乙型肝炎病毒基因型与拉米夫定疗效关系的研究

探讨乙型肝炎病毒(HBV)基因型与拉米夫定治疗慢性乙型肝炎(CHB)疗效的关系。采用PCR、核酸杂交和酶联显色技术对CHB进行HBV基因分型,观察123例(B型93例和C型30例)CHB患者拉米夫定治疗1年后肝功能、病毒学指标和YMDD变异的变化。ALT复常率为92.47%,HBeAg阴转率为27.96%,HBVDNA阴转率为82.80%,有效应答率为89.25%,与C基因型相比差异有显著性(P<0.05或P<0.005)。B型YMDD变异的发生率为9.68%,显著低于C型的26.67%(P<0.05)。B型对拉米夫定的抗病毒疗效高于C型,YMDD变异的发生率则低于C型。HBV基因型是影响拉米夫定疗效和变异的重要因素之一。

Study on the relationship between hepatifis B virus genotypes and effect of lamivudine therapy

To study the relationship between hapatitis B virus genotypes and effect of lamivudine therapy on chronic hepatitis B.Plasma samples of 123 patients with chronic hepatitis B were detected and compared by PCR,Microplate,Hybridization-ELISA.All the patients,93 patients with genotype B and 30 patients with genotype C,received lamivudine therapy for more than one year.Liver function,viral markers and YMDD mutation were detected one year after treatment.The results showed in B genotype,the recovery rate of ALT was 92.47%,the negative conversion rate of HBeAg was 27.96%,the negative conversion rate of HBV DNA was 82.80%,the antiviral response was 89.25% showing a significant difference as compared with genotype C (P<0.05 or P<0.01).The emergence rate of YMDD mutation in genotype B was significantly lower than that in genotype C (9.68% and 26.67%,P<0.05).The antiviral response of lamivudine in HBV genotype B is significantly higher than that in genotype C,and the emergence rate of YMDD mutation in genotype B was significantly lower than that in genotype C.HBV genotypes may be an important determinant of lamivudine therapy of chronic hepatitis B.