Akarsu Mesut, Sengonul Aylin, Tankurt Ethem, Sayiner Ayca Arzu, Topalak Omer, Akpinar Hale, Abacioglu Yusuf Hakan
Department of Gastroenterology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
J Gastroenterol Hepatol. 2006 Dec;21(12):1783-8. doi: 10.1111/j.1440-1746.2006.04567.x.
Mutations of hepatitis B virus (HBV) polymerase, especially occurring at the highly conserved YMDD region, are related to resistance to lamivudine. Although these mutations are frequently secondary to lamivudine use, they can also occur naturally. The aim of the present study was to determine the prevalence of YMDD variants that exist naturally in patients who are inactive HBV carriers.
Seventy-one adult inactive HBV carriers were studied. All of the patients were confirmed to have maintained normal alanine aminotransferase (ALT) values for one or more years by monitoring serum ALT levels at 3-monthly intervals. None of the patients received interferon or antiviral agents. YMDD variants were analyzed by the HBV Drug Resistance Line Probe assay (Inno-Lipa HBV-DR).
YMDD variants were detected in 13 (18.3%) of the 71 anti-HBe positive inactive HBV carriers. Of the 13 patients, 10 (76.9%) also had accompanying L180M mutation. The combination of wild type and YMDD variant HBV was present in 11 of 13 patients. In two patients, only YIDD and/or YVDD variants plus L180M were detected without the presence of wild YMDD motif.
Naturally occurring YMDD motif variants were detected at a high rate in a group of lamivudine-untreated inactive HBV carriers.
乙型肝炎病毒（HBV）聚合酶突变，尤其是发生在高度保守的YMDD区域的突变，与拉米夫定耐药有关。尽管这些突变常继发于拉米夫定的使用，但也可能自然发生。本研究的目的是确定在非活动性HBV携带者中自然存在的YMDD变异体的流行率。
对71例成年非活动性HBV携带者进行研究。所有患者通过每3个月监测血清丙氨酸氨基转移酶（ALT）水平，确认ALT值持续正常1年或1年以上。所有患者均未接受干扰素或抗病毒药物治疗。采用HBV耐药线性探针检测法（Inno-Lipa HBV-DR）分析YMDD变异体。
在71例抗-HBe阳性的非活动性HBV携带者中，有13例（18.3%）检测到YMDD变异体。在这13例患者中，10例（76.9%）同时伴有L180M突变。13例患者中有11例同时存在野生型和YMDD变异型HBV。在2例患者中，未检测到野生型YMDD基序，仅检测到YIDD和/或YVDD变异体加L180M。
在一组未接受拉米夫定治疗的非活动性HBV携带者中，自然发生的YMDD基序变异体检出率较高。
