Epidemiology study of HBV genotypes and antiviral drug resistance in multi-ethnic regions from Western China.
Epidemiology study of HBV genotypes and antiviral drug resistance in multi-ethnic regions from Western China.
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中国西部多民族地区乙型肝炎病毒基因型及抗病毒药物耐药性流行病学研究
DOI：
10.1038/srep17413
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发表时间：
2015-11-27
影响因子：
4.6
通讯作者：
Wang L
中科院分区：
文献类型：
--
作者：
Zhang Q;Liao Y;Chen J;Cai B;Su Z;Ying B;Lu X;Tao C;Wang L
乙型肝炎病毒感染是一个严重的全球性健康问题，在中国西部地区中度流行，但乙肝病毒的分子流行病学特征仍然有限。我们进行了这项研究，以调查在这个多民族地区的乙肝病毒基因型和抗病毒耐药突变。2011年至2013年，共招募了来自四个民族的1316名乙肝患者。用Sanger测序法确定其基因分型和耐药突变。共鉴定出B、C、D和C/D四种基因型。汉族人群以B、C型为主，维吾尔族以D型为主。藏族和彝族均以C型为主，仅在藏族中发现重组C/D。拉米夫定耐药在所有人群中都很常见，尤其是在汉族人群中，拉米夫定耐药率为42.8%。无论种族如何，几乎没有观察到恩替卡韦耐药。C型菌株的rtA181T/V率高于B型菌株(13.5%vs.5.1%，P <； 0.001)，对阿德福韦的耐药率也较高(20.0%vs.9.5%，P <； 0.001)。而对其他药物和临床因素的耐药突变发生率在不同基因型间无差异。中国西部地区乙肝病毒基因分型和耐药变异具有不同的地理和人口学分布，为临床治疗提供了分子流行病学资料。
Hepatitis B virus (HBV) infection is a critical global health issue and moderately epidemic in Western China, but HBV molecular epidemiology characteristics are still limited. We conducted this study to investigate HBV genotypes and antiviral resistant mutations in this multi-ethnic area. A total of 1316 HBV patients were recruited from four ethnic groups from 2011 to 2013. Genotypes and resistant mutations were determined by Sanger sequencing. Four genotypes (B, C, D and C/D) were identified. Genotype B and C were common in Han population, while genotype D was predominant in Uygurs. Genotype C was the major genotype in both Tibetans and Yis and recombinant C/D was found in Tibetans only. Lamivudine resistance was common in all populations, especially in Hans with prevalence of 42.8%. Entecavir resistance was barely observed regardless of ethnicity. Genotype C isolates had higher rates of rtA181T/V than genotype B (13.5% vs. 5.1%, P < 0.001), in accordance with higher prevalence of resistance to adefovir (20.0% vs. 9.5%, P < 0.001). While incidence of resistant mutations to other drugs and clinical factors showed no difference among different genotypes. HBV genotypes and resistance-conferring mutations had different geographic and demographic distributions in Western China, which provided molecular epidemiology data for clinical management.