乙型肝炎病毒(HBV)基因型情况及其与临床特点的相关性,应用型特异性引物进行巢式PCR方法对长春市69例慢性乙型肝炎患者血清HBV进行基因分型检测。在69例血清标本中,B型10例(占14.5%);C型41例(占59.4%);B C混合型8例(占11.6%);未分型的患者共10例(占14.5%)。C基因型患者的HBV-DNA定量、HBeAg阳性率明显高于B基因型患者(HBV-DNA:P<0.01;HBeAg:χ2=3.98,P<0.05),C基因型患者肝功检查指标谷丙转氨酶(ALT)和总胆红素(TB IL)均较B基因型患者高(P<0.01)。长春地区存在HBV B基因型、C基因型、B C混合基因型及未分型,C基因型为优势基因,引起的肝脏活动性炎症较B基因型明显。     

部分肝病患者和健康人血清中HBV基因型分析

确定了内蒙古海拉尔地区乙型肝炎病毒 (HBV)感染者HBV基因型的分布情况。采用基因型特异引物的巢式聚合酶链式反应方法对 38例无症状HBV携带者 ,3例急性肝炎 ,41例慢性肝炎 ,3例肝硬化 ,3例肝癌患者和38例健康人血清中HBV基因型进行分析。结果显示 ,12 6例中有 91例检测到HBVDNA ,其中 ,HBVB型 ,C型分别为 11例 ( 12 .1% )和 6 8例 ( 74.7% ) ,同时检测到B型和C型者有 8例 ( 8.8% ) ,有 4例 ( 4.4% )尚未确定基因型别。可见 ,在海拉尔地区HBV感染同时存在HBVB型和C型 ,而且C型是这一地区流行的主要基因型。     

内蒙古地区乙型肝炎病毒的基因分型及临床意义

为了探讨乙型肝炎病毒在内蒙古地区的基因分型,为本地区乙型肝炎的临床治疗、病情进展和发病机制等方面研究提供有益的实验依据。2013年7月至2014年7月本研究在内蒙古自治区人民医院、内蒙古医科大学第一附属医院、通辽市医院的门诊及住院病例中随机选取已感染乙型肝炎病毒的253例。以荧光定量PCR法检测HBV基因分型和HBV病毒基因载量,Elisa法检测血清标志物HBeAg,全自动生化分析仪检测ALT、AST、TBA、TBIL和ALB。实验发现,内蒙古地区253例患者HBV基因分型结果以B型(49例,19.37%)、C型(188例,74.31%)为主,且C基因型显著多于B基因型(p<0.05);HBeAg阳性率为67.59%,且C基因型HBeAg阳性率高于B基因型;高载量病例中B型占31例(63.27%),而C型占162例(86.17%),C基因型组中HBV DNA载量显著高于B基因型组(p<0.01);B基因型与C基因型TBA、TBIL和ALB结果比较差异无统计学意义(p>0.05),但C基因型的ALT和AST这两项生化指标均显著高于B基因型组(p<0.05)。本研究结果初步说明,内蒙古地区HBV感染以B型和C型为主,尤以C型居多;且C型病毒的复制较活跃,致病力较强,HBV感染者更易转成严重肝病。     

乙肝患者病变程度与病毒基因分型的相关性分析

目的探讨乙型肝炎（乙肝）病毒（HBV）基因分型与病变程度之间的关系。方法对165例经肝组织切片证实的急性轻型肝炎、轻度慢性肝炎（CHB）、中度慢性肝炎和重度慢性肝炎及肝硬化的乙肝患者血清进行基因分型。结果基因型以B型和C型为主,分别为12．1％和86．7％。C型中度慢性肝炎所占的百分比显著高于B型,而重度慢性肝炎在B型和C型中所占百分比差异无统计学意义;基因C型感染者HBeAg阳性率显著高于基因B型感染者,而基因C型感染者中HBeAb阳性率显著低于基因B型感染者。结论C型HBV感染和乙肝病情加重有一定关系,而B型HBV感染者预后相对较好。     

