66株乙型肝炎病毒P基因区耐药突变分析  

Study on drug- resistant mutation in P gene of 66 HBV strains

作　　者：陈洁[1] 毛雄英 王卫华[1] 陈辉 赵枫[1] 张步荣[1] 

机构地区：[1]宁波大学医学院附属医院检验医学中心,浙江宁波315020 [2]宁波市医学科学研究所分子诊断中心,浙江宁波315020

出　　处：《中国卫生检验杂志》2013年第17期3319-3321,共3页Chinese Journal of Health Laboratory Technology

基　　金：宁波市自然科学基金(2011A610022)

摘　　要：目的了解慢性乙型肝炎患者在核苷(酸)类药物(NAs)治疗过程中HBV P基因区的突变情况及其临床意义。方法采用PCR产物直接测序法,检测分析HBV P基因区耐药突变情况。结果检测到66株(42.6%)与NAs耐药相关的基因突变。变异类型主要为rtM204 V/I(29.0%)、rtL180 M(13.5%)、rtA181V/T(9.0%)、rtN236T(1.9%)。变异组合模式共有16种,有rtM204I 20例、rtA181T 7例、rtA181V 5例、rtN236T 3例、rtM204V+rtL180M 12例、rtM204I+rtL80I 4例、rtM204I+rtL180M 2例、rtM204I+rtL80V 2例等。结论乙型肝炎患者长期应用NAs治疗过程中HBV P区耐药变异发生率高,变异形式复杂多样;动态监测耐药突变,尽早发现和确认耐药突变株,对HBV抗病毒治疗至关重要。Objective To study the mutations in the P gene of hepatitis B virus （HBV） in chronic hepatitis B（CHB） patients and its clinical significance. Methods HBV P gene resistant mutations were detected and analyzed by direct sequencing of PCR products. Results Sixty - six HBV strains were detected drug -resistant mutations against nucleos（t） ide analogues, and the mutation types were rtM204 V/I（29.0% ）, rtL180 M（ 13.5% ）, rtA181V/T（9.0% ）, rtN236T（ 1.9% ）. There were 16 kinds of variation patterns related to nucleotide drugs resistance, such as rtM204I（20/66）, rtA181T（7/66）, rtA181V（5/66）, rtN236T（3/66）, rtM204V ＋rtL180M（12/66）, rtM204I ＋rtL80I（4/66）, rtM204I ＋rtL180M（2/66）, rtM204I ＋rtL80V（2/ 66）. Conclusion The incidence of drug resistant mutation become higher with the process of antiviral treatment of hepatitis B patients, and the variation patterns have become more complex. It is essential to monitor HBV resistant mutation dynamieally to early find and confirm the drug - resistant strains, so as to guide the further antiviral treatment of HBV patients.

关 键 词：乙型肝炎病毒 核苷(酸)类似物 耐药突变 

分 类 号：R373.21[医药卫生—病原生物学]