核苷和核苷酸类药物治疗慢性乙型肝炎过程中耐药突变株动态演变特征的研究进展  

Research progress in dynamic evolution characteristics of nucleos( t) ide analogue-resistant mutants

作　　者：王扬[1] 刘霜[1] 周莉[1] 郑素军[1] 段钟平[1] 

机构地区：[1]首都医科大学附属北京佑安医院人工肝中心,北京100069

出　　处：《临床肝胆病杂志》2015年第4期614-617,共4页Journal of Clinical Hepatology

基　　金："艾滋病和病毒性肝炎等重大传染病防治"科技重大专项(2012ZX10002004-006;2013ZX10002002-006);北京市卫生系统高层次卫生技术人才(2011-3-083);北京市科委首都临床特色应用研究项目(Z131107002213019)

摘　　要：核苷和核苷酸类药物长期单药抗HBV治疗过程中易导致病毒发生耐药突变,可能与慢性乙型肝炎的重症化和原发性肝癌的发生相关,是目前研究热点之一。深入理解耐药变异株在长期抗病毒治疗中的演变特征,在基因型耐药发生至病毒学突破发生的时间间隔内,选择适用于临床耐药的监测方法,动态监测耐药株在准种池中的比例变化,及时更改治疗方案,对慢性乙型肝炎的优化治疗有重要的指导意义,同时也有助于研发高效的抗病毒药物。Long-term antiviral therapy with nucleos（t）ide analogues against hepatitis B virus may lead to the occurrence of drug-resistant viral mutations.As a challenging topic in antiviral research,the problem of drug-resistant mutations may be associated with the aggregation of chronic hepatitis B and the development of primary hepatic carcinoma.In-depth understanding of the evolution characteristics of drug-resistant mutants during long-term antiviral therapy will allow a selection of appropriate clinical drug resistance monitoring approach.Within the time interval between the occurrence of genotypic resistance and virological breakthrough,dynamic monitoring of variations in the propor-tion of drug-resistant variants in the quasispecies pool and timely change of the therapeutic regimen will help to optimize the treatment of chronic hepatitis B and develop effective antiviral drugs.

关 键 词：乙型 肝炎 慢性 核苷类 核苷酸类 抗病毒药 抗药性 综述 

分 类 号：R512.62[医药卫生—内科学]