786例慢性乙型肝炎患者恩替卡韦基因型耐药突变及特征分析  

Genotypic analysis of entecavir-resistant mutation in 786 patients with chronic hepatitis B

作　　者：岳秀娟[1] 李庆[1] 王珊珊[1,2] 陈德喜 石英[1,2] YUE Xiu-juan;LI Qing;WANG Shan-shan;CHEN De-xi;SHI Ying(Beijing You’an Hospital,Capital Medical University,Beijing 100069,China;Beijing Institute of Hepatology,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京佑安医院,100069 [2]北京市肝病研究所

出　　处：《肝脏》2021年第12期1344-1347,共4页Chinese Hepatology

基　　金：国家自然科学基金(81870424);北京市自然科学基金(7182072);北京市教育委员会科技计划重点项目(KZ201810025037)。

摘　　要：目的了解恩替卡韦耐药突变特点。方法选取2009年1月至2020年10月北京佑安医院检测的恩替卡韦基因型耐药的CHB患者786例,分析耐药情况。结果786例恩替卡韦基因型耐药患者中HBV基因型C亚型705例(89.7%),B亚型79例(10.1%),D亚型2例(0.3%)。共发现21种耐药突变类型,其中rtL180M+rtM204V(或者rtM204I)+rtV173耐药突变类型219例(27.9%),rtL180M+rtM204V(或者rtM204I)+rtT184耐药突变类型218例(27.7%),rtL180M+rtM204V+rtS202耐药突变类型175例(22.3%),rtL180M+rtM204V+rtS202+rtT184耐药突变类型52例(6.6%),rtL180M+rtM204V+rtM250耐药突变类型44例(5.6%),其他16种耐药突变类型共78例(9.9%)。结论恩替卡韦基因型耐药患者中,HBV基因型C亚型占绝对优势,rtL180M+rtM204V(或者rtM204I)+rtV173突变类型数量最多,rtT184位点突变数量最多。Objective To investigate the genotypic features of entecavir-resistant mutation in patients with chronic hepatitis B(CHB)in our hospital,and provide clinical data about characteristics and trends of entecavir-resistant mutation.Methods A total of 786 patients with entecavir-resistant mutation admitted to our hospital from January 2009 to October 2020 were selected.The drug-resistant situation were further analyzed.Results Among the 786 entecavir-resistant mutation patients,the numbers of hepatitis B virus(HBV)C genotype,HBV B genotype and HBV genotype were 705(89.7%),79(10.1%)and 2(0.3%),respectively.Twenty-one drug-resistant mutation types were found.The numbers of rtL180M+rtM204V(or rtM204I)+rtV173,rtL180M+rtM204V(or rtM204I)+rtT184,rtL180M+rtM204V+rtS202,rtL180M+rtM204V+rtS202+rtT184,rtL180M+rtM204V+rtM250 mutation types were 219(27.9%),218(27.7%),175(22.3%),52(6.6%)and 44(5.6%)respectively.There were other 16 mutation types with a total number of 78(9.9%).Conclusion HBV genotype C are the most common genotype among patients with entecavir-resistant mutation in our hospital.The rtL180M+rtM204V(or rtM204I)+rtV173 is the most prevalent mutation type and rtT184 is the most prevalent mutation site.Our research can help people understand the HBVgenotypes and mutation types of CHB patients with entecavir-resistant mutation in our hospital.

关 键 词：慢性乙型肝炎 恩替卡韦 基因分型 耐药突变 

分 类 号：R512.62[医药卫生—内科学]