Li Min-wei, Hou Wei, Wo Jian-er, Liu Ke-zhou
Institute of Infectious Diseases, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
J Zhejiang Univ Sci B. 2005 Jul;6(7):664-7. doi: 10.1631/jzus.2005.B0664.
To investigate the relationship between HBV (hepatitis B virus) polymerase gene 180 and 204 sites mutation and lamivudine resistance.
One hundred forty-one patients with lamivudine resistance after lamivudine treatment and 60 chronic hepatitis B patients without lamivudine treatment were enrolled in this study. The serum HBV DNA mutation was analyzed by sequence detection via polymerase chain reaction (PCR). The sequences of the same patient were analyzed before and after lamivudine treatment.
One hundred and nine lamivudine resistance patients had HBV YMDD (tyrosine-methionine-aspartate-aspartate) mutation. Among them, 45 patients had rtL180M/M204V mutation (41.28%), 28 patients had rtL180M/M204I mutation (25.70%) and 36 patients had rtM204I mutation (33.02%). There were 6 patients with rtL180M mutation in 32 lamivudine resistance patients. Sixty chronic hepatitis patients without lamivudine treatment had no mutations.
HBV mutations, which play an important role in lamivudine resistance usually locate at polymerase gene 204 site; 180 site mutation was also observed in these patients. Evaluation of the anti-virus therapy by surveillance of the two sites mutations is of importance.
探讨乙肝病毒(HBV)聚合酶基因180及204位点突变与拉米夫定耐药性之间的关系。
本研究纳入141例拉米夫定治疗后出现耐药的患者以及60例未经拉米夫定治疗的慢性乙型肝炎患者。采用聚合酶链反应(PCR)测序检测血清HBV DNA突变情况。对同一患者在拉米夫定治疗前后的序列进行分析。
109例拉米夫定耐药患者出现HBV YMDD(酪氨酸-甲硫氨酸-天冬氨酸-天冬氨酸)突变。其中,45例患者发生rtL180M/M204V突变(41.28%),28例患者发生rtL180M/M204I突变(25.70%),36例患者发生rtM204I突变(33.02%)。32例拉米夫定耐药患者中有6例发生rtL180M突变。60例未经拉米夫定治疗的慢性肝炎患者未出现突变。
HBV突变在拉米夫定耐药中起重要作用,通常位于聚合酶基因204位点;这些患者中也观察到180位点突变。通过监测这两个位点的突变来评估抗病毒治疗具有重要意义。