乙型肝炎病毒逆转录酶区基因序列准种与变异特点

乙型肝炎病毒(Hepatitis B Virus,HBV)P基因编码产物从功能上分为末端蛋白(1～178aa)、间隔区(179～336aa)、逆转录酶区(337～682aa)和RNA酶H区(683～816aa),各区有相应的生物学功能;逆转录酶区包含S基因主蛋白编码区.近年来的研究提出HBV感染者体内存在有准种[1,2]的假说.我们以逆转录酶区序列为研究靶区域,应用聚合酶链反应(PCR)技术扩增慢性乙型肝炎患者血清中的靶基因序列,随机选择克隆测序,比较其结果,证明了HBV准种特点的存在,并发现多种基因突变形式.     

乙型肝炎病毒DNA聚合酶研究进展

乙型肝炎病毒(HBV)DNA聚合酶兼具反转录酶及DNA聚合酶活性,对其结构和功能的研究长期以来一直是HBV研究的难点及热点,本文综述了HBV DNA聚合酶研究现状及进展.     

1．3倍体HBV YIDD变异株真核表达载体构建及鉴定

构建HBV YIDD拉米夫定耐药株1．3倍全基因真核表达载体,为进一步探讨乙肝病毒变异株的生物学特性及筛选抗病毒药物奠定基础。参考GenBankHBV序列设计并合成一系列引物,以临床证实为拉米夫定耐药的病人HBV DNA为模板,通过PCR扩增得到HBV全基因组并克隆至pGEM—T Easy载体中,经测序证实聚合酶基因存在YIDD变异,然后以该病人的HBV全基因组为模板构建1．3倍全基因HBV—YIDD变异真核表达载体pcDNA3．1（＋）-1．3HBV。通过PCR扩增,酶切及测序证明pcDNA3．1（＋）-1．3HBV表达载体构建成功,该表达载体的构建为后期建立稳定表达HBV—YIDD变异的细胞模型提供材料。     

利用基因芯片分析拉米夫定治疗过程中HBV DNA的基因变异

依据乙型肝炎病毒(Hepatitis B virus; HBV)聚合酶基因序列研制HBV基因芯片,此芯片可分析HBV的7个基因型、4种血清型和HBV聚合酶基因rtV173、rtL180、rtM204和rtV207位点的突变.利用此芯片对A、B两组共计45例拉米夫定治疗12个月的患者进行服药前和服药后3、6、9、12个月的动态检测,其中C基因型39例,且血清型均为adr;B基因型6例,其血清型均为adw.在完成全程检测的38例患者中,17例ALT升高的A组出现1例拉米夫定耐药变异株,而21例ALT正常的B组出现4例变异株,且所有变异株均为rtM204 V/rtL180M,其中2例野生株和变异株共存.rtM204V变异最早在服药6个月时出现,随后出现rtL180M变异.10份PCR产物测序分析表明,芯片检测结果与测序结果基本一致,仅在rtL173位点出现1例差异.进一步分析HBV DNA变异与HBV DNA含量、ALT水平和HBeAg血清转换率的相关性,初步结果表明变异株的出现与治疗过程中的DNA反弹呈正相关,而与起始HBV DNA水平、ALT值无关联.HBV基因芯片可初步用于HBV DNA 检测,可能是临床追踪评价抗病毒治疗效果的较好方法之一.     

064一种对乙型肝炎病毒快速基因分型的聚合酶链反应

根据基因组的差别,目前可以将全世界范围内的乙型肝炎病毒(HBV)分成A～F 6个基因型.鉴于HBV的基因型有典型的地域分布特点及不同基因型HBV可能在血清学反应、致病性、治疗反应等方面存在差异,进行HBV的基因分型对于弄清病毒传播和疾病发生具有重要意义.目前用于HBV基因分型的方法主要有种系发生分析和限制性片段长度多态性分析,但是这些方法存在不适合大规模基因分型工作和敏感性、特异性不足等方面的缺点.本文介绍了一种使用类型特异的引物进行聚合酶链反应(PCR)的简单、快速、特异的HBV基因分型方法.     

