Rereacher About The Connections Of Genotype, Mutation Of BCP、PC、RT、S-gene,and HCC Among The Chronic HBV Infectors In Yunan Provice

[Objective]To understand the infection status of the genotype and the testing situation of the virus mutation sites for further discussion about the connection of the genotype, normal mutation sties and HCC of the chronic HBV infectors in Yunnan Province.[Research Objects and Methods]PCR product direct sequencing method is used to detect105cases of chronic hepatitis b (nucleotide (acid) a similar drug therapy partial virological response and virological breakthrough in16cases),61cases of hepatitis b cirrhosis and hepatitis b with45cases of liver cancer, a total of211cases of serum specimens (including HBeAg positive for119cases, HBeAg negative92cases,152cases of male and female59cases) virus genotype and HBV mutation.In automatic gene sequencing analyzer, using quantitative method and Chromas program to judge the results;Using fluorescence quantitative detection of HBV DNA polymerase chain reaction method;Using enzyme-linked immunosorbent assay (ELISA) to detect serum HBV antigen antibody markers.All measurements using SPSS17.0statistical software package for testing data for statistical analysis.Describe count statistics on the number of cases is adopted to form than said the count data of two samples than the four c2table data, various data in this form than using line x list of c2inspection, when sample cases compare<40with four tables exact probability method.Screening of affecting factors using binary classification Logistic regression analysis, all results adopt bilateral inspection. P<0.05, the difference was statistically significant.[Results]1、211cases of HBV infection in C genotype in150cases, accounting for71.0%(150/211), genotype B59cases,28.0%(59/211), D genotype in2cases,1.0%(2/211), found no other genotypes.HBV genotypes in CHB, LC, HCC distribution in three groups of C genotype respectively63.8%(67/105),82.0%(50/61),73.35%(33/45), genotype B35.2%(37/105),18.0%(11/61),24.4%(11/45),1.0%D genotype (1/105),0%(0/61),2.3%(1/45), the difference was statistically significant (P<0.05).In LC and HCC group, C genotype accounted for the vast majority of proportion, but the genotype distribution of similar between the two groups have no statistical significance (P>0.05), and compare the two merged with CHB group, the difference was statistically significant (P<0.05), LC, HCC C genotype in the two groups is higher than the proportion of CHB group.2、check out the2D genotype in2cases, respectively, HBeAg positive patients with CHB and hepatitis b cirrhosis combined HCC patients, including patients with CHB for male, han ethnic group, without BCP, PC and S genetic variation;Hepatitis b cirrhosis combined HCC patients for men, the dai, HBeAg negative, with PC area variation, no BCP and S genetic variation.3、B, C, and D genotype in HBeAg positive proportion of chronic HBV infection was25.2%(30/119),73.9%(88/119),0.8%(1/119);In HBeAg negative chronic HBV infection was31.5%(29/92),67.4%(62/92),1.1%(1/92), there was no statistically significant difference (P>0.05).4、 BCP mutation in113cases, the mutation rate was53.6%(113/211), BCP variable in C, B, D as a proportion of the genotypes were60%(90/150),39%(23/59).0%(.two survivors);PC mutation in99cases, the mutation rate was46.9%(99/211), PC variable in C, B, D as a proportion of the genotypes were52.7%(79/150),32.2%(19/59),50%(1/2), C genotype BCP, PC mutations were more than B and D genotype difference was statistically significant (P<0.05). 5、 CHB BCP variable in C, B, D as a proportion of the genotypes were56.3%(40/71).27.3%(9/33),0%(0/1), LC group were47.9%(23/48),84.6%(11/13),0%(0/0), type HCC group were87.1%(27/31),23.1%(3/13),0%(0/1), three diseases in the group C genotype is higher than the BCP mutation genotype B and D, the difference was statistically significant (P<0.05).6, PC in CHB group variation in C,B,D as a proportion of the genotypes were59.7%(40/67),21.6%(8/37),0%(0/1), in the LC group were27.0%(14/52),77.8%(7/9),0%(0/0), in HCC group were83.3%(25/30),28.6%(4/14),100%(1/1);3C genotype in disease group than PC mutation genotype B and D, the difference was statistically significant (P<0.05).7、 BCP, PC variation in HBeAg positive chronic HBV infection as a share of34.5%(41/119) and31.1%(37/119), respectively in HBeAg negative chronic HBV infection was78.3%(72/92) and67.4%(62/92), HBeAg negative chronic HBV infection BCP,PC variation is higher than the HBeAg positive chronic HBV infection, difference was statistically significant (P<0.05).8、 nucleotide (acid) a similar drug treatment in16patients with CHB (lamivudine treatment of11cases, some of these8virological response and virological breakthrough in3patients; adefovir ester treatment in5cases, some of these virological4cases, virological breakthrough in1case), check out the RT area variation and3cases,2cases in the treatment of LAM,24weeks partial virological response, respectively genotype B and C genotype, resistance loci for rtM204V, rtL180M and rtM204I;1to ADV treatment48weeks virological breakthrough, resistance loci rtQ215H, for C genotype.9、 check out the area S gene mutations in1case, mutation rate was0.47%(1/211), for G145R mutation sites, C genotype, with PC variation, clinical diagnosis of HBeAg negative CHB.Female patients,59, has a history of hepatitis b familial aggregation.HBeAg positive CHB, nucleotide (acid) a similar drug treatment group, LC and HCC group found no area S genetic variation.10、209cases of B, C genotype with chronic HBV infection were divided into44cases of HCC and non-HCC group of165cases, the respective variable Logistic regression analysis showed that genotype C. the virus mutates, HBeAg-negative were associated with HCC closely related (P<0.05).[Conclusions]1、 the Yunnan region of chronic HBV infection (including chronic hepatitis, liver cirrhosis and hepatocellular carcinoma HBV) genotypes B-, C-, D-, with C-based, this study found no other genotypes.2、 there is a D genotype Yunnan region, but a smaller proportion, D genotype PC mutation may be associated with severe liver disease (liver cirrhosis and hepatitis B with hepatocellular carcinoma) related.3、 chronic HBV infection and clinical spectrum of disease related genotypes, C genotype with more severe liver disease (liver cirrhosis and hepatitis B with hepatocellular carcinoma) related.4、 similar to the distribution of genotype C in HBeAg-positive and HBeAg-negative chronic HBV infection.5、 C genotype BCP. PC mutation were more than B, D genotype.6、 HBeAg-negative chronic HBV infection and PC BCP mutation than HBeAg-positive chronic HBV infection.7、 the Yunnan region of chronic HBV infection in S gene region mutation rate, may be associated with family history of hepatitis B, longer duration, HBeAg-negative and PC variation related to the need for further expansion of case studies. PC Zone and the S gene region variation is observed with liver cancer deserves further study track.8、 this study receiving nucleos (t) similar drugs part virological response in patients with virologic breakthrough and resistant S gene region mutation was not found.9、 C genotype, BCP. PC variation, HBeAg-negative and the occurrence of HCC, the exact mechanism is unclear, need further exploration. S gene region mutation is associated with, HCC occurrence and development related to the need to expand further in-depth case studies。...