乙型肝炎病毒耐药突变位点与基因型及肝硬化相关性研究

摘要/Abstract

摘要： 目的探讨乙型肝炎病毒(HBV)基因不同耐药位点的突变率与病毒基因型及患者肝硬化的关系。方法选取391例经核苷(酸)类似物(NA)抗病毒治疗的乙型肝炎患者为研究对象,根据基因型分为B型345例和C型46例两组,比较两组6个耐药位点(rtL180M、rtM204V、rtM204I、rtV207I、rtA181V、rtN236T)突变率、联合突变模式构成比;根据不同疾病进程分为慢性乙型肝炎组(342例)和肝硬化组(43例),比较两组6个耐药位点突变率。结果 C基因型组的耐药位点rtL180M突变率(21.7%比7.0%)和联合突变模式rtM204V+rtL180M构成比(6/13比16.5%)均高于B基因型组(P<0.05);肝硬化组的rtA181V位点突变率高于慢性乙型肝炎组(7.0%比0.3%),差异有统计学意义(P<0.05)。结论 HBV基因不同耐药位点突变率与不同基因型和肝硬化相关,检测乙型肝炎患者HBV耐药突变位点能为临床合理用药提供参考。

关键词: 乙型肝炎, 耐药, 基因型, 核苷(酸)类似物

Abstract: Objective To investigate the correlation between mutation rates in different drug-resistance sites of hepatitis B virus (HBV) gene and genotype as well as cirrhosis.Methods A total of 391 patients with chronic hepatitis B (CHB) treated in our hospital were enrolled. All the patients were treated with nucleoside (acid) analogue (NAs), they were divided into 2 groups according to genotype: B genotype (345 cases) and C genotype (46 cases). Mutation rates of 6 drug-resistance sites (rtL180M, rtM204V, rtM204I, rtV207I, rtA181V, rtN236T) and ratios of multi-mutation types were compared between the 2 groups. The patients were divided into the CHB group and (342 cases) and cirrhosis group (43 cases) according to the existence of cirrhosis, and the mutation rates of 6 drug-resistance sites were compared between the 2 groups.Results The mutation rates of rtL180M (21.7% vs 7.0%) and rtM204V+rtL180M (46.2% vs 16.5%) in C genotype group were higher than those in B genotype group (P<0.05). The mutation rate of rtA181V in cirrhosis group was significantly higher than that in CHB group (7.0% vs 0.3%), (P<0.05).Conclusion Mutation rates of HBV gene at different drug-resistance sites are correlated with different genotypes and cirrhosis. Detection of drug resistance mutation sites in patients with CHB can provide reference for antiviral therapy in clinic.

Key words: Hepatitis B, Drug resistance, Genotype, Nucleoside analogues

郑璟, 彭燕燕. 乙型肝炎病毒耐药突变位点与基因型及肝硬化相关性研究[J]. 肝脏, 2022, 27(7): 752-755.

ZHENG Jing, PENG Yan-yan. Correlation between drug-resistance mutation sites and genotype, as well as cirrhosis in patients with chronic hepatitis B[J]. Chinese Hepatolgy, 2022, 27(7): 752-755.

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