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耐药相关DNA突变体的构建及在寡核苷酸基因芯片分析中的应用

拉米呋啶（Lamivudine)是近年来开发成功的一种治疗HBV慢性感染病人的核苷类药物。随着拉米呋啶在临床上广泛使用,HBV耐药现象已成为临床实践中的棘手问题。建立HBV耐药测定技术成为HBV基础研究和临床实践中企待解决的一个重要问题。寡核苷酸芯片（Oligochip)是近年来发展并逐步成熟的一种高通量基因检测技术,已成功应用于基因突变快速和高通量检测。本研究在构建HBV拉米呋啶抗性相关HBV多聚酶基因突变体基础上,设计并制备了HBV耐药寡核苷酸芯片（HBV－Lam Oligochip)。根据HBV拉米呋啶抗药性相关突变主要位于HBV多聚酶基因的L526、A546、M550和V553等氨基酸位点,设计了28条寡核苷酸探针。探针对应序列为HBV DNA聚合酶基因反义链,HBVHBVhb长度为15－18nt。探针合成时在其3′端接氨基和间隔臂（spacer)等特定修饰;探针纯化与定量后,用基因芯片点样仪点到醛基修饰载玻片上,制成HBV耐药寡核苷酸芯片（HBV－Lam Oligochip)。为了分析基因芯片的性能,克隆了833号HBV病人血清中HBV DNA聚合酶基因,测序证实为HBV DNA野生型（即未发生突变）。以该DNA为模板,用PCR法构建了HBV耐药相关突变体。用HBV－Lam Oligochip对HBV野生型DNA和人工构建DNA突变体进行了检测。结果发现,HBV－Lam Oligochip能有效检测出野生型DNA序列。检测突变体时,HBV－Lam Oligochip检测结果与相应突变体DNA序列一致,表明HBV－Lam Oligochip不仅可检测出野生型序列,而且可有效地分辨出单碱基突变,可应用于HBV耐药基因突变临床检测。     

原发性肝癌患者乙型肝炎病毒前C区联合基本核心启动子变异的分析

目的:研究原发性肝癌患者乙型肝炎病毒前C区联合基本核心启动子变异情况及与基因型的关系.方法:收集乙型肝病毒感染者血清132份,HBV DNA均阳性,用半巢式聚合酶链反应扩增HBV前C及c基因部分片段,产物纯化后直接测序,检测前C A1896联合BCP T1762/A1764变异.用S基因PCR-RFLP方法确定HBV基因型.结果:乙型肝炎病毒前C区联合基本核心启动子变异在原发性肝癌组的阳性率为41.18%(14/34),显著高于慢性肝病组的11.22%(11/98)(P<0.01).前CA1896联合BCP T1762/A1764变异在B基因型检出率与C基因型相比,差异无显著性(P>0.05).结论:乙型肝炎病毒前C区联合基本核心启动子变异与原发性肝癌关系密切,与基因型无相关性.     

乙型肝炎病毒前S基因区缺失突变发生机制的探讨

检测慢性乙型肝炎病毒(HBV)携带者和患者外周血内HBV前S区基因缺失突变的分子结构特点,探讨其发生机理.用聚合酶链反应方法从慢性乙肝患者和携带者血清中扩增出前S区基因片段,克隆、测序,分析缺失发生的结构特点,从而推测这些前S区基因缺失突变的产生机制.从262例慢性乙肝患者和103例无症状HBV携带者体内扩增出前S区片段,共在30例患者和携带者中检测出多种前S区基因缺失突变,主要集中于前S1区的3′端和前S2区的5′端.其中有9例患者和携带者体内存在完全一样的nt3019～nt3201 183bp的缺失突变,该缺失突变符合真核细胞mRNA剪接机制,在此位置上各基因型的序列高度保守.同时有另外两种缺失突变,即nt3019～nt3147 129bp缺失、nt3019～nt3109 91bp缺失也符合该剪接机制.有23种缺失突变部分于重复序列之间,符合逆转录过程中的模板转换机制所导致的缺失.根据前基因组RNA预测出二级结构,仅部分缺失突变在RNA二级结构中对应于局部的结构.此结果表明:HBV在外界因素mRNA的剪接机制和内在因素聚合酶蛋白的功能特点的共同作用下,产生各种突变,不同的机制将导致不同类型的缺失突变.除真核细胞mRNA剪接机制外,逆转录过程中的模板转换是主要机制之一.     

