Palumbo Emilio
Department of Pediatrics, Hospital of Sondrio, Sondrio, Italy.
Am J Ther. 2007 May-Jun;14(3):306-9. doi: 10.1097/01.pap.0000249927.67907.eb.
The aim of this review is to examine the impact of hepatitis B virus (HBV) genotypes on biochemical and virologic response to antiviral drugs (alfa-interferon and pegylated-interferon alfa-2b, lamivudine, and adefovir dipivoxil) actually used for the treatment of chronic hepatitis, HBV related. International literature evidences that HBV genotypes D and C are associated with a lower rate of favorable response to alfa-interferon and pegylated-interferon alfa-2b therapy than genotypes A and B. The rate of resistance to lamivudine was higher in patients with genotype A infection than in patients infected by genotype D, whereas no difference in the risk of lamivudine resistance is found between patients with genotype B and patients with genotype C. In regard to the new nucleotide analogue, adefovir dipivoxil, a preliminary trial appears to provide no evidence of any difference in virologic response among the different HBV genotypes. The current study has determined that the different HBV genotypes have a very important impact on response to antiviral therapy, in particular interferon treatment. For this reason, determining the HBV genotype could be helpful for predicting the outcome of antiviral therapy in patients affected by chronic hepatitis B.
本综述的目的是研究乙型肝炎病毒（HBV）基因型对目前用于治疗慢性乙型肝炎相关疾病的抗病毒药物（α干扰素、聚乙二醇化干扰素α-2b、拉米夫定和阿德福韦酯）的生化和病毒学反应的影响。国际文献表明，与A和B基因型相比，HBV D和C基因型对α干扰素和聚乙二醇化干扰素α-2b治疗的良好反应率较低。A基因型感染患者对拉米夫定的耐药率高于D基因型感染患者，而B基因型患者和C基因型患者之间拉米夫定耐药风险没有差异。关于新的核苷酸类似物阿德福韦酯，一项初步试验似乎没有提供不同HBV基因型之间病毒学反应存在差异的证据。目前的研究已确定，不同的HBV基因型对抗病毒治疗，特别是干扰素治疗的反应有非常重要的影响。因此，确定HBV基因型有助于预测慢性乙型肝炎患者抗病毒治疗的结果。
