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.     

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。     

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。     

Genotype-specific genomic markers associated with primary hepatomas, based on complete genomic sequencing of hepatitis B virus

We aimed to identify genomic markers in hepatitis B virus (HBV) that are associated with hepatocellular carcinoma (HCC) development by comparing the complete genomic sequences of HBVs among patients with HCC and those without. One hundred patients with HBV-related HCC and 100 age-matched HBV-infected non-HCC patients (controls) were studied. HBV DNA from serum was directly sequenced to study the whole viral genome. Data mining and rule learning were employed to develop diagnostic algorithms. An independent cohort of 132 cases (43 HCC and 89 non-HCC) was used to validate the accuracy of these algorithms. Among the 100 cases of HCC, 37 had genotype B (all subgenotype Ba) and 63 had genotype C (16 subgenotype Ce and 47 subgenotype Cs) HBV infection. In the control group, 51 had genotype B and 49 had genotype C (10 subgenotype Ce and 39 subgenotype Cs) HBV infection. Genomic algorithms associated with HCC were derived based on genotype/subgenotype-specific mutations. In genotype B HBV, mutations C1165T, A1762T and G1764A, T2712C/A/G, and A/T2525C were associated with HCC. HCC-related mutations T31C, T53C, and A1499G were associated with HBV subgenotype Ce, and mutations G1613A, G1899A, T2170C/G, and T2441C were associated with HBV subgenotype Cs. Amino acid changes caused by these mutations were found in the X, envelope, and precore/core regions in association with HBV genotype B, Ce, and Cs, respectively. In conclusion, infections with different genotypes of HBV (B, Ce, and Cs) carry different genomic markers for HCC at different parts of the HBV genome. Different HBV genotypes may have different virologic mechanisms of hepatocarcinogenesis.     

乙型肝炎病毒RT区变异及其与基因型分布的关系

目的：探讨大样本乙型肝炎病毒（HBV）感染患者RT区耐药位点变异的流行情况,及各耐药位点变异与HBV基因型的关系。方法：采用P区测序法对1117例慢性乙型肝炎患者的血清病毒进行P区测序、进化树分型。结果：RT区耐药位点变异发生率与基因型关系密切,在基因型C患者中的变异发生率远远高于基因型B患者（P=O．000）。Rt180、rtM204V、rtM204I、rt181、rt213位点变异均与基因型c有关（P〈O．05）。主要的三种变异类型rt180＋rtM204V、rtM204I、rt180＋rtM204I间基因型分布存在显薯差异（P=0．003）。不同HBeAg状态下,耐药变并的发生有显著差并（P=O．020）,特别是rt181和rt236位点变畀。结论：HBV基因型影响RT区耐药变异发生率及变异类型。且耐药变异发生率也与HBeAg状态有关。     

A Novel Complex A/C/G Intergenotypic Recombinant of Hepatitis B Virus Isolated in Southern China

Hepatitis B virus (HBV) genotypes and subgenotypes may vary in geographical distribution and virological features. Previous investigations, including ours, showed that HBV genotypes B and C were respectively predominant in South and North China, while genotypes A and D were infrequently detected and genotype G was not found. In this study, a novel A/C/G intergenotype was identified in patients with chronic HBV infection in Guilin, a city in southern China. Initial phylogenetic analysis based on the S gene suggested the HBV recombinant to be genotype G. However, extended genotyping based on the entire HBV genome indicated it to be an A/C/G intergenotype with a closer relation to genotype C. Breakpoint analysis using the SIMPLOT program revealed that the recombinant had a recombination with a arrangement of genotypes A, G, A and C fragments. Compared with the HBV recombinants harboring one or two genotype G fragments found in Asian countries, this Guilin recombinant was highly similar to the Vietnam (98–99%) and Long An recombinants (96–99%), but had a relatively low similarity to the Thailand one (89%). Unlike those with the typical genotype G of HBV, the patients with the Guilin recombinant were seropositive for HBeAg. Moreover, a relatively high HBV DNA viral load (>2×10⁶ IU/ml) was detected in the patients, and the analysis of viral replication capacity showed that the Guilin recombinant strains had a competent replication capacity similar to genotypes B and C strains. These findings can aid in not only the clarification of the phylogenetic origin of the HBV recombinants with the genotype G fragment found in Asian countries, but also the understanding of the virological properties of these complicated HBV recombinants.     

