重庆地区丙型肝炎病毒基因型分布及临床意义

Genotype distribution and clinical significance of hepatitis C virus in Chongqing

摘要:

目的：了解重庆地区近年来丙型肝炎病毒（hepatitis C virus，HCV）基因型分布、演变和可能的临床意义，为更好防治丙型肝炎提供依据。方法：回顾性研究2010年1月至2013年12月期间在重庆医科大学附属第二医院就诊并有基因分型结果的丙型肝炎患者的基因型分布，并与该地区其它文献报道的数据相比较，探讨基因型演变的可能影响因素。结果：共收集941例HCV感染者，检出4种基因型、9种基因亚型，成功进行基因分型有857例（均为单一基因型，分型率 91.1%）。其基因型分布为：1a 30例（3.5%）、1b 238例（27.8%）、2a 42例（4.9%）、2b 1例（0.1%）、3a 132例（15.4%）、3b 244例（28.5%）、3k 6例（0.7%）、6a 124例（14.5%）、6b 40例（4.7%）。与5年前的结果比较发现HCV 1b、2a亚型明显下降，3型、6型比例上升，差异具有统计学意义。结论：3b、１b型为目前重庆地区丙型肝炎患者感染HCV的主要基因型，3a、6a型亦占有较大比例，提示重庆地区HCV流行的基因型呈现多样性。

Abstract:

Objective：To investigate hepatitis C virus（HCV） genotypes distribution，evolution and possible clinical significance in Chongqing area，and to provide basic evidence for better treatment and prevention of HCV. Methods：HCV genotype distribution of hepatitis C patients who had information of HCV genotypes from January 2010 to December 2013 diagnosed in the Second Affiliated Hospital of Chongqing Medical University were retro－spectively analyzed and compared with the reported literatures in this area. The possible factors influencing evolution of HCV genotype were investigated. Results：Totally 941 cases were re－cruited in this study. Four genotypes and 9 genetic subtypes of HCV were founded among the 857 cases who had single genotype（the typing rate was 99.1%），and the genotypes were not clearly typed in the other 84 cases. Among those genotypes and genetic subtypes，there were 30 cases（3.5%）genotype 1a，238 cases（27.8%） 1b，42 cases（4.9%） 2a，1 cases（0.1%）2b，132 cases（15.4%）3a，244 cases（28.5%）3b，6 cases（0.7%）3k，124 cases（14.5%） 6a and 40 cases（4.7%） 6b. Compared with the results of 5 years ago，1b and 2a genetic subtype were decreased obviously，and the proportion of genotype 3 and 6 increased. Conclusion：HCV genotype 3b and 1b are the predominant genotypes among HCV infection patients in Chongqing；however genotypes 3a and 6a also have relative high proportion，indicating the diversity and complexity of HCV genotype in Chongqing.