乙型肝炎病毒基因型对阿德福韦酯抗病毒疗效影响  

The influence of hepatitis B virus genotypes on AdefovirDipivoxil （ADV） anti-viral effect

作　　者：欧强[1] 诸思赟[1] 殷科珊[1] 卢洪洲[1] 

机构地区：[1]上海市复旦大学附属公共卫生临床中心感染科,上海201508

出　　处：《公共卫生与临床医学》2010年第1期46-49,共4页Public health and dinical medicine

摘　　要：目的探讨乙型肝炎病毒（HBV）基因型对阿德福韦酯抗HBV疗效的影响。方法选择e抗原均阳性的慢性乙型肝炎患者36例为研究对象，均予以阿德福韦酯（10mg／d）抗病毒治疗48wk，治疗前检测其病毒基因型。观察治疗过程中的不良反应并比较不同基因型患者抗病毒的疗效。结果36例慢性乙型肝炎患者B型13例，C型23例，未发现HBV其它型别。HBVB型患者阿德福韦酯治疗48wk后病毒应答率、血清生物化学应答率、HBeAg阴转率及e抗原／抗体血清转换率均高于HBVC型患者，但两组差异无显著统计学意义（P〉0．05）。未发现明显的不良反应。结论HBVB和C型为我国优势基因型。HBV基因型可能不是预测阿德福韦酯抗病毒疗效的重要因素。没有检测出HBV其它基因型，需进一步扩大治疗病例深入探讨HBV基因型和抗病毒疗效的相关性。Objective To investigate the influence of HBV genetypes on AdefovirDipivoxil （ADV） anti-viral efficacy. Methods 48 chronic B hepatitis patients （HBeAg positive） were treated with ADV for 48 weeks. HBV genotypes were determined before treatment. Adverse reactions during treatment were collected and anti-viral efficacy were compared among different HBV genotypes infection. Results Of the 36 HBeAg positive patients, 13 （36.1%） were genotype B, and 23 （63.9%） were genotype C. No other genotypes were identified in the studied subjects The rate of virology response, serum biochemistry response, HBeAg loss and HBeAg seroconversion in patients with HBV B subtype infection was 61.5% , 76.9%, 30.8%, 23.1%, in patients with HBV C subtype infection group, were 52.1%, 65.2%, 21.7%, 17.4%, respectively. There was no significant statistical difference in two groups （P〉0.05）. No adverse reactions were observed. Conclusions HBV B and C subtypes were the major subtypes in Shanghai. No predominant mutations associated with protease were identified. HBV genotypes may be irrelevant factor on ADV anti-viral effect.

关 键 词：HBV 基因型 阿德福韦酯 

分 类 号：R512.62[医药卫生—内科学]