A type-specific nested PCR assay established and applied for investigation of HBV genotype and subgenotype in Chinese patients with chronic HBV infection

ABSTRACT: BACKGROUND: Many studies have suggested that hepatitis B virus (HBV) genotypes show not only geographical distribution and race specificity, but also are associated with disease progression and response to interferon treatment. The objective of this study was to develop a nested polymerase chain reaction (nPCR) assay for genotypes A-D and subgenotypes B1, B2, C1 and C2 of hepatitis B virus (HBV) and to investigate the distribution characteristics of HBV genotypes/subgenotype in China. METHODS: After redesigning the primers and optimizing the reaction conditions using common Taq polymerase, the sensitivity, specificity and reproducibility of the method were evaluated using plasmids and serum samples. In total, 642 serum samples from patients with chronic HBV infection were applied to investigate the distribution of HBV genotype and subgenotype in China. RESULTS: The genotype and subgenotype could be identified when the HBV DNA load of a sample was ≥10(2.3) IU/mL. For the 639 successfully genotyped samples, the sequencing results of 130 randomly selected samples (20.3%, 130/639) were consistent with those of the nPCR method. The present study showed that HBV genotype B (11.2%, 72/642), C (68.2%, 438/642) and D (7.2%, 46/642) were circulating in China, while genotype C was the dominant strain except for western region where genotype D was the prevalent strain. The main subgenotypes of genotypes B and C were B2 (87.5%, 63/72) and C2 (92.9%, 407/438), respectively. CONCLUSIONS: The low-cost nPCR method would be a useful tool for clinical and epidemiological investigation in the regions where genotypes A-D are predominant.     

Impact of Genetic Heterogeneity in Polymerase of Hepatitis B Virus on Dynamics of Viral Load and Hepatitis B Progression

Objective

The hepatitis B virus (HBV)-polymerase region overlaps pre-S/S genes with high epitope density and plays an essential role in viral replication. We investigated whether genetic variation in the polymerase region determined long-term dynamics of viral load and the risk of hepatitis B progression in a population-based cohort study.

Methods

We sequenced the HBV-polymerase region using baseline plasma from treatment-naïve individuals with HBV-DNA levels≥1000 copies/mL in a longitudinal viral-load study of participants with chronic HBV infection followed-up for 17 years, and obtained sequences from 575 participants (80% with HBV genotype Ba and 17% with Ce).

Results

Patterns of viral sequence diversity across phases (i.e., immune-tolerant, immune-clearance, non/low replicative, and hepatitis B e antigen (HBeAg)-negative hepatitis phases) of HBV-infection, which were associated with viral and clinical features at baseline and during follow-up, were similar between HBV genotypes, despite greater diversity for genotype Ce vs. Ba. Irrespective of genotypes, however, HBeAg-negative participants had 1.5-to-2-fold higher levels of sequence diversity than HBeAg-positive participants (P<0.0001). Furthermore, levels of viral genetic divergence from the population consensus sequence, estimated by numbers of nucleotide substitutions, were inversely associated with long-term viral load even in HBeAg-negative participants. A mixed model developed through analysis of the entire HBV-polymerase region identified 153 viral load-associated single nucleotide polymorphisms in overall and 136 in HBeAg-negative participants, with distinct profiles between HBV genotypes. These polymorphisms were most evident at sites within or flanking T-cell epitopes. Seven polymorphisms revealed associations with both enhanced viral load and a more than 4-fold increased risk of hepatocellular carcinoma and/or liver cirrhosis.

Conclusions

The data highlight a role of viral genetic divergence in the natural course of HBV-infection. Interindividual differences in the long-term dynamics of viral load is not only associated with accumulation of mutations in HBV-polymerase region, but differences in specific viral polymorphisms which differ between genotypes.     

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.     

Genetic Diversity of the Hepatitis B Virus Strains in Cuba: Absence of West-African Genotypes despite the Transatlantic Slave Trade

