耐拉米夫定乙型肝炎病毒聚合酶P区变异与基因分型  

A study on relationship between variation of P gene region and genotyping of Lamivudine-resistant hepatitis B virus

作　　者：杨国灿[1] 茅国峰[1] 沈少卿[1] 郑专[1] 陈建军[1] 

机构地区：[1]绍兴市人民医院(浙江大学绍兴医院),浙江绍兴312000

出　　处：《浙江预防医学》2014年第6期544-547,共4页Zhejiang Journal of Preventive Medicine

摘　　要：目的分析拉米夫定耐药的慢性乙型肝炎患者HBV P区变异和基因分型的关系,为制定针对不同HBV基因型抗病毒的个体化方案提供依据。方法应用聚合酶链反应(PCR)和酶联免疫吸附试验(ELISA)对187例拉米夫定耐药患者的HBV DNA载量及HBV-M进行检测,用特异的引物对待检标本HBV P区进行全序列测定,对不同性别、年龄的测序结果的基因分型作比较;并对C、B基因型发生实变模式作分析。结果 187例慢性乙型肝炎患者感染的HBV均为B和C基因型,B基因型51例(27.27%),C基因型134例(71.66%),并存在混合感染2例(1.07%);HBeAg含量在B基因型和C基因型间差异有统计学意义(P<0.05);P区基因突变结果显示,B基因型以单纯YMDD突变为主,C基因型以YMDD突变+rtL180M突变为主。结论本研究对象的HBV基因型主要是C型,不同基因型可能决定了与耐药相关的P区变异模式。Objective To analyze hepatitis B virus（ HBV）genotype and the correlation between variation of P gene region and genotyping of Lamivudine-resistant HBV,in order to provide molecular virology basis for anti-virus individualized treatment to different HBV genotypes. Methods Serum markers and HBV DNA of 187 Lamivudine -resistant chronic HBV patients were detected by ELISA and fluorescent quantitative polymerase chain reaction. Moreover,DNA Star and viral genotyping tool were used. Results Of the 187 cases infected with HBV genotype B and C,51 cases were B gene （27. 27%）,134 cases were C gene（71. 66%）,and 2 cases were mixed infections（1. 07%）. HBeAg levels were significantly different between genotype B and C（P〈0. 05）. P gene mutation results showed that genotype B dominated by YMDD mutation alone and genotype C dominated by YMDD and rtL180M mutation. Conclusion The main HBV genotype of this study is genotype C,and different genotypes may determine the variation patterns of P region which associated with resistance.

关 键 词：乙型肝炎病毒 基因型 拉米夫定 耐药 

分 类 号：R512.62[医药卫生—内科学]