摘要
目的测定慢性乙型肝炎病毒(HBV)感染者HBV DNA全序列,分析S区基因缺失模式、频率及相关因素。方法慢性HBV感染者59例,其中HBV携带7例,慢性肝炎31例,肝硬化10例,重型肝炎6例,原发性肝癌5例。结果25.4%(15/59)慢性HBV感染者有S区基因缺失,未发现S基因缺失。Pre-S基因缺失均见于C基因型患者。Pre-S基因缺失患者中,20%(3/15)HBsAg、抗HBs共存,与无S区缺失者比较有明显差异(P<0.05)。PreS基因缺失与病程(偏相关系数0.28,P=0.049)、抗病毒治疗(偏相关系数-0.451,P=0.036)有密切关系。结论Pre-S基因缺失在基因C型、严重肝病及活动性HBV复制患者多见,可能与病程长及抗病毒治疗有关。Pre-S基因缺失可导致HBV免疫逃避或免疫治疗失败,可能是肝脏疾病发展的重要原因。
Objective Hepatitis B virus （HBV） mutants with deletions in the S region have not well been evaluated. This study was to assay full - length of HBV DNA, to analyze the pattern, frequency and clinical factors of S region deletion of patients with chronic HBV infection. Methods Full - length sequences of HBV DNA were acquired in 59 patients who included 7 of HBV carrier, 31 of chronic hepatitis, 10 of liver cirrhosis, 6 of chronic severe hepatitis and 5 of primary carcinoma of liver. Genotype of HBV was analyzed with PCR - RFLP. Serum HBV DNA was quantitatively measures with teal - time PCR. The full genome of complete genome of HBV DNA was amplified with routine PCR and full - length sequencing was directly performed. HBV DNA nucleotide and amino acid sequences were analyzed with bioinformatics technique analysis. Results 25.4% （15/59） of patients with chronic HBV infection had S region deletion. Pre- S gene deletion had a closedly related to genotype C. 20% （3/15）patients with Pre -S gene deletion coexisted HBsAg and anti -HBs. There was significant difference compared with patients without Pre - S gene deletion （ P 〈 0. 05 ）. Long HBV infection （ coefficien 0.28,P=0.049） and antiviral therapy（coefficient -0.451, P=0.036）. Conclusion A greater frequency of Pre -S gene deletion mutants with genotype C, advanced liver disease and active viral replication are demonstrated. It is suggested that Pre - S gene deletion would leads to failure of HBV immune evasion or immunotherapy.
出处
《临床肝胆病杂志》
CAS
2008年第3期177-179,共3页
Journal of Clinical Hepatology
基金
北京市教育委员会基金项目(KM20070025024)
北京市中西医结合重点学科资助
