| Objective To investigate the relationship with HBV-DNA and ALT and serum markers ofchronic hepatitis B patients in the Ningxia Region,and to evaluate the correlation betweenprognosis of HBV infection and HBV genotypes and NAs resistance mutation, and toexplore the relationship of HLA-DRB1gene and HBV related disease.Methods283patients with CHB (Chronic hepatitis B) were enrolled. Usingchemiluminescent microparticle immunoassay method to detect the serum markers andusing fluorescence quantitative PCR to detect HBV-DNA load respectively, and analyzethe correlation of the results.134patients with CHB inpatients also were inrolled togenotyping by nested-PCR with using type-specific primers, and applicated directsequencing to verify the genotypes and the resistance mutations. The relationships of HBVgenotype with gender and age, ALT, HBV-DNA and serum markers of the patients wereanalyzed, and the difference of clinical parameters with different mutation model as well.To choose87patients with CHB,78patients with liver cirrhosis,31cases of liver cancerpatients and50healthy subjects as the object of study, adopt polymerase chainreaction-sequence specific primers (PCR-SSP) to analyse their HLA-DRB1gene site.Results Compared with HBeAg-negative patients, the HBeAg-positive patients’sHBV-DNA load are higher than them,but HBeAb are lower (P<0.001,P<0.001). Thewomen’s HBeAg and HBeAb are higher than men (P=0.026,P=0.004). The differenceamong three age groups in CHB patients of lg10HBV-DNA,HBeAg and HBeAb was significant (P=0.005,P<0.001,P<0.01); HBV-DNA load with HBeAg is positive correlated(r=0.451,P<0.001),HBV-DNA with HBeAb is positive correlated (r=0.434,P<0.001);ALTand HBsAg is positive correlated (r=0.131,P=0.029).Serum specimens from134patients with HBV infection,11cases of B genotype(8.2%),10men,1woman;123cases of C genotype (91.8%),87men,36women. There isa significant difference of HBV-DNA and ALT level between B and C(Z=3.23，P<0.05；Z=0.19，P<0.05).28cases of NAs-resistance was detected within all cases, the rate ofmutation is20.9%, and rtS213T (25.0%) is the most conmon mutation.Compared with healthy controls,the DRB1*07, DRB1*12allele frequency of livercirrhosis patients is significantly higher than the healthy control group (P<0.05, OR=2.237,95%CI:1.689～2.961; P<0.05, OR=2.317,95%CI:1.707～3.143); The are somesignificantly differences about DRB1*04, DRB1*13, DRB1*15allele frequencies inhepatitis B patients and healthy controls of Han (P<0.05, OR=0.481,95%CI:0.367～0.623; P<0.05, OR=0.462,95%CI:0.355～0.602; P<0.05, OR=2.292,95%:1.599～3.283).Conclusion Serum HBeAg concentration is related to serum HBV-DNA load in patientswith hepatitis B,There is a significant correlation among283cases CHB of HBV-DNAload and ALT and serological markers.It is consistent with the research results of domesticand other countries. The HBV-DNA load and HBsAg level had no close correlation; butALT level and HBsAg level is positively correlated.The concentration of HBeAg infemale patients is higher than the male, there is no significant difference in otherindexes.Most of CHB patients were30-50years old, and this group of patients hadsignificant difference with other age groups about the level of HBV-DNA, HBeAg andHBeAb.The majority of genotypes with CHB patients in Ningxia are B and C type, and Ctype is the main genotype. There is an association between HBV genotypes and HBV-DNA, ALT levels, but HBV genotypes had no significant difference with otherindexes in this study. CHB patients are resistant to lamivudine (LAM) and adefovirdipivoxil (ADV), and generate mutations about unit rtS213T and hybrid mutation.HLA-DRB1*07, DRB1*12may be susceptible genes of liver cirrhosis;HLA-DRBI*04and DRBI*l3may be resistant gene in Han population; carryingDRB1*15in Han population is more likely to occur hepatitis B virus associated diseases. |
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