乙型肝炎病毒核心启动子的T^(1762)A^(1764)变异与干扰素疗效的关系  

Relationship between hepatitis B virus core promoter mutation and the response to interferon-α treatment

作　　者：温帆渊[1] 朱瑞芳[1] 谭斌[1] 李韶光[1] 

机构地区：[1]广东省惠州市中心人民医院消化内科肝病区,516001

出　　处：《广东医学》2005年第7期915-916,共2页Guangdong Medical Journal

基　　金：广东省惠州市科技计划立项项目(编号:2004Y03)

摘　　要：目的为探讨乙型肝炎病毒(HBV)核心启动子(CP)区域T1762A1764变异对干扰素治疗疗效的影响。方法41例HBeAg阳性、HBVDNA阳性及ALT升高的慢性乙型肝炎(CHB)患者给予干扰素治疗,在治疗前后均应用聚合酶链反应(PCR)技术并对其产物直接测序分析,并定期检测肝功能及HBVDNA。结果治疗前41例CHB患者中有22例存在T1762A1764变异,占54%。干扰素治疗6个月后,HBVDNA阴转率在T1762A1764变异株感染患者中显著高于野生株感染的患者(64%vs37%,P<0.01);HBeAg阴转率在变异株感染患者中显著高于野生株感染的患者(55%vs42%,P<0.05);两组ALT复常率差异无显著性(54%vs46%,P>0.05)。在野生株治疗有效的6例患者中有1例患者出现T1762A1764变异株。结论CP区域T1762A1764变异可提高干扰素治疗疗效,干扰素治疗可能会增加T1762A1764变异的机会。Objective To investigate the relationship between hepatitis B virus core promoter mutation and interferon-α treatment. Methods HBV core promoter gene fragments were detected by using PCR combined with direct sequencing before and after interferon treatment in 41 chronic hepatitis B patients. The levels of ALT and HBV DNA were measured during study. Results Before interferon treatment, 22 cases(54%) had mutation with T^(1762)A^(1764) in CP region. By the end of interferon treatment, the rate of HBVDNA negativity and HBeAg seronconversion in the mutant-group was significant higher than that in the wild-type group(64% vs 37%,P<0.01; 55% vs 42%,P<0.05. respectively). There levels were no significance in ALT level between the two groups(54% vs 46%,P>0.05). Conclusion These results suggest that the CP mutation could induce the effectof interferon treatment, and interferon might induced T^(1762)A^(1764) mutation.

关 键 词：乙型肝炎病毒核心启动子 乙型肝炎病毒(HBV) 聚合酶链反应(PCR) HBVDNA阳性 干扰素治疗 HBeAg阳性 慢性乙型肝炎 DNA阴转率 治疗疗效 感染患者 ALT升高 ALT复常 野生株 变异株 测序分析 治疗前后 定期检测 肝功能 CHB 显著性 

分 类 号：R512.62[医药卫生—内科学] R511[医药卫生—临床医学]