血清HBV DNA反跳发生时间与YMDD变异的关系

目的:研究拉米夫定治疗HBeAg阳性慢性乙型肝炎(CHB),血清HBVDNA反跳发生时间与YMDD变异的关系。方法:采用聚合酶链反应(PCR)方法,分别检测拉米夫定治疗前的血清样本和治疗后不同时间发生HBVDNA反跳时的血清样本中是否存在YMDD变异株。结果:40例发生血清HBVDNA反跳的HBeAg阳性CHB病人,拉米夫定治疗前的血清中均未检出YMDD变异株。拉米夫定治疗6个月时发生HBVDNA反跳的6例病人,血清中也未检出YMDD变异(0/6);于治疗9个月时发生HBVDNA反跳的13例病人中有3例病人的血清检出YMDD变异(23·08%);于治疗12个月时发生HBVDNA反跳的21例病人中有18例病人的血清检出YMDD变异(85·71%);P<0·01。结论:拉米夫定治疗HBeAg阳性慢性乙型肝炎,血清HBVDNA反跳发生时间与YMDD变异呈正相关,治疗9个月以后发生的血清HBVDNA反跳主要是由YMDD变异所致。

The Relationship of the Time Sequence between the Serum HBV DNA Relapse and YMDD Mutation

Objective:To study the relationship of the time sequence between the serum HBV DNA relapse and YMDD mutation in the Lamivudine treating patients with HBeAg positive chronic hepatitis B.Methods:To detect virus YMDD mutation before Lamivudine therapy and during the HBV DNA relapse after the therapy by Polymerase Chain Reaction.Results:YMDD mutation were not detected in the serum before Lamivudine therapy of the 40 patients with HBV DNA relapse.The mutation of HBV also were not found in the 6 patients with HBV DNA relapse at Lamivudine therapy 6 months (0/6),but the YMDD mutation were detected in the 3 cases of the 13 relapse patients at the 9 months (23.08%),and in the 18 cases of the 21 relapse patients at the 12 months (85.71%);P<0.01.Conclusions:In the Lamivudine treating patients with HBeAg positive chronic hepatitis B,the time sequence of the serum HBV DNA relapse showed positive correlation with YMDD mutation,and the serum HBV DNA relapse after Lamivudine therapy 9 months resulted mostly from YMDD mutation.