乙肝病毒表面抗原的抗体双阳性者中病毒S区基因序列分析

为了解乙肝病毒（HBV）表面抗原和抗体双阳性患者中病毒的基因型及其HVB S区是否有变异。用放射免疫试剂检测HBsAg阳性样品中的抗－HBs抗体，用聚合酶链反应法检测双阳性样品中的HBV DNA，然后对阳性样品进行克隆和基因序列分析，并将所得序列与HBV不同基因型的代表株进行比较分析。结果显示389例HBsAg阳性样品中有10例为抗HBs抗体阳性；该10例双阳性样品中有5例为HBV DNA阳性；序列分析显示该5株HBV均为B基因型，其中4株为adw亚型，1株为adr亚型；其中有2株在S区的“a”决定簇的氨基酸发生了变异。     

Clinical and Virological Characteristics of Chronic Hepatitis B Patients with Coexistence of HBsAg and Anti-HBs

Coexistence of hepatitis B surface antigen (HBsAg) and antibody against HBsAg (anti-HBs) comprises an atypical serological profile in patients with chronic hepatitis B virus (HBV) infection. In this study, in total 94 patients with coexisting HBsAg and anti-HBs and 94 age- and sex-matched patients with positive HBsAg were characterized by quantitatively measuring HBsAg and HBV DNA, sequencing large S genes, and observing clinical features. Compared with common hepatitis B patients, the patients with coexisting HBsAg and anti-HBs had lower HBsAg and HBV DNA levels. These two groups had similar rate of pre-S deletion mutations. However, in patients with coexisting HBsAg and anti-HBs, more amino acid substitutions in the a determinant of S gene were observed in HBV genotype C, but not in genotype B. Fourteen patients with coexisting HBsAg and anti-HBs were followed up for an average of 15.5 months. There were no significant changes in the levels of HBsAg, anti-HBs, HBV DNA and ALT over the follow-up period. Compared with the baseline sequences, amino acid substitutions in the MHR of HBsAg occurred in 14.3% (2/14) patients. In conclusion, coexistence of HBsAg and anti-HBs may be associated with higher frequency of mutations in the a determinant of HBV genotype C.     

Naturally occurring escape mutants of hepatitis B virus with various mutations in the S gene in carriers seropositive for antibody to hepatitis B surface antigen.

Hepatitis B virus (HBV) DNA was extracted from sera of six carriers with hepatitis B e antigen as well as antibody to hepatitis B surface antigen and sequenced within the pre-S regions and the S gene. HBV DNA clones from five of these carriers had point mutations in the S gene, resulting in conversion from Ile-126 or Thr-126 of the wild-type virus to Ser-126 or Asn-126 in three carriers and conversion from Gly-145 to Arg-145 in three of them; clones with Asn-126 or Arg-145 were found in one carrier. All 12 clones from the other carrier had an insertion of 24 bp encoding an additional eight amino acids between Thr-123 and Cys-124. In addition, all or at least some of the HBV DNA clones from these carriers had in-phase deletions in the 5' terminus of the pre-S2 region. These results indicate that HBV escape mutants with mutations in the S gene affecting the expression of group-specific determinants would survive in some carriers after they seroconvert to antibody against surface antigen. Carriers with HBV escape mutants may transmit HBV either by donation of blood units without detectable surface antigen or through community-acquired infection, which would hardly be prevented by current hepatitis B immuneglobulin or vaccines.     