青海地区献血者HBV感染隐匿风险与基因型分析

目的:探讨青海地区献血者乙型肝炎病毒(hepatitis b virus,HBV)感染隐匿风险与基因型的相关性。方法:采用回顾性研究方法,选择2014年2月-2018年1月在我院进行无偿献血的青海地区人群750例,采用聚合酶链式反应-限制性内切酶片段法(PCR-RFLP)检测HBV DNA基因的多态性,并进行HBV感染隐匿风险分析。结果:在750例人群中,检出HBV隐匿性感染8例,检出率为1.1%,其中窗口期感染3例,一过性感染5例;基因C型6例,基因B型2例,基因B型患者的都为窗口期感染,核酸定量都≤20 IU/m L,与基因C型患者对比差异有统计学意义(P0.05)。多因素Logistic回归分析显示基因C型、核酸定量、家属病史、吸烟为导致HBV隐匿性感染的独立危险因素(P0.05)。结论:青海地区献血者HBV感染隐匿风险相对比较低,多为基因C型,基因C型为导致HBV隐匿性感染的独立危险因素。     

HBV基因型、基本核心启动子区双突变和肝细胞癌发生及临床病理特征的关系

目的探讨乙型肝炎病毒(HBV)基因型、基本核心启动子(BCP)区双突变(简称BCP双突变)和肝硬化(LC)、肝细胞癌(HCC)发生的关联,分析BCP双突变和HCC临床病理特征的关系。方法随机收集233例慢性HBV感染者的血清,其中80例为慢性乙型肝炎(CHB)患者、75例为LC患者、78例为HCC患者,并系统整理患者的常规检查和病理等资料。采用实时荧光定量聚合酶链反应(FQ-PCR)检测BCP双突,用特异性引物多重PCR扩增确定HBV基因型。用SPSS 11.0分析结果。结果 HBV基因型结果均为B和C型,分别在CHB和LC组,CHB和HCC组间分布差异有统计学意义(P<0.05),在LC和HCC组间分布差异无统计学意义(P>0.05),感染C基因型与LC和HCC发生相关(分别OR=2.73,95%CI=1.29～5.82;OR=2.00,95%CI=0.98～4.09)。BCP双突变也分别在CHB和LC组,CHB和HCC组间分布差异有统计学意义(P<0.05),在LC和HCC组间分布差异无统计学意义(P>0.05),双突变与LC和HCC发生相关(分别OR=1.91,95%CI=0.96～3.82;OR=2.05,95%CI=1.04～4.06)。BCP双突变和伴肝硬化的HCC相关(P<0.05)。结论感染HBV C基因型、BCP双突变可能均是LC和HCC发生的危险因素,BCP双突变可作为LC和HCC早期预警生物标记物。     

重庆地区乙肝血清特殊模式患者HBV基因分型及临床自然病程分析

目的了解重庆地区乙肝病毒（HBV）血清学标志物为特殊模式的HBV感染患者病毒基因型的分布情况,分析其临床特征及自然病程。方法从1000例HBV感染者中检测到48例乙肝病毒血清学标志物为特殊模式的患者（HBsAg与抗一HBs同时阳性,HBeAg与抗一HBe同时阳性）。采用巢式聚合酶链式反应（nPCR）对特殊模式患者的HBV进行基因分型,同时对两组特殊模式患者的临床资料和HBV感染的自然史进行分析。结果48例乙肝病毒血清学标志物为特殊模式的HBV感染者中,36例患者HBsAg与抗-HBs同时阳性,12例患者HBeAg与抗-HBe同时阳性。HBeAg＋／抗-HBe＋患者组的年龄较HBsAg＋／抗-HBs＋患者组的小（P〈0．05）。HBsAg＋／抗-HBs＋患者中,3例（8．3％）为B2亚型,12例（33．3％）为c2亚型,21例（58．4％）未分型;HBeAg＋／抗-HBe＋患者中,8例（66．7％）为B2亚型,1例（8．3％）为c2亚型,3例（25．0％）未分型,两组在HBV基因型的分布上差异具有统计学意义（Y2=17．44,P〈0．05）。在HBsAg＋／抗-HBs＋患者中,2例（4．2％）处于免疫清除期,14例（29．2％）处于低复制期,7例（14．6％）处于再活动期。HBeAg＋／抗-HBe＋患者中,5例（10．4％）处于免疫清除期。两组在HBV感染的自然病程中的分布差异具有统计学意义（X2=18．26,P〈0．05）。结论重庆地区乙肝病毒血清学标志物为特殊模式的慢性HBV感染者中,HBeAg与抗-HBe同时阳性的HBV感染者中B2亚型为优势基因型;HBsAg与抗-HBs同时阳性的HBV感染者中,HBV基因型以C2亚型为主。     

