摘要
目的探讨乙型肝炎拉米夫定治疗耐药的发生与乙型肝炎病毒(HBV)基因型及P基因区变异的关系。方法选取37例乙型肝炎患者,利用MassARRAY Assay和PCR技术检测HBV基因型及P基因区变异。结果 37例患者中感染HBV B基因型19例(51.35%),C基因型15例(40.54%),B、C混合基因型2例(5.41%),无D基因型,其他基因型1例(2.70%)。37例患者中有34例患者对拉米夫定耐药,耐药患者HBV P基因区突变均为B和C基因型,B、C混合型和其他基因型无耐药。耐药患者HBV P基因区突变中,YIDD型21例(61.76%),YVDD型13例(38.24%),YIDD变异率与YVDD变异率比较差异有统计学意义(P<0.05)。基因型B中,7例(36.84%)发生YIDD变异,12例(63.16%)发生YVDD变异;基因型C中,14例(93.33%)发生YIDD变异,1例(6.67%)发生YVDD变异。基因型C与基因型B比较,YIDD和YVDD变异率差异均有统计学意义(P<0.05)。结论乙型肝炎拉米夫定治疗耐药时,HBV基因型C多发生YIDD基因变异,基因型B多发生YVDD基因变异。因此检测HBV基因型对拉米夫定耐药患者的临床诊治有指导意义。
Objective To examine the correlation between hepatitis B resistance to lamivudine and different genotypes of hepatitis B virus and mutations in the P gene region. Methods Subjects were 37 patients with hepatitis B. In these pa tients, the hepatitis B virus genotype and mutations in the P gene region were determined using a MassARRAY Assay and polymerase chain reaction （PCR）. Results Of the 37 patients with hepatitis B, 19 had the B genotype of hepatitis （51.35%） ; 15 had the C genotype （40.54%） ; 2 had a mixed B and C genotype （5.41%） ; none had the D genotype; and 1 had a genotype other than B, C, or D （2.70%）. Of the 37 patients, 34 had lamivudine-resistant hepatitis B. Patients with lamivudine-resistant hepatitis B had the B or C genotype with mutations in the P gene region. The patients with a mixed B and C genotype and the patient with another genotype did not have lamivudine-resistant hepatitis 13. Patients with lamivudine resistant hepatitis B had hepatitis B with mutations in the P gene region. The YIDD mutation was noted in 21 patients （61.76%） while the YVDD mutation was noted in 13 （38. 24%） ; The YIDD mutation was more prevalent than the YVDD mutation. Of the patients with the Bgenotype of hepatitis B, the YIDD mutation was present in 7 （36.84%） while the YVDD mutation was present in 12 （63.16%）. In patients with C genotype of hepatitis B, the YIDD mutation was present in 14 （93. 33%） while the YVDD mutation was present in 1 （6.67%）. The YIDD mutation was more prevalent with the C genotype than with the 13 genotype, and the YVDD mutation was more prevalent with the 13 genotype than with the C genotype. The differences in mutation prevalence were statistically significant （P〈0.05）. Conclusion In patients with hepatitis B that is resistant to lamivudine, the YIDD mutation is most prevalent with the C genotype while the YVDD mutation is most prevalent with the B genotype. Genotyping the hepatitis B virus can be greatly guide the clinical diagnosis and treatment of patients with lamivudine-resistant hepatitis B.
出处
《中国病原生物学杂志》
CSCD
北大核心
2013年第6期556-558,共3页
Journal of Pathogen Biology
