HBV前C／BCP区变异对HBeAg阳性慢乙肝患者干扰素治疗早期应答的影响

目的：研究HBV DNA前C区1896位变异，BCP区1762/1764位变异与干扰素α治疗应答的关系。方法以41例接受干扰素治疗的HBeAg阳性慢性乙型肝炎（慢乙肝）患者为研究对象。治疗前取患者外周血清，采用PCR 技术扩增前C区、BCP区，并测序分析。同时监测治疗0、12、24周患者外周血ALT、HBsAg、HBeAg、HBV DNA水平。结果①PC/BCP区变异（突变型，non-WT）患者HBeAg转阴率（ n＝13，72．2％）高于未发生PC/BCP变异（野生型，WT）患者（n＝4，28．8％）（P＝0．014）；②突变组HBsAg降低（ n＝5，56．7％）、HBVDNA转阴（n＝8，53．5％），完全应答（ n ＝5，62．5％），野生组 HBsAg 降低（ n ＝6，43．3％）、HBV DNA 转阴（ n ＝7，46．7％），完全应答（n＝3，37．5％），2组间无明显差异。结论突变型患者HBeAg转阴率高于野生型患者。

Effec ts of the mutations of hepatitis B virus precore and basal core promoter on early response of patienst with HBeAg-positi ve chronic hepatitis B

Objective To investigate the relationship between the precore 1896 ando/r the basal core promoter （BCP） 1762/1764 mutations and patient response for IFN-αtreatment.Me thods Forty-one patients with HBeAg -positive chronic hepatitis B who received IFN -αtherapy were enrolled in this study .Serum HBVDNA was extracted from peripheral blood before treatment , then polymerase chain reaction （ PCR） was performed to sequence PC/BCP gene frag-ments.Meanwhile, we monitored the amounts of ALT , HBsAg, HBeAg and HBV DNA at weeks 0, 12 and 24.Results① More patients with PC/BCP mutants （ non -wild -type, non -WT） present HBeAg negative status （ n=13, 72.2 %） than those without PC/BCP mutation （wild-type, WT） （ n=4, 28.8%） （P=0.04）.②For non-WT pa-tients , their levels of HBsAg are decreased （n =5, 56.7%）, while they manifest HBVDNA negative status （n =8, 53.5%）, and complete response （n=5, 62.5%）.For WT patients, their levels of HBsAg are decreased （n=6, 43.3%）, while they also manifest HBV DNA negative status （ n =7, 46.7%）, and complete response （ n =3, 37.5%）.There is no significant difference between the two groups .Conclusion More non -WT patients present HBeAg negative status than WT patients .