Comparison and significance of specific and non-specific cellular immunity in patients with chronic hepatitis B caused by infection with genotypes B or C of hepatitis B virus

The present study was designed to investigate possible relationships between the genotypes of hepa-titis B virus (HBV) and the HBV-specific cytotoxic T lymphocyte (CTL) responses. HBV genotypes, HBV specific CTL HBV DNA and other markers of HBV infection were determined in 138 patients with chronic hepatitis B. The results showed that the patients infected with genotype C (n=62) had a significantly lower HBV-specific CTL response than those who were infected with HBV genotype B (P<0.01). HBV DNA titer was higher in patients infected with HBV genotype C than in those infected with HBV geno-type B (P<0.01). Both alanine aminotransferase (ALT) and total bilirubin (TBIL) were higher in HBV genotype C infected patients than in those infected with genotype B (P<0.01 and <0.05, respectively). These results suggest that compared with CHB patients infected with HBV genotype B, the higher HBV DNA level and more severe liver damages in the patients infected with genotype C of HBV may be as-sociated with genotype C of the virus.     

桂西壮族人群乙肝病毒基因型研究

To study the distribution characteristics of Hepatitis B virus (HBV) genotypes in groups of the Zhuang nationality of Baishe in Guangxi, the PCR sandwich hybridization-ELISA technique was used to determine the genotypes in 30 patinets of Zhuang nationality with hepatitis B. Geontype B, C, D and non A-F were found in this group, in which 56.6% of them were type D,46.6% type C,33.3% typeA-F, 20% type B, Most patients were found with types C D, D B or C B. It is suggested that there are genotypes D, C, B and non A-F in this area, and the major one was genotype D. There are mixture of genotypes C D, B C, D B in this region, so the HBV genotype might be associated with area and nationality.     

Analysis of precore/core covariances associated with viral kinetics and genotypes in hepatitis B e antigen-positive chronic hepatitis B patients

Hepatitis B virus (HBV) is one of the most common DNA viruses that can cause aggressive hepatitis, cirrhosis and hepatocellular carcinoma. Although many people are persistently infected with HBV, the kinetics in serum levels of viral loads and the host immune responses vary from person to person. HBV precore/core open reading frame (ORF) encoding proteins, hepatitis B e antigen (HBeAg) and core antigen (HBcAg), are two indicators of active viral replication. The aim of this study was to discover a variety of amino acid covariances in responses to viral kinetics, seroconversion and genotypes during the course of HBV infection. A one year follow-up study was conducted with a total number of 1,694 clones from 23 HBeAg-positive chronic hepatitis B patients. Serum alanine aminotransferase, HBV DNA and HBeAg levels were measured monthly as criteria for clustering patients into several different subgroups. Monthly derived multiple precore/core ORFs were directly sequenced and translated into amino acid sequences. For each subgroup, time-dependent covariances were identified from their time-varying sequences over the entire follow-up period. The fluctuating, wavering, HBeAg-nonseroconversion and genotype C subgroups showed greater degrees of covariances than the stationary, declining, HBeAg-seroconversion and genotype B. Referring to literature, mutation hotspots within our identified covariances were associated with the infection process. Remarkably, hotspots were predominant in genotype C. Moreover, covariances were also identified at early stage (spanning from baseline to a peak of serum HBV DNA) in order to determine the intersections with aforementioned time-dependent covariances. Preserved covariances, namely representative covariances, of each subgroup are visually presented using a tree-based structure. Our results suggested that identified covariances were strongly associated with viral kinetics, seroconversion and genotypes. Moreover, representative covariances may benefit clinicians to prescribe a suitable treatment for patients even if they have no obvious symptoms at the early stage of HBV infection.     

