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目的探讨庆阳地区丙型肝炎病毒(hepatitis C virus,HCV)基因型分布特点及其临床意义。方法收集庆阳地区289例各种丙型肝炎患者的临床资料及血液样本,采用PCR-荧光探针法检测HCV RNA和基因型,并对检测数据进行统计学分析。结果 289份HCV RNA阳性血清标本中1b型139例(48.1%),2a型136例(47.1%),3a型8例(2.8%),3b型5例(1.7%),未分出型1例(0.3%)。HCV基因型与患者的性别、年龄分布差异有统计学意义(P<0.05)。不同感染途径患者的基因型分布差异有统计学意义(P<0.05),输血是最主要的HCV感染途径,其次是血液透析。HCV基因2a型组的持续病毒学应答(sustained virological response,SVR)率(77.2%)高于1b组(69.8%),但差异无显著统计学意义(P>0.05)。不同基因型的HCV RNA载量差异有统计学意义(P<0.05)。1b型患者中肝硬化和肝癌的比例明显高于其他基因型(P<0.05)。结论庆阳地区HCV基因型呈多基因型分布特点,主要为1b和2a型,两型比例相当;HCV基因型与患者性别、年龄、感染途径、HCV RNA水平、肝病的严重程度均有相关性。
Objective To investigate the distribution and clinical significance of hepatitis C virus (HCV) genotypes in Qingyang area. Methods The clinical data and blood samples of 289 patients with hepatitis C in Qingyang area were collected. The HCV RNA and genotypes were detected by PCR-fluorescence probe, and the detection data were statistically analyzed. RESULTS: Of the 289 HCV RNA positive sera, 139 (48.1%) were type 1b, 136 (47.1%) were type 2a, 8 (2.8%) were type 3a and 5 (1.7%) were type 3b Example (0.3%). The gender and age distribution of HCV genotype had significant difference (P <0.05). The distribution of genotypes of patients with different routes of infection was significantly different (P <0.05). Blood transfusion was the most important route of HCV infection, followed by hemodialysis. The sustained virological response (SVR) rate of HCV genotype 2a group was higher than that of 1b group (77.2%), but the difference was not statistically significant (P> 0.05). The HCV RNA loads of different genotypes were significantly different (P <0.05). The ratio of cirrhosis and hepatocellular carcinoma in type 1b patients was significantly higher than that in other genotypes (P <0.05). Conclusion The genotypes of HCV genotypes in Qingyang were mostly genotypes 1b and 2a, and the proportions of the two genotypes were similar. The genotypes of HCV were correlated with sex, age, infection route, HCV RNA level and the severity of liver disease .