初治核苷/核苷酸类药物患者中乙型肝炎病毒对恩替卡韦的耐药动态变化
Dynamics of hepatitis B virus resistance to entecavir in a nucleoside/nucleotide-naïve patient.
作者信息
Guo Jin-Jun, Li Qing-Ling, Shi Xiao-Feng, Zhang Da-Zhi, Zeng Ai-Zhong, Feng Tao, Huang Ai-Long
机构信息
Key Laboratory of Molecular Biology on Infectious Diseases, Ministry of Education, Institute for Viral Hepatitis, The Second Affiliated Hospital, Chongqing Medical University, 1 Yixueyuan Road, Chongqing 400016, China.
出版信息
Antiviral Res. 2009 Feb;81(2):180-3. doi: 10.1016/j.antiviral.2008.09.004. Epub 2008 Oct 21.
The genotypic evolution of HBV quasi-species was analyzed in a nucleoside/nucleotide-naïve patient who developed resistance to entecavir. The lamivudine resistant quasi-species (rtM204V+/-rtL180M), absent at baseline, were emerged as early as 48 weeks after entecavir administration. Entecavir-resistant quasi-species (rtM204V+/-rtL180M plus S202G) were found after week 112 and gradually became the predominant mutations afterwards. The lamivudine- and entecavir-resistant mutations emerged closely in combination with the rtV207L, rtA222T, rtP237T or rtI163V substitutions. Our results indicated that the lamivudine-resistant mutations were developed first and may serve as a prequisite for subsequent entecavir-resistant mutations in this nucleoside/nucleotide-naïve patient.
对一名初治的核苷/核苷酸类药物患者进行了分析，该患者出现了对恩替卡韦的耐药性，分析其HBV准种的基因型演变情况。基线时不存在的拉米夫定耐药准种（rtM204V+/-rtL180M），在恩替卡韦给药后48周时最早出现。在第112周后发现了恩替卡韦耐药准种（rtM204V+/-rtL180M加S202G），之后逐渐成为主要突变类型。拉米夫定和恩替卡韦耐药突变与rtV207L、rtA222T、rtP237T或rtI163V替代密切相关。我们的结果表明，在这名初治的核苷/核苷酸类药物患者中，拉米夫定耐药突变首先出现，可能是随后恩替卡韦耐药突变的先决条件。
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