内江地区慢性乙型肝炎患者的基因型及拉米夫定联合阿德福韦酯抗病毒治疗效果

目的探讨内江地区慢性乙型肝炎患者的基因型及拉米夫定联合阿德福韦酯抗病毒的治疗效果。方法将201例慢性乙型肝炎患者进行HBV基因型的测定,其中120例HBeAg(+)慢性乙型肝炎患者随机分为三组:A组、B组和C组,每组40例。A组给予拉米夫定(LAM)治疗;B组给予恩替卡韦(ETV)治疗;C组给予LAM联合阿德福韦酯(ADV)治疗,比较治疗情况。结果 201例慢性乙型肝炎患者中B型119例(59.2%),C型68例(33.8%),B/C混合型10例(5.0%),未知型4例(2.0%),各分型之间的性别、年龄差异无统计学意义(P0.05)。C型感染者HBeAg阳性率为86.8%,显著高于B型的51.3%(P0.05)。HBeAg(+)的3组患者治疗12、24和48周时,B组和C组患者的ALT复常率、HBV DNA阴转率及48周时的HBeAg血清转换率均显著高于A组(P0.05);C组患者与B组比较差异无统计学意义(P0.05)。治疗期间均未见不良反应发生。C组患者(包括B型19例、C型21例)中B型的HBV DNA阴转率及HBeAg血清转换率显著高于C型(P0.05)。结论地处西南方的内江地区慢性乙型肝炎患者主要以B型为主,C型次之,B型和C型共占93.0%,其他型别仅占较少部分。ETV方案或LAM联合ADV方案治疗HBeAg(+)慢性乙肝疗效优于LAM治疗。初始LAM联合ADV治疗基因B型HBeAg(+)慢性乙型肝炎疗效优于C型。     

乙型肝炎病毒不同基因分型与淋巴细胞亚群分布、肝功能及脂代谢的关系

目的:探讨乙型肝炎病毒(HBV)不同基因分型与淋巴细胞亚群分布、肝功能及脂代谢的关系。方法:选择2016年10月-2017年12月在我院治疗的HBV患者130例,将患者进行HBV基因分型检查,根据不同基因分型将患者分为B型组(n=59)和C型组(n=71),采用实时荧光PCR法检测血清HBV-DNA载量,采用ADVIA2400全自动生化分析仪测定患者丙氨酸转氨酶(ALT)、白蛋白(ALB)、总胆红素(Tbil)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平,采用美国ACL-TOP700血凝仪检测凝血酶原时间(PT)。采用流式细胞仪测定不同基因分型患者CD3~+、CD4~+、CD8~+及CD4~+/CD8~+水平。结果:两组患者HBV-DNA载量、PT比较差异无统计学意义(P0.05);B型组患者ALT、ALB、TbiL水平均低于C型组(P0.05)。B型组患者CD3~+、CD4~+、CD4~+/CD8~+水平均高于C型组,CD8~+水平低于C型组(P0.05)。两组患者TC、TG、HDL-C和LDL-C水平比较差异无统计学意义(P0.05)。结论:不同基因分型对HBV患者病毒复制能力及脂代谢无明显影响,但C型HBV对患者免疫功能及肝功能损伤更严重。     