Cuba is an HBsAg low-prevalence country with a high coverage of anti-hepatitis B vaccine. Its population is essentially the result of the population mix of Spanish descendants and former African slaves. Information about genetic characteristics of hepatitis B virus (HBV) strains circulating in the country is scarce. The HBV genotypes/subgenotypes, serotypes, mixed infections, and S gene mutations of 172 Cuban HBsAg and HBV-DNA positive patients were determined by direct sequencing and phylogenetic analysis. Phylogenetic analysis of HBV S gene sequences showed a predominance of genotype A (92.4%), subgenotype A2 (84.9%) and A1 (7.6%). Genotype D (7.0%) and subgenotype C1 (0.6%) were also detected but typical (sub)genotypes of contemporary West-Africa (E, A3) were conspicuously absent. All genotype A, D, and C strains exhibited sequence characteristics of the adw2, ayw2, and adrq serotypes, respectively. Thirty-three (19.1%) patients showed single, double, or multiple point mutations inside the Major Hydrophilic domain associated with vaccine escape; eighteen (10.5%) patients had mutations in the T-cell epitope (amino acids 28-51), and there were another 111 point mutations downstream of the S gene. One patient had an HBV A1/A2 mixed infection. This first genetic study of Cuban HBV viruses revealed only strains that were interspersed with strains from particularly Europe, America, and Asia. The absence of genotype E supports previous hypotheses about an only recent introduction of this genotype into the general population in Africa. The presence of well-known vaccine escape (3.5%) and viral resistance mutants (2.9%) warrants strain surveillance to guide vaccination and treatment strategies.     

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。     

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。     

乙型肝炎病毒RT 区变异及其与基因型分布的关系

目的:探讨大样本乙型肝炎病毒(HBV)感染患者RT区耐药位点变异的流行情况,及各耐药位点变异与HBV基因型的关系。方法:采用P区测序法对1117例慢性乙型肝炎患者的血清病毒进行P区测序、进化树分型。结果:RT区耐药位点变异发生率与基因型关系密切,在基因型C患者中的变异发生率远远高于基因型B患者(P=0.000)。Rt180、rtM204V、rtM204I、rt181、rt213位点变异均与基因型C有关(P<0.05)。主要的三种变异类型rt180+rtM204V、rtM204I、rt180+rtM204I间基因型分布存在显著差异(P=0.003)。不同HBeAg状态下,耐药变异的发生有显著差异(P=0.020),特别是rt181和rt236位点变异。结论:HBV基因型影响RT区耐药变异发生率及变异类型,且耐药变异发生率也与HBeAg状态有关。     

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。     

Hepatitis B Virus Genotype Distribution and Genotype-Specific BCP/preCore Substitutions in Acute and Chronic Infections in Argentina

Aim

In order to assess Hepatitis B Virus genotype (g) and subgenotype (sg) implications in the course of infection, 234 HBsAg positive patients in different infection stages were characterized (66 acute infections, 63 HBeAg positive chronic infections and 105 anti-HBe positive chronic infections).

Results

Overall, sgA2 (17.9%), gD (20.9%), sgF1b (34.2%) and sgF4 (19.7%) were the most prevalent. Subgenotype F1b was overrepresented in acute and chronic HBeAg infections (56.1%), whereas gD was the most frequent (40.0%) in anti-HBe positive chronic infections. Among chronic infections, HBeAg positivity rates were 50.0, 12.5, 62.8 and 35.3% for sgA2, gD, sgF1b and sgF4, respectively (p <0.05). A bias toward BCP/preCore mutations was observed among genotypes. In anti-HBe positive chronic infections, sgF1b was more prone to have A1762T/G1764A mutation than sgA2, sgF4 and gD (75.0, 40.0, 33.3 and 31.8%, p<0.005), whereas in the pC region, gD and sgF4 were more likely to have G1896A than sgA2 and sgF1b (81.0, 72.7, 0.0 and 31.3%, p <0.001). The unexpected low frequency of the G1896A mutation in the sgF1b (despite carrying 1858T) prompted us to perform a further analysis in order to identify genotype-specific features that could justify the pattern mutations observed. A region encompassing nucleotides 1720 to 1920 showed the higher dissimilarity between sgF1b and sgF4. Genotypes and subgenotypes carrying the 1727G, 1740C and 1773T polymorphisms were prevented to mutate position 1896.

Discussion

HBeAg seroconversion is a critical event in the natural history of HBV infection. Differences in the HBeAg positivity rate might be relevant since different studies have observed that delayed HBeAg seroconversion is associated with a more severe clinical course of infection, highlighting the critical role that genotypes/subgenotypes might play in the progression of HBV infection. Polymorphisms in the regions 1720 to 1920 could be involved in the molecular mechanisms underlying seroconversion of each genotype/subgenotype.     

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.     

