未经拉米夫定治疗HBV YMDD变异的临床分析

目的分析未经拉米夫定治疗的HBV病毒YMDD变异出现的情况,探讨HBV病毒YMDD变异出现可能的机理,了解以YMDD自然变异的慢性HBV感染患者的肝损害情况。方法对140例HBVDNA阳性,未经拉米夫定治疗的慢性HBV感染者进行YMDD检测,同时检测谷丙转氨酶(ALT)、谷草转氨酶(AST)、血清总胆红素(TBIL)、白蛋白(ALB)、发病年龄、HBeAg与抗HBe等临床相关指标。结果140例未经拉米夫定治疗的慢性乙肝病毒感染者中20例自然发生YMDD变异,YMDD变异组与未变异组引起的肝损害无显著性差异(P>0.05)。YMDD变异与HBeAg与抗HBe的阳性表达无明显差异(P>0.05)。结论HBV病毒YMDD变异株作为一个准种与野毒株同时存在感染个体,YMDD变异对肝损害严重性无关,YMDD变异与HBeAg阳性率与抗HBe阳性率无明显差异。

Clinical Analysis of HBV YMDD Mutation in Patients Receiving No Lamivudine Treatment

Objective To analyze the occurrence of tyrosine-methionine-aspartate-aspartate (YMDD)motif mutation in patients receiving no Lamivudine treatment and the mechanism of YMDD mutation, especially in patients with hepatic lesion and chronic HBV infection. Methods 140 patients with chronic HBV infection were examined for the YMDD mutation. Comparisons among ALT, AST, TBIL, ALB, HBeAg and anti-HBe were made. Results 20 patients had YMDD motif mutation. There was no significant difference in hepatic lesion between the group of patients with YMDD motif mutation and the group of patients without YMDD mutation(P>0.05). There was also no correlation between YMDD mutation and the production of HBeAg and anti-HBe(P >0.05). Conclusion Both HBV wild types and YMDD motif mutants can be found in the same infected individual.There is no correlation between YMDD motif mutation and the severity in hepatic lesion. There is no correlation between YMDD mutation and the expression of HBeAg and anti-HBe.