广西地区104例泰国缺失型alpha-地中海贫血1 的研究

目的：对广西地区的泰国缺失型琢-地中海贫血1 的血液学、基因型、临床表现及民族分布进行分析。方法：对门诊病人进行 血常规、血红蛋白电泳及- 地中海贫血基因分析,收集已确诊为泰国缺失型琢- 地中海贫血1 患者的检测数据及临床资料,并用 SPSS 统计软件对以上数据进行统计分析。结果：共检出104 例泰国缺失型alpha- 地中海贫血1,其中71 例基因型为--THAI /alpha-alpha,17 例 基因型为--THAI/-alpha3.7,14 例基因型为--THAI/alpha CS alpha ,2 例基因型为--THAI/alpha QS alpha。统计学分析：--THAI/alpha alpha杂合子和--SEA/alpha-alpha杂合子的血常规 结果比较没有统计学意义,P>0.05;泰国型Hb H病(--THAI/-alpha3.7、--THAI/alpha-CSalpha、--THAI/alpha-CSalpha)和东南亚型Hb H病（--SEA/-alpha-alpha3.7、--SEA/alpha-CS-alpha)的血常 规结果比较有统计学意义,P<0.01;民族分布上,有67 例为壮族,34 例为汉族,其他民族3 例。结论：泰国缺失型- 地中海贫血1 在 广西有一定的发生率,在壮族人群多见;和东南亚缺失型Hb H病相比,泰国缺失型Hb H病出现临床症状的时间更早、贫血更严 重。     

Research on Hepatitis B virus Genotypes and Subgenotypes among Bai Nationality in Dali, Yunnan Province

To investigate the distribution of hepatitis B virus （HBV） genotypes and subgenotypes among the Bai nationality in Dali, a total of 100 serum samples from patients with chronic HBV-infection were collected for the detection of HBV genotypes and subgenotypes by genotype-specific primers and restriction fragment length polymorphism （RLFP）, respectively. Among the 100 samples, the proportions of genotype B, C and mixed genotype （B＋C） were 41%, 25% and 34%, respectively. All the genotype B strains belonged to subgenotype Ba In genotype C, 84% were Subgenotype Cs and 12% were subgenotype Ce. The distribution of genotypes B, C and B＋C showed no significant difference between male and female patients （P=0.182） and among the age groups of patients （P=0.812）. The rates of HBeAg/HBeAg positivity were no significantly different among genotypes B, genotype C and mixed genotype （B＋C） （P=0.077/P=0.663）. In Dali, genotypes B, B＋C and C existed among Bai nationality with chronic HBV-infection, and genotype B was the major genotype. Subgenotypes Ba and Cs were the predominant strains in patients with HBV genotype B/C infection. The most prominent characteristic was the higher prevalent rate of mixed genotype （B＋C） in patients.     

Research on hepatitis B virus genotypes and subgenotypes among Bai nationality in Dali, Yunnan Province

To investigate the distribution of hepatitis B virus (HBV) genotypes and subgenotypes among the Bai nationality in Dali, a total of 100 serum samples from patients with chronic HBV-infection were collected for the detection of HBV genotypes and subgenotypes by genotype-specific primers and restriction fragment length polymorphism (RLFP), respectively. Among the 100 samples, the proportions of genotype B, C and mixed genotype (B C) were 41%, 25% and 34%, respectively. All the genotype B strains belonged to subgenotype Ba. In genotype C, 84% were Subgenotype Cs and 12% were subgenotype Ce. The distribution of genotypes B, C and B C showed no significant difference between male and female patients (P=0.182) and among the age groups of patients (P=0.812). The rates of HBeAg/HBeAg positivity were no significantly different among genotypes B, genotype C and mixed genotype (B C) (P=0.077/P=0.663). In Dali, genotypes B, B C and C existed among Bai nationality with chronic HBV-infection, and genotype B was the major genotype. Subgenotypes Ba and Cs were the predominant strains in patients with HBV genotype B/C infection. The most prominent characteristic was the higher prevalent rate of mixed genotype (B C) in patients.     

我国常见乙型肝炎病毒基因型与基本核心启动子及前C区突变关系的初步研究

收集81份HBV DNA阳性血清标本,经PCR扩增和序列测定确定其中有50份属于基因型C,31份属于基因型B;C基因型的基本核心启动子BCP T1762/A1764的突变率(38%)明显高于B基因型(12.9%,P<0.05);前C区A1896的突变在B、C两基因型间无显著性差异,B基因型为9.7%,C基因型为12%,P>0.05;HBeAg的表达与否与BCP双突变或前C区A1896突变均无明显相关性。经定量PCR检测证明,HBeAg阳性组中的HBV DNA含量明显高于抗-HBe阳性组,P<0.05。组内BCP双突变株和野生株及前C1896突变株和野生株的HBV DNA含量无显著性差异。