HBV YMDD变异与HBV-DNA水平的关系

目的 观察拉米夫定治疗慢性乙型肝炎病毒YMDD变异的产生与血清HBV-DVA水平的关系.方法 拉米夫定治疗慢性乙型肝炎患者106例,平均疗程32月(12～48月),治疗前及治疗中每4～6月采血,用荧光实时PCR定量检测HBV-DNA,采用错配聚合酶链反应-限制性片段长度多态性分析的方法检测HBVYMDD变异.分析出现YMDD变异组与非变异组治疗前HBV DNA水平差异.结果 YMDD变异组治疗前血清HBV DNA定量水平显著高于未产生YMDD变异(P＜0.01).结论 慢性乙型肝炎患者治疗前血清病毒载量水平越高,应用拉米夫定治疗越容易产生YMDD变异,且产生时间越早.血清病毒载量可作为应用拉米夫定治疗YMDD变异产生的早期预测指标.

Relationship between hepatitis B virus YMDD mutation and serum viral DNA loadings

Objective To investigate the relationship between lamivudine-resistant mutants of hepatitis B virus(HBV)and serum HBV DNA loading before antiviral therapy.Methods This study involved 106 patients with hepatitis B receiving lamivudine treatment for an average of 32 months(rang 12-48 months).Serum HBV DNA loadings were measured with PCR before and every 4 to 6 months during lamivudine therapy.HBV YMDD mutants were detected using mismatched PCR-restriction fragment length polymorphism(PCR-RFLP)during lamivudine treatment.Results HBV DNA loading was significantly higher in patients infected with HBV YMDD mutants during lamivudine therapy than those infected with HBV without YMDD mutation.Conclusion High viral loading in hepatitis B patients before treatment is associated with high likeliness of HBV YMDD mutation during lamivudine treatment.HBV DNA loading may be indicative for the occurrence of YMDD mutation during lamivudine therapy.