| BACKGROUND Hepatitis B virus (HBV) is a well-known agent of acute and chronic hepatitis,it distributes all over the world. It is said by the World Health Organization(WHO),HBV has infected about 2 billion individuals worldwide and caused chronic liver disease about 350 million,over 1 million has died of HBV-related liver failure, liver cirrhosis or hepatocellular carcinoma(HCC) annually. China is a hyperepidemic area of HBV infection.The prevalence of HBsAg carriers is as high as 9.09% among the general population in China, and the number of chronic hepatitis B patients is more than 20 million.The probability is around 25% to advanced to be liver cirrhosis or HCC who was infected below 6 years old. There fore, viral hepatitis B is a major public health problem in China and has a substantial impact on the health of people.At present, eight genotypes of hepatitis B virus have been distinguished based on a divergence over the entire genomic sequence of ≥8% or over the S gene sequence ≥4%,and they are named with capital letters from A to H.It is reported recently, genotype can be further classified into subgenotypes.HBV genotypes and subgenotypes have distinct geographical distributions,also have the probability to be related to the race,infecting approach,manifestation of clinical liver diseases, response to treatment,et al.OBJECTIVE To investigate the hepatitis B virus genotype and subgenotype distribution and its clinical significance in patients with hepatitis B virus infection in Shandong province. METHODS HBV genotypes and subgenotypes were detected in 277 patients with HBV infections of different diagnose using nested polymerase chain reaction based on genotype and subgenotype specific primers,including 42 chronic HBV carriers, 11 acute hepatitis, 185 chronic hepatitis,35 liver cirrhosis and 4 hepatocellular carcinoma patients.We have a profound investigation and comparison about different diagnose,HBeAg status,age,sex,ALT,HBV DNA level in patiets with different HBV genotypes and subgenotypes. The statistics were made by SPSS13.0 for windows.Differences were considered statistically significant at a P value of <0.05(two sides).RESULTS Among 277 cases,232 (83.3%)were identified for HBV genotypes as follows:genotype B 8.6%(20/232),genotype C 85.3%(198/232), B/C mixed genotype 6.1%(14/232).Genotype A,D,Eand F were not found.Of 20 HBV genotype B patients, 16(80%) were subgenotype Ba,3(15%) were subgenotype Bj,and 1(5%) were neither Ba nor Bj.Of 198 genotype C patients,159 (80.3%) were subgenotype C2,39 (19.7%) were neither C1 nor C2,and genotype C1 was not found.Of 14 genotype B/C patients,78.6%(ll/14) were subgenotype Ba+C2,21.4%(3/14) were Ba + nither C1 nor C2.The proportion of genotype C in patients with liver cirrhosis and chronic hepatitis B was higher than that in patients with chronic HBV carriers (P<0.05). Genotyp B was not found in HBeAg(-) chronic hepatitis B patients.Genotype distribution showed no significant difference between different genders, but showed significant difference between different ages.The proportion of genotype C in patients of ≥20 years old was higher than that in patients of <20 years old (P<0.05).In the chronic hepatitis B patients,the ALT of genotype C is significant higher than that of genotype B,but HBV DNA level showed no difference between genotype B and C.CONLUSIONS Genotype B,C and B/C have been detected among patients with HBV infection in shandong province, with the predominant of subgenotype C2 and Ba.The proportion of genotype C in patients with liver cirrhosis and chronic hepatitis B is higher than that in chronic HBV carriers.In the chronic hepatitis B patients,The ALT of genotype C is significant higher than that of genotype B.The genotype maybe is associated with age and HBeAg status, but not related to genderand HBV DNA level. |
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