HBeAg转阴与HBV基因型分布和YMDD变异位点的相关性分析  

Correlation study between HBeAg-negative and HBV genotype YMDD mutations in patients with hepatitis B virus infection

作　　者：吴艾霖[1] 熊怡淞[1] 王艳艳[1] 曲远青 段小刚[1] 吴丽娟[1] 

机构地区：[1]成都军区总医院临床实验医学研究与保障中心,成都610083

出　　处：《检验医学与临床》2014年第20期2854-2855,2857,共3页Laboratory Medicine and Clinic

摘　　要：目的研究感染乙型肝炎病毒患者的乙型肝炎病毒e抗原(HBeAg)转阴与长期应用拉米夫定诱发的YMDD变异和病毒基因型的相关性。方法选取本院确诊的慢性乙型肝炎患者1 200例,其中HBeAg血清学转阴患者577例,未转阴患者623例,检测患者HBeAg、乙型肝炎病毒脱氧核糖核酸(HBV-DNA)和HBV基因型,并比较和探讨3者的关系。结果 577例HBeAg阴性患者中有233例(40.38%)存在病毒复制(HBV-DNA≥103);对233例基因分型显示,A、B、C、D基因型分别为163例(69.96%)、57例(24.46%)、11例(4.72%)、2例(0.86%);YMDD突变检测发现,233例患者中106例(45.49%)发生YMDD突变,其中Ⅴ突变68.87%,Ⅰ突变22.64%,Ⅰ/Ⅴ共生突变8.49%。在106例YMDD突变患者中A、B、C、D基因型分别为0例(0.00%)、72例(67.92%),27例(25.47%),7例(6.60%)。结论本院所在地区HBeAg血清转阴的慢性乙型肝炎患者病毒复制仍保持一定的活力,持续监测病毒拷贝数、YMDD突变和基因型对于此类患者治疗非常必要。Objective To study the correlation between hepatitis B e antigen （HBeAg）-negative and HBV gen-otype ,YMDD mutation induced by long-term use of lamivudine in patients with hepatitis B virus infection .Methods 1 200 patients with chronic hepatitis B were recruited in this study ,of which 577 patients were HBeAg negative and 623 were HBeAg positive .Enzyme-linked immunoadsordent assay（ELISA） ,Taqman QPCR and linear probe hybrid-ization were used to detect HBeAg 、HBV-DNA and HBV genotypes respectively .And the relationships between them were analyzed .Results There were 233 patients（40 .38% ）with HBV-DNA virus replication （HBV-DNA ≥ 103 ） in all the 577 HBeAg-negetive patients .Further genotyping results showed that there were 163 （69 .96% ） ,57 （24 .46% ） ,11（4 .72% ） and 2（0 .86% ） cases in genotype A ,B ,C and D respectively .YMDD mutation test found that there was 106 cases in 233 patients（45 .49% ）with YMDD mutation ,composed by Ⅴ mutation（68 .87% ） ,Ⅰ muta-tions（22 .64% ） ,and Ⅰ/Ⅴ symbiotic mutation（8.49% ） .In the 106 YMDD mutation cases there were 0（0 .00% ） ,72 （67 .92% ） ,27（25 .47% ） ,and 7（6 .60% ）cases for genotype A ,B ,C and D respectively .Conclusion Replication of hepatitis B virus was somewhat exist in patients with HBeAg-negative .Continuous monitoring of HBV viruses copy number ,YMDD mutation and genotype is necessary for the treatment of these patients .

关 键 词：E抗原阴性 乙型肝炎病毒 YMDD突变 HBV基因型 

分 类 号：R512.62[医药卫生—内科学]