重叠感染SEN病毒影响拉米夫定抗乙型肝炎病毒疗效

目的 通过检测慢性乙型肝炎(CHB)患者在拉米夫定治疗过程中SEN病毒(SENV)感染情况,了解SENV感染对拉米夫定抗乙型肝炎病毒(HBV)疗效的影响。 方法 采用套式聚合酶链反应检测45例CHB患者经拉米夫定治疗12个月时血清中的SENV DNA,并采用基因芯片技术对HBV DNA阳性的患者进行拉米夫定耐药相关基因YMDD基序(酪氨酸-蛋氨酸-天冬氨酸-天冬氨酸)变异检测。 结果SENV在拉米夫定治疗12个月时CHB患者中的感染率为11.1％(5/45),5例SENV DNA阳性的CHB中4例为HBV DNA阳性,其中2例出现YMDD变异,1例为HBV DNA阴性;40例SENV DNA阴性患者中10例HBV DNA为阳性,30例为阴性,SENV感染组与无感染组之间HBV DNA对拉米夫定的应答率差异有显著性,x2-3.97,P<0.05。 结论 CHB患者在治疗过程中重叠SENV感染可能会使HBV DNA对拉米夫定的应答率下降。

Influence of SEN virus infection on their response to lamivudine in patients with chronic hepatitis B

Objective To investigate the influence of SEN virus infection on their response to lamivudine in patients with chronic hepatitis B (CHB). Methods SEN virus-D and -H DNA were detected in 45 CHB patients who received lamivudine 12 months with nested-PCR, and YMDD motif mutations in HBV DNA were investigated with gene chip. Results The positive rate of SEN virus DNA was 11.1% (5/45), and there were four out of the five SEN virus DNA positive patients whose HBV DNA was positive, among them, two patients existed YMDD motif mutation. While ten out of the forty SEN virus DNA negative patients appeared HBV DNA positive. The response rate was significant lower in SEN virus-infected patients than that in uninfected patients ( x2= 3.97, P < 0.05). Conclusion Coinfection with SEN virus in chronic hepatitis B patients may adversely affect the outcome of treatment with lamivudine.