拉米夫定耐药株感染者HBV基因型和逆转录酶区变异分析  

The hepatitis B viral genotype and mutations of reverse transcriptase domain analysis in patients with lamivu-dine-resistant mutant infection

作　　者：傅茂英 李国云 

机构地区：[1]江苏省昆山市第一人民医院感染病科,215300

出　　处：《实用肝脏病杂志》2009年第5期345-346,365,共3页Journal of Practical Hepatology

摘　　要：目的了解拉米夫定耐药株感染者HBV基因型特征并分析耐药株HBV逆转录酶(RT)区变异位点和变异类型。方法应用PCR扩增和直接测序HBV逆转录酶区并与Genebank中90株不同基因型野毒株序列进行比较,确定54例耐药株感染者HBV基因型和HBVRT核苷酸的变异特点。结果在54例拉米夫定耐药株感染者中,HBVB基因型占27.78%,C型占70.37%,B/C混合型占1.85%;51例患者出现RT保守区氨基酸变异(包括550和526位氨基酸变异);18例患者出现除主型区外HBVRT非主型区伴随变异;3例患者未检测到与拉米夫定相关性变异。结论拉米夫定耐药株感染者HBV基因型主要为B型和C型;拉米夫定耐药株的氨基酸变异不仅见于RT区的526和550两个位点,其他位点以及RT非保守区也可发生变异。Objective To investigate the hepatitis B viral genotype and mutations of reverse transcriptase domain in patients with lamivudine-resistant mutant infection. Methods Hepatitis B virus genotypes in 54 patiens with chronic hepatitis B were assayed and HBV reverse transcriptase sequences were analyzed by PCR and gene sequencing. Result Out of the 54 patients,15（27.78%） were with HBV genotype B,38（70.37%） with genotype C,and 1（1.85%） with mixed B and C infection;51 patients had amino acid variation at HBV RT domains （including sites of 550 and 526）,18 had additional amino acid variation at HBV non-conservative domains and 3 didn＇t have their amino acid variation detected. Conclusion HBV genotype B and C are the major HBV genotypes in this series of patients;Lamivudine-resistant HBV strains may accompany amino acid variation not only in the sites of 550 and 526 of HBV RT conservative domains,but also in the non-conserved domains outside YMDD motif.

关 键 词：慢性乙型肝炎 HBV基因型 拉米夫定 YMDD基序变异 

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