一例YMDD变异治疗后乙型肝炎病毒准种的变化  

The evolution of HBV quasispecies of one patient with YMDD mutant afte sequential treatment

作　　者：刘磊[1] 韩涛[1,2] 高英堂[2] 刘彤[2] 景丽[2] 李莹[1] 

机构地区：[1]天津市第三中心医院肝内科,天津300170 [2]天津市第三中心医院天津市人工细胞重点实验室肝胆疾病研究所

出　　处：《中华实验和临床感染病杂志（电子版）》2009年第1期19-21,共3页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：天津市科委基金(06YFJMJC13100)

摘　　要：目的研究拉米夫定耐药后续治疗过程中乙型肝炎病毒准种的变化情况。方法选取1例拉米夫定耐药变异后加用阿德福韦酯治疗无应答、换用替比夫定仍无应答的病例,对其中的两个时间点(拉米夫定耐药后和替比夫定无应答)的血清进行巢式PCR扩增、克隆分析。结果发现了治疗过程中的几种变异模式:L80I+M204I;L80I+L180M+M204I;L80I+A181T+M204I;L80V+M204I。结论随着不同抗病毒药物的应用,乙型肝炎病毒的准种不断演变,拉米夫定耐药相关突变会影响到以后其他核苷类似物的后续治疗。Objective To investigate the evolution of HBV quasispecies of one patient with YMDD mutant when received sequential antiviral therapy, Methods Sera from one patient who had been found to have resistant HBV mutations to lamivudine, lamivudine plus adefovir, and telbivudine, were cloned after nested polymerase chain reaction, Results The patterns of mutation were： L80I＋M204I; L80I ＋ L180M ＋ M204I; L80I＋ A181T ＋ M204I; L80V＋M204I with the administration of NAs. Conclusions The quasispecies of the HBV evolve step by step, Lamivudine-resistance in HBV polymerase region may affect the efficacy of sequential antiviral therapy with other NAs.

关 键 词：变异 乙型肝炎病毒 准种 耐药 

分 类 号：R512.62[医药卫生—内科学] R441.9[医药卫生—临床医学]