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[目的]探讨山东地区HBV基因型的分布情况,研究不同HBV基因型感染者的临床特点及病毒学特点。[方法]设计针对HBV S基因片段扩增的引物,采用PCR-RFLP的基因分型方法,对128例HBV感染者进行了HBV基因分型并检测了HBV前C及基本核心启动子(BCP)变异。[结果]128份血清中,基因C型104例,占81.25%;基因B型22例,占17.19%,未检测到其它基因型。有2份血清未能明确分型。[结论]山东地区HBV基因型以C型为主,其次为B型。HBV基因C型与基因B型比较有显著不同的临床特点。在慢性HBV携带者中基因C型的比例明显低于慢性肝炎、重型肝炎及肝细胞癌患者;HBV基因B型患者的平均年龄明显小于基因C型。HBV基因C型与基因B型比较有显著不同的病毒学特点。HBV DNA基因C型感染者的HBeAg阳性率、病毒载量及BCP变异率均明显高于基因B型。提示有可能基因B型更容易出现HBeAg的血清转换,高HBV复制水平的基因C型更容易导致反复的肝脏炎症活动。不同HBV基因型的病毒学特点部分决定了其临床特点。
[Objective] To investigate the distribution of HBV genotypes in Shandong and to investigate the clinical characteristics and virological characteristics of patients with different HBV genotypes. [Methods] The primers designed for the amplification of HBV S gene fragment were designed and HBV genotyping was performed in 128 cases of HBV infected patients by PCR-RFLP genotyping method. HBV pre-C and basic core promoter (BCP) variation. [Results] Of 128 serum samples, 104 (81.25%) were genotype C and 22 (17.19%) were genotype B, no other genotypes were detected. There are 2 cases of serum can not be a clear type. [Conclusion] The genotypes of HBV in Shandong are mainly C type, followed by B type. HBV genotype C and genotype B have significantly different clinical features. The proportion of genotype C in chronic HBV carriers was significantly lower than that in patients with chronic hepatitis, severe hepatitis and hepatocellular carcinoma. The average age of HBV genotype B patients was significantly less than that of genotype C. HBV genotype C and genotype B have significantly different virological characteristics. HBeAg positive rate, viral load and BCP mutation rate of HBV DNA genotype C genotype were significantly higher than genotype B genotype. Suggesting that it is possible that genotype B is more prone to seroconversion of HBeAg, and genotype C with higher levels of HBV replication is more likely to cause recurrent hepatic inflammatory activity. The virological characteristics of different HBV genotypes partly determine their clinical characteristics.