The HBV E genotype discover in Dai nationality in Xishuangbanna, Yunnan Province

To investigate the distribution of Hepatitis B virus (HBV) genotypes among the population of Dai nationality in Xishuangbanna, Yurman Province HBV genotypes of the Serum samples were tested by PCR-RFLP. This is the first time to discover the B+E genotypes in China. This finding provides new information for understanding the distribution of HBV genotype in China and a provides a basis for establishing a Chinese gene bank.     

Characteristics of hepatitis B virus isolates of genotype G and their phylogenetic differences from the other six genotypes (A through F)

Eight hepatitis B virus (HBV) isolates of genotype G were recovered from patients and sequenced over the entire genome. Six of them had a genomic length of 3,248 bp and two had genomic lengths of 3,239 bp (USG15) and 3,113 bp (USG18) due to deletions. The 10 HBV/G isolates, including the 8 sequenced isolates as well as the original isolate (AF160501) and another isolate (B1-89), had a close sequence homology of 99.3 to 99.8% among themselves (excluding USG18 with a long deletion) but of <88.7% to any of the 68 HBV isolates of the other six genotypes with the full-length sequence known. The eight HBV/G isolates possessed an insertion of 36 bp in the core gene and two stop codons in the precore region, as did the AF160501 and B1-89 isolates. The 10 HBV/G isolates clustered on a branch separate from those bearing the other six genotypes (A through F [A-F]) in the phylogenetic tree constructed from full-length sequences of 78 HBV isolates as well as in those constructed from the core, polymerase, X, and envelope genes. Despite two stop codons in the precore region that prohibited the translation of the HBV e antigen (HBeAg), all of the eight patients with HBV/G infection possessed the HBeAg in serum. By restriction fragment length polymorphism of the surface gene, all of the eight patients were found to be coinfected with HBV of genotype A (HBV/A), which would be responsible for the expression of HBeAg in them. It is worthy of examination to determine how coinfection occurs and whether HBV/G needs HBV/A for replication.     

阿德福韦酯抗病毒治疗1a后乙肝病毒基因型变化情况的观察

观察阿德福韦酯抗病毒治疗1 a后慢性乙肝患者体内HBV基因型变化情况.随机选择152例慢性乙肝患者作为研究对象,其中52例患者作为抗病毒治疗组,口服阿德福韦酯进行抗病毒治疗,另外100例患者作为对照组,口服护肝片进行护肝治疗,2组病人治疗周期均为1 a,分别在用药后第3、6、12个月进行随访,随访内容包括患者的依从性和不良反应、HBeAg/HBeAb、肝功能、HBV DNA定量检测,并采用多对型特异性引物巢武PCR基因分型技术动态监测治疗期间HBV基因型的变化情况.治疗1 a后,抗病毒治疗组中有1例患者体内HBV基因型发生改变,由治疗前的B型变为B/C混合型,并且病情出现反弹和加重.对照组未发现HBV基因型改变.2组HBV基因型变化率(1.9％和0％)之间没有显著性差异(P＞0.05).慢性乙肝患者体内HBV基因型可发生改变,而且1 a内即可发生,抗病毒治疗可能是促进HBV基因型改变的相关因素.HBV基因型转变可导致患者病情反弹和加重.     

广西桂北地区HBV感染者不同免疫状态HBV基因型分布研究

为了了解广西桂北地区乙型肝炎病毒(Hepatitis B Virus,HBV)感染者基因型分布情况及探讨HBV感染不同免疫状态与基因型的关系。将HBV感染者按免疫耐受、免疫清除(应答)和免疫不全(病毒残留)三种免疫状态分类,各选150例,共450例,运用实时荧光定量PCR法检测HBV感染三种不同免疫状态者的HBV基因型。450例中B型为323例、C型为94例、B+C混合型为23例和非B非C型为10例;HBV感染三种免疫状态均B型占多数,分别为70.0%、78.0%和67.33%,不同免疫状态基因型构成比差异无统计学意义;免疫状态与基因型相关性无统计学意义;B型HBV-DNA载量高于C型,各组中年龄≥30岁者C型显著多于30岁者,差异有统计学意义;各基因型间丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBil)阳性率差别无统计学意义;男女基因型分布差异无统计学意义。结果表明,广西桂北地区HBV基因型以B型为主,C型占部分比例,少量B+C混合型,偶有未能分型;HBV感染免疫耐受、免疫清除(应答)和免疫不全(病毒残留)三种免疫状态均B型占多数,慢性HBV感染免疫状态与HBV基因型相关性无统计学意义。