目的了解广东省人类免疫缺陷病毒(HIV)/HCV共感染者与单纯HCV感染者的感染途径、HCV的基因亚型分布及其遗传特征,为丙型肝炎病毒感染的治疗与预防提供依据。方法采用巢式逆转录-聚合酶链反应扩增广东省95例HIV/HCV共感染者及99例单纯HCV感染者HCVNS5B基因区域,扩增产物测序后进行HCV基因亚型分析,遗传分析利用MEGA4软件。不同种基因亚型型内基因距离以碱基置换率表示。结果HIV/HCV共感染者HCV有5种基因亚型,其中6a型占53.7%(51/95)、3a型占17.9%(17/95)、1b型占15.8%(15/95)、3b型占11.6%(11/95)、1a型占1.0%(1/95);1b亚型内基因距离为6.30%±1.27%,高于其他基因亚型。HIV/HCV共感染者主要通过静脉注射毒品感染(75/95,78.9%),其基因亚型主要为6a型,占60.0%(45/75)。单纯HCV感染者HCV有7种基因亚型,其中1b型占67.7%(67/99)、6a型占17.2%(17/99)、3a型占6.1%(6/99)、2a型占5.0%(5/99)、3b型占2.0%(2/99)、4a型占1.0%(1/99)、5a型占1.0%(1/99);1b亚型内基因距离为5.17%±1.03%,高于其他基因亚型。单纯HCV感染者主要通过输血或血液制品感染(80/99,80.8%),其HCV基因亚型主要为1b型,占76.2%(61/80)。结论广东地区HIV/HCV共感染者及单纯HCV感染者HCV基因亚型呈现多样性,HIV/HCV共感染者与单纯HCV感染者主要感染途径不同,HCV主要基因亚型也不同。
Objective To explore the transmission routes, genotypes/subtypes distribution and genetic character of HCV in HIV/HCV co-infected and HCV mono-infected individuals in Guangdong Province. Methods Reverse transcription (RT) nested PCR was performed to amplify the HCV NS5B gene region from 95 HIV/HCV co-infected and 99 HCV mono-infected individuals lived in Guangdong province. The PCR products were then sequenced for HCV subtyping. Genetic analysis was done by MEGA4 software. Results (1) HIV/HCV co-infected individuals infected HCV mostly through injection drug use (IDU, 78.9%), the HCV subtypes were identified as 6a (53.7%), 3a (17.9%), lb (15.8%), 3b (11.6%) and la (1.0%) respectively, the genetic distance within subtype lb was longer than those within other subtypes, the predominant HCV subtype in HIV/HCV co-infected individuals infected through IDU was 6a (60.0%). (2) HCV mono-infected individuals infected HCV mostly through blood or blood products transfusions (80.8%), the HCV subtypes were identified as lb (67.7%), 6a (17.2%), 3a (6.1%), 2a (5.0%), 3b (2.0%), 4a (1.0%) and 5a (1.0%) respectively, the genetic distance within subtype lb was also longer than those within other subtypes, the predominant HCV subtype in HCV mono-infected individuals infected through blood or blood products transfusions was lb (76.2%). Conclusion The diversity of HCV subtypes in HIV/HCV co-infected and HCV mono-infected individuals in Guangdong Province was high, both the major transmission route and HCV subtype between HIV/HCV co-infected individuals and HCV mono-infected individualswere different.