Analysis of HBV genotype distribution and its association with liver cirrhosis in Xinjiang Uygur Autonomous Region, China
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摘要: 目的探讨新疆地区HBV基因分型构成特点及其与肝硬化之间的关系。方法收集2011年10月至2013年6月新疆维吾尔自治区中医医院收治的慢性HBV感染者1018例。其中检测出基因型、资料完整的828例。根据实验室检查及彩超或CT结果将患者分为慢性乙型肝炎组、肝硬化组、原发性肝癌组。采用PCR法对HBV基因分型,运用列联卡方、秩和检验、多因素Logistic回归分析等方法对HBV基因型与临床病情及相关慢性肝病结局进行分析。结果 828例患者中,以C型为主,占总样本的54.11%(448/828),B型占25.15%(200/828),D型占16.18%(134/828);各基因型病情程度构成差异无统计学意义(H=0.1689,P>0.05);116例肝硬化患者中基因C型占20.84%,与B型和D型相比较差异均有统计学意义(χ2值分别为25.486、20.947,P值均为0.000);乙型肝炎病程10年以上、基因C型、HBV DNA高病毒载量、ALT>ULN进入回归模型(P<0.05)。其中基因C型与肝硬化的相关度最高(OR=2.819,95%CI:1.582~5.021)。...Abstract: Objective To investigate the distribution of hepatitis B virus (HBV) genotypes among patients in Xinjiang Uygur Autonomous Region, China, and to explore its association with liver cirrhosis. Methods HBV genotypes of 1018 hepatitis B patients were determined by PCR analysis. The relationship of HBV genotype with clinical outcomes and relevant chronic liver diseases was assessed by contingency chi-square test, Kruskal-Wallis test, and multivariate unconditional logistic regression analysis. Results Among the 828 patients whose HBV genotyping was completed in this study, type C was the major genotype and the percentage was 54. 11% (448 /828) , 25. 15% (200 /828) had type B, and 16. 18% (134 /828) had type D. Among the 116 patients with liver cirrhosis, 20. 84% had type C, which was significantly more frequent than other genotypes (P < 0. 00) . The multivariate unconditional logistic regression model identified several risk factors for liver cirrhosis, including duration of hepatitis B≥10 years, C genotype, high HBV DNA viral load, and impaired liver function characterized by abnormal alanine aminotransferase test. Among all these factors, genotype C had the highest relevance to liver cirrhosis (OR =2. 819, 95% CI: 1. 582-5. 021) . Conclusion The leading genotype of HBV in Xinjiang Uygur Autonomous Region is type C, followed by type B and type D. Genotype C is an independent risk factor for HBV-related liver cirrhosis.
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Key words:
- hepatitis B, chronic /
- genotype /
- liver cirrhosis
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