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目的应用基因测序技术检测武汉地区慢性乙型肝炎患者的乙型肝炎病毒(HBV)基因型并分析其耐药情况。方法收集2015年1月—2016年12月武汉大学人民医院感染科263例乙型肝炎病毒基因(HBV-DNA)阳性的慢性乙型肝炎患者血浆标本,通过Sanger测序法测定HBV P基因RT区的基因序列,与NCBI genebank数据库中HBV基因型数据进行比对,分析患者HBV基因型。同时分析P基因RT区的突变位点和耐药情况。结果共检测出5种HBV基因型,分别是B型181例(68.82%),C型76例(28.90%),D型3例(1.14%),B/C混合型1例(0.38%)和B/F/G混合型2例(0.76%)。共检出耐药株109例(41.44%),HBV B基因型耐药突变发生率高于C基因型,以L180M+M204V/I和M204V/I耐药模式最为常见。结论武汉地区HBV基因型以B型为主,其次为C型;耐药形式复杂多样,耐药发生率与基因型别存在一定关系。
Objective To detect hepatitis B virus (HBV) genotypes in patients with chronic hepatitis B in Wuhan by gene sequencing and analyze their drug resistance. Methods A total of 263 HBV-DNA positive patients with chronic hepatitis B from the Department of Infectious Diseases, People’s Hospital of Wuhan University from January 2015 to December 2016 were collected for the determination of HBV P gene RT region by Sanger sequencing Gene sequences were compared with HBV genotype data in NCBI genebank database to analyze HBV genotype. At the same time, we analyzed the mutation sites and drug resistance of P gene in RT region. Results A total of five HBV genotypes were detected, which were 181 (68.82%) in type B, 76 (28.90%) in type C, 3 (1.14%) in type D and 1 (0.38%) in type B / And B / F / G mixed type in 2 cases (0.76%). A total of 109 resistant strains (41.44%) were detected. The incidence of drug-resistant mutations of HBV B genotype was higher than that of genotype C, and the most common patterns were drug resistance of L180M + M204V / I and M204V / I. Conclusion The genotypes of HBV in Wuhan are mainly B genotype, followed by C genotype. The drug resistant forms are complex and diverse, and the incidence of genotypes of genotypes is related to the incidence of HBV genotypes.