Proteaselike sequence in hepatitis B virus core antigen is not required for e antigen generation and may not be part of an aspartic acid-type protease.

The hepatitis B virus (HBV) C gene directs the synthesis of two major gene products: HBV core antigen (HBcAg[p21c]), which forms the nucleocapsid, and HBV e antigen (HBeAg [p17e]), a secreted antigen that is produced by several processing events during its maturation. These proteins contain an amino acid sequence similar to the active-site residues of aspartic acid and retroviral proteases. On the basis of this sequence similarity, which is highly conserved among mammalian hepadnaviruses, a model has been put forward according to which processing to HBeAg is due to self-cleavage of p21c involving the proteaselike sequence. Using site-directed mutagenesis in conjunction with transient expression of HBV proteins in the human hepatoma cell line HepG2, we tested this hypothesis. Our results with HBV mutants in which one or two of the conserved amino acids have been replaced by others suggest strongly that processing to HBeAg does not depend on the presence of an intact proteaselike sequence in the core protein. Attempts to detect an influence of this sequence on the processing of HBV P gene products into enzymatically active viral polymerase also gave no conclusive evidence for the existence of an HBV protease. Mutations replacing the putatively essential aspartic acid showed little effect on polymerase activity. Additional substitution of the likewise conserved threonine residue by alanine, in contrast, almost abolished the activity of the polymerase. We conclude that an HBV protease, if it exists, is functionally different from aspartic acid and retroviral proteases.     

拉米夫定联合阿德福韦酯治疗前后乙型肝炎病毒的全基因组序列分析

目的探究拉米夫定治疗反弹后联合阿德福韦酯治疗前后乙型肝炎全基因组序列变化。方法分别提取服用拉米夫定治疗24周反弹后和阿德福韦酯辅助治疗24周后的患者2份血清病毒核酸,用聚合酶链反应扩增核酸后进行全基因组测序分析。结果测序结果显示,共计有29个氨基酸发生了突变,其中,S区突变点有5个（17．2％）,C区突变点有12个（41．3％）,P区突变点有6个（20．6％）,X区突变点有6个（20．6％）,其中P区与拉米夫定的相关位点173和204位点发生了突变翻转,但服用阿德福韦后出现了与之相关的突变位点（181、214、236和237位点）。结论核苷酸药物的使用和HBV基因耐药突变密切相关,定期检测HBV基因突变对于合理使用核苷酸药物具有重要意义。     

Hepatitis B virus polypeptide X: expression in Escherichia coli and identification of specific antibodies in sera from hepatitis B virus-infected humans.

Sequence analysis of the hepatitis B virus (HBV) genome revealed the presence of an open reading frame (ORF X) which has the potential to encode a 154-amino acid polypeptide. A fusion protein containing 145 of the amino acids encoded by ORF X and 8 amino acids of beta-galactosidase was expressed and characterized in bacterial extracts. Immunoprecipitations with the ORF X fusion protein as a radioactively labeled antigen were performed to screen sera of humans infected with HBV for the presence of antibodies against ORF X-encoded determinants (anti-X). Such antibodies were identified in 9 samples from a set of 26 sera characterized as positive for HBV surface antigen but were not found in 16 normal human sera. The data reported here demonstrate that sera from some patients with markers of HBV infection contain antibodies directed against the polypeptide encoded by ORF X. As such, these findings represent evidence that ORF X constitutes a gene, or a portion of a gene, which is expressed during HBV infection. Although there does not appear to be a direct relationship between anti-X and any individual markers of HBV infection, our data suggest that anti-X is more prevalent in HBV-positive sera containing antibodies to HBe3 antigen (anti-HBe3).     

