从516中国患者不同的临床表现 - 一个完整的基因组分析

StephenW

J Med Virol. 2013 Jul 12. doi: 10.1002/jmv.23640. [Epub ahead of print]
A complete genomic analysis of hepatitis B virus isolated from 516 Chinese patients with different clinical manifestations.
Li X, Liu Y, Xu Z, Wan Z, Bai S, Mao P, Mao Y, Xin S, Xu D.
Source

Viral Hepatitis Research Laboratory, Institute of Infectious Diseases, Beijing, China.
Abstract

This study investigated features and clinical implications of HBV mutations in patients with different clinical manifestations. In total, 516 patients were enrolled in this study, including 131 patients with acute hepatitis B, 239 patients with chronic hepatitis B, and 146 patients with acute-on-chronic liver failure. HBV genotypes and mutations were analyzed by direct sequencing of complete viral genomes. Genotypes B2, C1, C2, and D1 accounted for 22.2%, 1.6%, 74.6%, and 1.6%, respectively. Genotype B was more frequently detected in patients with acute hepatitis B than those with chronic hepatitis B and acute-on-chronic liver failure. Deletion mutations were detected mostly in preS1 and preS2 regions and the detection rates were 3.8%, 19.7%, and 24.7% for acute hepatitis B, chronic hepatitis B and acute-on-chronic liver failure patients, respectively. Incidences of point mutation T53C (preS1F53L), G1613A (polR841K), G1775A and A1762T + G1764A in the basal core promoter region, G1896A and G1899A in precore region and A2189C (coreI97L) in core region increased along with acute hepatitis B, chronic hepatitis B, and acute-on-chronic liver failure. The mutation G1896A was independently associated with poor survival of patients with acute-on-chronic liver failure. The gradual increase of viral mutation incidences was also observed in three HLA-A2-restricted cytotoxic T lymphocyte epitopes from HLA-A2-positive patients, that is env188-196 (5.8%, 10.1%, 22.5%), core107-115 (4.3%, 4.6%, 19.7%), and x92-100 (1.4%, 20.2%, 33.8%). In conclusion, certain viral mutations in various regions of HBV genome are associated with disease progression of HBV infection. J. Med. Virol. © 2013 Wiley Periodicals, Inc.

StephenW

这项研究调查的乙肝病毒基因突变的患者不同的临床表现的特点和临床意义。在这项研究中，共入选516例，包括131例急性乙型肝炎，慢性乙型肝炎239例，146例急性发作，慢性肝功能衰竭。 HBV基因型与突变直接测序完整的病毒基因组进行了分析。基因型B2，C1，C2，和D1分别占22.2％，1.6％，74.6％，和1.6％。 B基因型更频繁地检测比那些有慢性B型肝炎和急性发作的慢性肝功能衰竭，急性乙肝患者。缺失突变大多是在检测前S1，前S2区的检出率分别为3.8％，19.7％，和24.7％的急性乙肝，慢性乙肝急性发作的慢性肝衰竭患者，分别。的发生率，G1896A点突变T53C（preS1F53L），G1613A（polR841K），G1775A和A1762T + G1764A基本核心启动区和前C区G1899A和A2189C（coreI97L）的核心区域随着日益增多的急性乙肝，慢性乙肝，急性慢性肝衰竭。突变G1896A与急性发作，慢性肝功能衰竭患者的不良预后独立相关。中也观察到3个HLA-A2限制性细胞毒性T淋巴细胞表位，HLA-A2阳性的患者，也就是env188-196（5.8％，10.1％，22.5％），core107-115（4.3病毒突变的发生率的逐步增加％，4.6％，19.7％），和X92-100（1.4％，20.2％，33.8％）。总之，某些病毒在不同地区HBV基因组突变是乙肝病毒感染相关的疾病进展。 J.医学。病毒学杂志©2013威利期刊公司