HBV基因型与阿德福韦酯抗病毒疗效的关系

目的 探讨HBV不同基因型对阿德福韦酯抗病毒疗效的影响.方法 选取42例应用阿德福韦酯治疗的慢性乙肝患者作为研究对象,观察治疗24周及48周时抗病毒疗效.采用型特异性引物进行巢式PCR,对患者血清中的HBV进行基因分型,采用荧光定量PCR检测患者血清HBV DNA复制水平,HBV血清病毒标志物采用双抗体夹心ELISA法检测.结果 42例慢性乙肝患者的HBV基因型分布为:B型23例,C型10例,B C混合型9例,未发现A、D、E、F基因型.不同基因型患者治疗前HBVDNA水平无统计学差异(P＞0.05).HBV基因型B型、C型和B C混合型患者治疗24周及48周时HBV DNA载量的变化、丙氨酸氨基转移酶(ALT)复常及HBeAg血清转换均无统计学差异(P＞0.05).结论 HBV基因型B型或C型对阿德福韦酯治疗的病毒学应答和生化应答相当,提示HBV基因型可能对阿德福韦酯的疗效无影响.

The relationship between HBV genotypes and antiviral efficacy of adefovir dipivoxil treatment

Objective To study the relationship between HBV genotypes and antiviral efficacy of adefovir dipivoxil(ADV) treatment.Methods 42 patients with chronic hepatitis B(CHB) who were treated with ADV,were recruited.The antiviral efficacy of ADV with all the patients were evaluated at the end of 24 and 48 weeks.The HBV genotypes were analyzed by nested PCR using type-specific primers.The levels of serum HBV DNA replication were determined by fluorescent quantitative PCR.HBV serologic markers of the patients were also detected by ELISA.Results The distributions of HBV genotypes in 42 CHB patients were as following:23 patients were genotype B,10 patients were genotype C and 9 patients were both genotype B and C.Genotypes A,D,E and F were not observed in these patients.There were no statistically significant differences in the chang of HBV DNA load,the normalization of ALT and seroconversion of HBeAg in the patients of genotype B,C and mixed genotype(P>0.05).Conclusion Genotype B of HBV could have the same virologic and biochemical response to ADV therapy as genotype C in CHB patients.It is suggested that the HBV genotypes have no effect on the antiviral efficacy of ADV.