A case of hepatitis B reactivation in an anti-HBs positive, anti-HBc positive non-Hodgkin’s lymphoma patient

Dear Editor, We report a case of HBV reactivation in an anti-HBs positive,anti-HBc positive non-Hodgkin's lymphoma patient.Hepatitis B virus (HBV) reactivation is a well-recognized complication of patients undergoing chemotherapy or immunosuppressive therapy for lymphomas.The presence of antibodies to the hepatitis B surface antigen (anti-HBs) has been identified to be a factor preventing HBV reactivation in patients with occult HBV infection receiving chemotherapy.In this paper,we present a non-Hodgkin Lymphoma patient who,before immunosuppressive therapy,displayed positive anti-HBs and positive antibodies to hepatitis B core antigens (anti-HBc),as markers of resolved HBV infection,and developed hepatitis B surface antigen (HBsAg) and high viraemia with an HBV escape mutant after rituximabbased administration.The sequencing data revealed HBV genotype D with two known escape mutations,P120S.     

Hepatitis B Virus with X Gene Mutation Is Associated with the Majority of Serologically “Silent” Non-B,Non-C Chronic Hepatitis

Hepatitis B virus (HBV) with X gene mutations has been a putative pathogen of chronic hepatitis without serological markers of known hepatitis viruses. The aim of this study was to reconfirm whether the HBV with the X gene mutation is associated with these serologically “silent” non-B, non-C (NBNC) chronic hepatitis, alcoholic liver disease (ALD) and autoimmune hepatitis (AIH). HBV DNA was amplified from serum and sequenced in 30 patients with NBNC chronic hepatitis in comparison with 20 patients with ALD and 5 patients with AIH. HBV DNA was identified in 21 patients (70%) in NBNC chronic hepatitis by nested polymerase chain reaction while only one patient (5%) in ALD and none in AIH showed HBV DNA. Eighteen (85.7%) of the 21 identified HBV DNAs had an identical 8-nucleotide deletion mutation at the distal part of the X region. This mutation affected the core promoter and the enhancer II sequence of HBV DNA and created a translational stop codon which truncated the X protein by 20 amino acids from the C-terminal end. All the HBV DNAs had a precore mutation at the 83rd nucleotide resulting in disruption of HBe antigen synthesis. These results indicate that HBV mutants are closely associated with the majority of serologically “silent” NBNC chronic hepatitis cases and the population of such mutant HBV DNAs is not uniform.     

Molecular epidemiology of hepatitis B viral serotypes and genotypes in taiwan

Subtypes of hepatitis B virus (HBV) have specific geographic distributions and can serve as epidemiological markers. The relationship of HBV serotypes and genotypes in Taiwan and their correlation with the domiciles of origin in 122 patients with chronic HBV infection were investigated. The serotype of HBV was determined by comparing the surface gene encoding amino acids 22-148 of the major surface protein with published sequences. Genotyping of HBV was performed by polymerase chain reaction-restriction fragment length polymorphism. Serotype adw accounted for 70% (85/122) of all HBVs, with the remaining belonging to serotype adr. All adr HBVs were genotype C, regardless of the patient's domicile. Of the 85 adw HBVs, 69 (81%) were genotype B, 10 (12%) were genotype C, 5 (6%) were genotype F and only 1 (1%) was genotype A. In the 31 patients originating from mainland China, the prevalence of adr/genotype C was higher than in the 91 Taiwanese patients (15/31 vs. 22/91; p < 0.05). The distribution of the HBV serotypes and genotypes was not significantly different between 17 patients born in Taiwan (6 adw/genotype B, 2 adw/genotype C, 1 adw/genotype F and 8 adr/genotype C) and 14 patients born in mainland China (5 adw/genotype B, 2 adw/genotype C and 7 adr/genotype C). Our results indicate that in Taiwan, most HBVs of serotype adw are genotype B, and all HBVs of serotype adr are genotype C. Patients with origins in mainland China have a higher proportion of serotype adr/genotype C infection.