含拉米夫定的高效抗反转录病毒治疗对HIV/HBV合并感染者YMDD变异的影响  

YMDD mutation induced by lamivudine as a component of HAART in HIV/HBV co-infected patients

作　　者：梁欣[1] 

机构地区：[1]广西钦州市第一人民医院感染性疾病科,535000

出　　处：《中国实用医药》2013年第10期4-6,共3页China Practical Medicine

基　　金：广西医药卫生自筹经费计划课题(项目编号:Z2009235);钦州市科学研究与技术开发计划项目(项目编号:20101904)

摘　　要：目的探讨HIV/HBV合并感染者经含拉米夫定(3TC)的高效抗反转录病毒治疗(highly active antiretroviral therapy,HAART)后YMDD变异的检出率和影响因素。方法对使用含3TC的HAART治疗的39例HIV/HBV合并感染者采用PCR-反向点杂交法检测HBV YMDD变异,并应用SPSS统计软件对YMDD变异检出率和影响YMDD变异的因素进行统计学分析。结果总的YMDD变异检出率为41.0%,随着治疗时间的延长,YMDD变异的检出率逐渐增加,治疗6～12月、12～24月、24～36月后YMDD的检出率分别为10.0%、42.1%和70.0%(P<0.05);YMDD变异组和未变异组的社会人口学特征、感染HIV途径、血清HBeAg状态、基线CD4+细胞水平、基线HBVDNA和ALT水平、有无肝硬化或纤维化、HBV基因型差异无统计学意义(P>0.05)。结论 HIV/HBV合并感染者的YMDD变异与含3TC的HAART治疗时间有关。Objective To investigate the YMDD mutation induced by Lamivudine as a component of HAART and the associated factors of mutation in HIV/HBV co-infected patients. Methods YMDD mutation was detected by PCR reverse dot blot hybridization （PCR-RDH） method in 39 HIV/HBV co-infected subjects. The clinical data were collected and analyzed using SPSS software. Results The rate of YMDD mutation was 41.0 % （16/39）. The YMDD mutation increase followed with the HAART containing 3TC. The rate of YMDD mutation in the patients treated from 6 to 12 mouths,12 to 24 mouths and 24 to 36 months was 10. 0%, 42. 1% and 70. 0%, respectively（P 〈 0. 05）. None of the following variables were associated with an increase disk of YMDD mutation ： social demographic characteristics, routes of transmission of HIV, serum HBeAg status, CIM cell count at baseline, serum HBV-DNA level and serum alanine transaminase levels at baseline, HBV genotypes and with liver fibrosis or cirrhosis （ P 〉 0.05 ）. Conclusion YMDD mutation in HIV/HBV co-infected patients is associated with the course of HAART.

关 键 词：人类免疫缺陷病毒 乙型肝炎病毒 合并感染 拉米夫定 YMDD变异 高效抗反转录病 毒治疗 

分 类 号：R512.62[医药卫生—内科学]