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目的了解广西HBsAg无症状携带者乙肝病毒(HBV)前S基因(PreS)缺失突变株的流行情况。方法按现况研究的原理,用三阶抽样法,在广西东、西、南、北、中各选定1个县,然后在每个县选择人口约1 000人的自然村,调查该村全人群HBV感染情况,用套式聚合酶链反应(nested PCR)对HBsAg阳性血清HBV前S基因扩增和序列分析。结果共调查4 513人,HBsAg总阳性率为8.7%(395/4 513),Pre-S基因缺失突变率为4.9%(17/350),男、女突变率(5.1%、4.5%)无显著性差异(2=0.07,P>0.05),25岁以下没有出现缺失突变,突变率在50岁年龄组最高,但各组间无显著性差异(P>0.05)。汉族人群突变率较高(6%);钦州突变率最高(7.5%),苍梧最低(1.5%),各民族之间、各县之间突变率均无显著性差异(P>0.05)。所有Pre-S缺失突变都是框内突变,82.4%(14/17)的突变发生在或涉及Pre-S2的5’端。Pre-S2起始密码发生突变率为6.9%(24/350)。基因型B、C、I和D前S基因缺失突变率分别为6.1%(7/114)、4.1%(9/221)、7.1%(1/14)和0(0/1),各组间无显著性差异(P>0.05)。结论广西HBV无症状携带者前S基因缺失突变率较低,PreS1的3’端和PreS2的5’端是缺失突变的好发部位,低年龄组罕见,突变与性别、民族、地理位置和基因型无关。
Objective To investigate the prevalence of hepatitis B virus (PreS) deletion mutants in asymptomatic HBsAg carriers in Guangxi. Methods According to the study of the current situation, a third-order sampling method was used to select one county in the east, west, south, north and center of Guangxi and then selected natural villages of about 1,000 in each county to investigate the whole village Population HBV infection, amplification and sequence analysis of HBV PreS gene with HBsAg positive serum by nested PCR. Results A total of 4 513 individuals were enrolled in this study. The overall positive rate of HBsAg was 8.7% (395/4 513). The Pre-S deletion mutation rate was 4.9% (17/350), and the male and female mutation rates were 5.1% (4.5%) (2 = 0.07, P> 0.05). There was no deletion mutation below 25 years old. The mutation rate was the highest in 50 years old group, but there was no significant difference among the groups (P> 0.05). The mutation rate of Han population was higher (6%). The mutation rate of Qinzhou was the highest (7.5%) and lowest in Cangwu (1.5%). There was no significant difference (P> 0.05) in the mutation rate among different ethnic groups and counties. All Pre-S deletion mutations were in-frame mutations, and 82.4% (14/17) of the mutations occurred at or involved the 5 ’end of Pre-S2. Pre-S2 start codon mutation rate was 6.9% (24/350). The deletion mutation rates of genotypes B, C, I and D before S gene were 6.1% (7/114), 4.1% (9/221), 7.1% (1/14) and 0 (0/1) There was no significant difference (P> 0.05). Conclusions The mutation rate of pre-S gene deletion in HBV asymptomatic carriers of Guangxi is low. The 3 ’end of PreS1 and the 5’ end of PreS2 are the predilection sites for deletion mutation. Rare mutations in the low-age group are associated with gender, ethnicity, geographical location and gene Has nothing to do with type.