Masaadeh Hani A, Hayajneh Wail A, Alqudah Enayat A
Department of Pediatrics, Faculty of Medicine, Jordan University of Science and Technology, PO Box 3030, Irbid 22110, Jordan.
World J Gastroenterol. 2008 Dec 21;14(47):7231-4. doi: 10.3748/wjg.14.7231.
To investigate and identify prevalent hepatitis B virus (HBV) genotypes and to explore lamivudine-resistant mutations among treated and untreated patients in Jordan.
A total of 107 cases with chronic hepatitis B were recruited from different medical centers in Jordan. Serological tests were preformed for all cases using a microparticle enzyme immunoassay. HBV Genotyping was performed for 70 cases using Line probe genotyping assay. The YMDD mutations were explored for 20 cases (4 were lamivudine naive) using the INNO-LiPA HBV DR assay.
Genotype D was the only detected genotype. A total of 6 YMDD mutations were detected in 5 treated patients (31%) while one mutation was detected in the naive patients. Seventeen percent of cases were positive for HBeAg and had statistically significant higher levels of serum aminotransferases.
HBV genotype D appears to be the only circulating type in Jordanian patients. The YMDD mutations were detected in 31% of lamivudine-treated cases with similar patterns to those found in the literature. We also found a relatively low prevalence of HBeAg expression among examined cases (17%). Awareness of these serologic, genotypic and resistance patterns might help in the formulation of management plans and for predicting clinical outcomes. Further larger scale studies are needed to confirm our results and to examine possible associations among clinical, serologic, and genetic patterns of HBV infections in Jordan.
调查并确定约旦流行的乙型肝炎病毒(HBV)基因型,探讨接受治疗和未接受治疗的患者中拉米夫定耐药突变情况。
从约旦不同医疗中心招募了107例慢性乙型肝炎患者。对所有病例采用微粒酶免疫测定法进行血清学检测。对70例患者采用线性探针基因分型测定法进行HBV基因分型。对20例患者(4例未接受过拉米夫定治疗)采用INNO-LiPA HBV DR测定法检测YMDD突变。
仅检测到D基因型。在5例接受治疗的患者(31%)中总共检测到6个YMDD突变,而在未接受过治疗的患者中检测到1个突变。17%的病例HBeAg呈阳性,血清转氨酶水平在统计学上显著更高。
HBV D基因型似乎是约旦患者中唯一流行的类型。在31%接受拉米夫定治疗的病例中检测到YMDD突变,其模式与文献报道相似。我们还发现受检病例中HBeAg表达的患病率相对较低(17%)。了解这些血清学、基因型和耐药模式可能有助于制定管理计划并预测临床结果。需要进一步开展更大规模的研究来证实我们的结果,并研究约旦HBV感染的临床、血清学和基因模式之间可能存在的关联。