乙型肝炎病毒基因耐药变异的研究现状

抗病毒治疗是慢性乙型肝炎（慢乙肝）最根本的治疗方法。核苷（酸）类似物（NA）是目前慢乙肝抗病毒治疗的主要药物，由于服用方便、抑制病毒作用明显以及不良反应少而被广泛使用。NA药物的作用靶点在于抑制乙肝病毒聚合酶以病毒前基因组RNA为模板逆转录生成病毒DNA，所以不能直接清除已有的病毒共价闭合环状DNA脱氧核糖核酸（cccDNA），需要长期治疗才能得到持久的应答疗效。然而，随着用药时间的延长，乙型肝炎病毒（HBV）产生耐药的风险也大大增加。YMDD变异所导致的耐拉米夫定现象已受到广泛的关注。随着研究的深入，目前人们发现HBV耐NA相关的基因变异新位点28个，涉及现在临床上应用的所有NA药物。为了便于开展HBV基因耐药突变与NA药物临床应用研究，目前首先需要建立适合于临床使用的全面检测HBV基因耐药突变位点的技术方法，从而有效指导临床用药。本文将就HBV基因耐药突变与NA药物的关系以及基因耐药突变位点检测方法的新进展做一综述。

Current situation of Hepatitis B Virus gene variant resistance

Antiviral therapy is the most radical therapies of chronic viral hepatitis type B.Now the main antiviral drugs are nucleoside analogue (NA),it was used widely for taking conveniently, antiviral effectively obviously and the litter adverse reaction.NA’s action target is to restrain HBV polymerase which use the pregenome RNA as RT templates to generate virus CCCDNA,it can not remove CCCDNA directly,so it can just duration response after long-term taking.However,with the time extending,the risk of hepatitis B virus generate resistance consumedly increased. YMDD varitant induce LAM resistance was extensively paid attention to. with the deeply researching, people found about twenty-eight new HBV gene resistant sites of LAM resistance,referring all the NA used in clinical. To research HBV gene resistant and NA expediently,now a method of technique which is suit for used in clinical to detect HBV gene resistant is needed firstly,then it can guide the medication in clinical efficiently. the present article will be reviewed the latest studies in the relationship between HBV gene resistant and NA.