HBV基因型与前C/C启动子变异及抗病毒疗效的关系  

Relationship between Shenzhen HBV genotype and precore/core promoter mutation and antiviral effects

作　　者：袁静[1] 周伯平[1] 龚作炯[2] 徐六妹[1] 蒋小玲[1] 溝上雅史[3] 

机构地区：[1]广东省深圳市东湖医院,武汉大学医学院在读博士生518020 [2]武汉大学医学院 [3]日本名古屋大学医学研究生院

出　　处：《中华实验和临床病毒学杂志》2006年第1期30-32,共3页Chinese Journal of Experimental and Clinical Virology

摘　　要：目的了解深圳市乙型肝炎病毒(HBV)基因分型情况,探讨HBV基因型与前C/C启动子变异、乙肝的病程进展及抗病毒疗效的关系。方法用单克隆抗体ELISA法(mAbs ELISA)对深圳市165例HBV感染者进行HBV基因分型;随机抽取24例慢性乙型肝炎(CHB)患者,用基因芯片技术检测HBV前C/C启动子变异;回顾性分析HBV基因型与干扰素、贺普丁抗HBV疗效的关系。结果①165例患者中,以B型106例(64·2%)和C型48例(29·1%)为主。慢性无症状乙肝病毒携带者(ASC)组B型占95·4%,肝硬化(LC)组C型占64·7%(P<0·05)。②24例CHB患者中,16例(10例B型,6例C型)发生HBV前C/C启动子变异:前C区变异(nt1896、1862)者10例(B型9例,C型1例),基本C区启动子变异(BCP)变异(nt1762、1764)者6例(B型1例,C型5例)。③用干扰素治疗的27例HBeAg(+)CHB患者,达到完全应答者B型11例(62·5%)较C型1例(9·1%)多见(P<0·05)。用贺普丁治疗的29例HBeAg(+)CHB患者,持续应答者B型15例(78·9%)较C型3例(30·0%)多见(P<0·05)。结论①深圳市HBV基因分型以B型为主,C型次之。②C型较B型易发生BCP变异,发生肝硬化机会较高,且对干扰素及贺普丁疗效较差。Objective To study the relationship between hepatitis B virus genotyping Shenzhen isolates and HBV precore/core promoter mutation and antiviral effects. Method The HBV genotyping of 165 patients with HBV was carried out with mAbs ELISA. HBV precore/core promoter mutation was detected with gene chip technology in 24 patients with CHB. The relationship between HBV genotyping and interferon, lamivudine effects was analyzed. Result （1）Out of 165 cases, 106 （64.2%） of type B but 48 （29. 1% ） of type C were found. Type B accounted for 95.4%in group ASC,and type C for 64.7%in group LC （ P 〈 0.05）. （2）Precore/core promoter mutation was found in 16 cases （10 of type B,and 6 of type C） out of 24 cases. Out of 16 cases,precore/core promoter mutation （nt1896,1862） was found in 10 cases （9 cases of type B and 1 case of type C）, while basal core promoter mutation （BCP mutation, nt1762, 1764） was found in 6 cases （ 1 case of type B and 5 of type C）.（3） Among 27 patients with CHB HBAg （ ＋ ） treated with interferon, 11 cases of type B but 1 case of type C were tested to be fully responsive to interferon. Among 29 patients with CHB HBAg （ ＋ ） treated with lamivudine, 15 cases of type B but 3 cases of type C were tested to be continuously responsive to lamivudine. Conclusion O HBV genotype popularity in Shenzhen area was classified as type B the first and type C the second. 0 Type C seems more apt to develop BCP mutation and cirrhosis, and to be less responsive to interferon or lamivudine.

关 键 词：肝炎病毒 乙型 基因分型 前C/C区突变 抗病毒治疗 

分 类 号：R512.62[医药卫生—内科学] R373.21[医药卫生—临床医学]