CAJ | 학술논문

目的：调查分析湖北地区 HCV流行特点及 HCVNS5B基因天然耐药位点分布情况，为临床 HCV患者个体化抗病毒治疗方案的选择提供依据。方法收集武汉大学人民医院检验科2011年3月～2014年4月253例 HCV患者标本，利用一代测序法进行 HCVNS5B基因部分序列测序确定亚型，将所测 HCVNS5B基因核苷酸序列在线比对，找出天然耐药位点记录统计。结果253例患者共四种基因型6种亚型，1a亚型3例、1b亚型192例、2a亚型38例、3a亚型3例、3b亚型11例和6a亚型6例。共发现13个天然耐药位点。2a 亚型天然耐药位点和变异数量较复杂，涉及13个天然耐药位点，其次是1b亚型。其中主要天然耐药位点是 L159F（475-477）占26.42％，C316Y（946-948）占16.98％，V321I（961-963）占15.09％和 S282T（844-846）占12.58％。结论在湖北地区 HCV流行情况和我国较一致，以1b亚型为主，2a亚型次之。HCVNS5B基因天然耐药位点较多较复杂，呈现一定分布特点，2a亚型天然耐药情况复杂，有13个天然耐药位点，1b亚型天然耐药位点有 L159F和C316N。可以为该地区 HCV患者个体化抗病毒治疗提供依据，为该地区 HCV流行病学提供资料支持。
목적：조사분석호북지구 HCV류행특점급 HCVNS5B기인천연내약위점분포정황，위림상 HCV환자개체화항병독치료방안적선택제공의거。방법수집무한대학인민의원검험과2011년3월～2014년4월253례 HCV환자표본，이용일대측서법진행 HCVNS5B기인부분서렬측서학정아형，장소측 HCVNS5B기인핵감산서렬재선비대，조출천연내약위점기록통계。결과253례환자공사충기인형6충아형，1a아형3례、1b아형192례、2a아형38례、3a아형3례、3b아형11례화6a아형6례。공발현13개천연내약위점。2a 아형천연내약위점화변이수량교복잡，섭급13개천연내약위점，기차시1b아형。기중주요천연내약위점시 L159F（475-477）점26.42％，C316Y（946-948）점16.98％，V321I（961-963）점15.09％화 S282T（844-846）점12.58％。결론재호북지구 HCV류행정황화아국교일치，이1b아형위주，2a아형차지。HCVNS5B기인천연내약위점교다교복잡，정현일정분포특점，2a아형천연내약정황복잡，유13개천연내약위점，1b아형천연내약위점유 L159F화C316N。가이위해지구 HCV환자개체화항병독치료제공의거，위해지구 HCV류행병학제공자료지지。
Objective To investigate epidemic characteristics of HCV and the distribution of naturally occurring resistance mutations of HCVNS5B in Hubei province,and provide the basis for individualized antiviral treatment for HCV infected pa-tients.Methods Collected HCV blood samples of 253 patients from March 2011 to May 2014 in Renming Hospital of Wu-han University,and determined the subtypes of HCVNS5B by first generation of sequencing technology,then compared the result with the nucleotide sequence of HCVNS5B online,located drug resistance loci and record.Results There were 4 gen-otypes and 6 different genetic subtypes in these 253 cases,namely 1a subtype 3,1b subtype 192,2a subtype 38,3a subtype 3, 3b subtypes 11 and 6a subtypes 6.Found 27 gene locus of resistance from 234 different places.The main drug resistance lo-ciare L159F (475-477)26.42%,followed by C316Y (946-948)16.98%,V321I (961-963)15.09% and S282T (844-846) 12.58%.Conclusion The epidemic characteristics of HCV in Hubei province were consistent with those of current in Chi-na;subtype 1b was the main types,followed by 2a subtype.The number of drug-resistant of HCVNS5B was more and com-plex,and presented some popular distributions.It was complex in mutations of 2a subtype,including 13 mutations of natural resistance.There were fewer mutations in subtype 1b,including sites of L159F and C316N.These results may provide the basis for antiviral therapy for HCV patients in this region.