144例HBsAg携带者HBV基因型分布及PreS区位点的突变
Distribution and PreS Region Mutation of Hepatitis B Virus Genotypes in 144 HBsAg Carriers
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摘要:
目的 研究HBsAg携带者所携带乙型肝炎病毒(HBV)的基因型分布及前S区(PreS)区位点的突变情况,为乙肝防治工作提供依据。 方法 采用问卷调查的方式对144例HBsAg携带者进行乙肝相关项目调查;用型特异性引物多重PCR法检测HBV基因型,扩增HBV PreS区序列并测序。 结果 问卷调查结果显示,在144名HBsAg携带者中, 8.33%的携带者近1个月内出现过≥ 1项肝炎相关症状;近3年内, 17.36%的携带者检测过肝功能, 6.94%做过肝区B超检查;首次发现HBsAg阳性的方式和时间为在就医时占20.14%,在本次调查时占79.86%。144份HBsAg携带者血清HBV基因型中61.81%为B型, 38.19%为C型;其中本地常住人群B、C基因型分别占31.25%、68.75%,外来流动人群B、C基因型分别占65.62%、34.38%。经χ2检验,两类人群基因型分布差异具有统计学意义(P<0.05)。HBV基因型PreS区突变分析显示:本地常住人群基因型C型PreS1区突变率为6.25%;外来流动人群基因型B、C型PreS1区突变率分别为16.67%、6.82%, PreS2区突变率分别为2.38%、4.55%。 结论 本次调查的144名HBsAg携带人群基因型分布为B、C型,检测到基因PreS区突变及部分携带者HBV复制呈活跃状态。应该按照慢性病管理方式,开展对本地常住HBsAg携带者社区随访,定期督导与监测,早发现、早诊断及早治疗乙肝患者;加强对外地来沪HBsAg携带人群基因型分布及突变监测,对本地乙肝有效防治具有指导意义。 Abstract:Objective To survey distribution and mutation of hepatitis B virus (HBV) genotype in HBsAg carriers and to provide evidence for prevention and treatment of hepatitis B. Methods Basic information of selected subjects were collected by a structured questionnaire. HBV genotypes of the subject samples were determined by a multiplex polymerase chain reaction (PCR) assay. PCR amplification and DNA sequencing of the PreS region were performed. Results Of 144 HBsAg carriers, 8.33% had more than one symptom related to hepatitis in a month before the survey; 17.36% of subjects ordered hepatic function tests and 6.94% did type B ultrasonic examination to liver section in last three years; 20.14% of subjects discovered positive HBsAg in hospital and 79.86% by the current survey; 61.81% of subjects were infected by HBV genotype B and 38.19% by HBV genotype C. In terms of proportion of HBV genotype B and C, 31.25% and 68.75% were found in the local resident group respectively, while 65.62% and 34.38% in the migrant group. By χ2 test, the distribution of HBV genotype in the two groups was significantly different (P < 0.05). In PreS region detection, 6.25% of subjects with genotype C in the local resident group were identified as PreS1, 16.67% and 6.82% of genotype B and C in the migrant group were identified as PreS1 respectively while 2.38% and 4.55% were PreS2 respectively in the same group. Conclusion The distribution of HBV genotype and PreS region mutation in selected groups are delineated. Some subjects also show active HBV reproduction. It suggests a community-based surveillance system covering HBsAg carriers in order to identify and treat hepatitis in very early stage and improve effectiveness of HBV infection prevention and control.
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