阿德福韦酯治疗慢性乙型肝炎原发性无应答患者基因型耐药分析

目的：观察阿德福韦酯治疗慢性乙型肝炎原发性无应答患者基因型耐药的发生情况。方法：阿德福韦酯治疗慢性乙型肝炎原发性无应答患者155例，应用荧光定量PCR法检测其rtN236T、rtAl81V、rtAl81T耐药位点。结果：155例患者共检出基因型耐药16例，发生率为10．3％，其中rtN236T位点3例、rtAl81V位点7例、rtAl81T位点2例、rtAl81V＋rtAl81T位点2例、rtAl81T＋rtN236T位点1例、rtN236T＋rtAl81V＋rtAl81T位点1例。结论：阿德福韦酯治疗慢性乙型肝炎原发性无应答患者基因型耐药发生率并不高，疗效不佳可能与阿德福韦酯抑制乙型肝炎病毒DNA能力较弱，病毒水平下降速度较慢有关。

Analysis of genotypic resistance of primary non-response patients following chronic hepatitia B virus infection treated with adefovir dipivoxil

Objective： To determine the genotypic resistance of primary non-response patients following chronic hepatitia B virus infection treated singly with adefovir dipivoxil. Methods： One hundred fifty-five cases of primary non-response patients following chronic hepatitia B virus infection treated with adefovir dipivoxil, rtN236T, rtA181V, rtA181T of them were determined by fluorescence quantitative PCR method. Results： Sixteen cases of the genotypic resistance were determined, the ratio of incidence was 10.3%, including three cases of rtN236T, seven cases of rtA181 V, two cases of rtA181 T, two cases of rtA181 V ＋ rtA181T, one case of rtA181T ＋ rtN236T and one case of rtN236T ＋ rtA181 V ＋ rtA181T. Conclusions：The present study confirmed the ratio of incidence of the genotypic resistance of primary non-response patients following chronic hepatitia B virus infection treated singly with adefovir dipivoxil was low. The poor efficacy may be that the inhibition effect on the ability of HBV DNA is weak, dropped speed of the virus levels is slow.