乙型肝炎病毒BCP变异与拉米夫定治疗后HBVDNA反弹关系的研究

目的 探讨HBV BCP变异与拉米夫定抗病毒治疗后HBVDNA反弹的关系.方法 应用PCR-序列分析法,检测拉米夫定治疗(100mg/d)1年以上,达到病毒学应答半年以上,再出现HBV DNA反弹(HBV DNA拷贝数≥1.0×104拷贝/ml)的27例乙型肝炎患者(治疗组),以及19例从未用过抗病毒治疗患者(对照组)的HBV C区基本核心启动子(BCP)的突变位点.结果 1.治疗组HBVDNA反弹的27例BCP(A1762T G1764A)变异检出率44.44%(12/27)高于对照组26.32%(5/19),但无统计学差异,P>0.05.2.4例HBVDNA反弹患者治疗前未检出BCP(A1762T G1764A)变异,治疗后有2例检出BCP(A1762T G1764A)变异.结论 BCP(T1762/A1764)变异可能与拉米夫定治疗后HBVDNA反弹有关.

Study of the relationship between BCP mutation in the hepatitis B virus gene and HBVDNA rebound after lamivudine therapy

Objective To investigate the relationship of Hepatitis B virus BCP mutation in the hepatitis B virus(HBV) genome and HBVDNA rebound after with lamivudine therapy.Methods With inspected twenty-seven patients(therapy group,HBVDNA>104 copie4/ml)with HBVDNA rebound after respond to virus beyond 6 months with infecting hepatitis B received lamivudine(100mg/day) oral application for at least 12 months and nineteen patients(control group) with infecting hepatitis B without treated with the drug of antivirus,we have examined mutation in the Basal Core Promoter(BCP) of the Hepatitis B virus(HBV) of two group by PCR-gene sequence analysis.Results 1.The rate of BCP(A1762T G1764A) mutations were 44.44%(12/27) in HBVDNA-negative group beyond control group 6.32%(5/19),but it has not statistic difference (P>0.05).2.In the therapy group,BCP(A1762T G1764A)mutation were not examined in four patients before therapy,but it were examined in two patients after therapy.Conclusion BCP(T1762/A1764)mutation may be associated with HBVDNA rebound after lamivudine therapy.