Department of Laboratory Medicine, West China Hospital, Sichuan University, Sichuan Province, China.
Med Sci Monit. 2011 Oct;17(10):PH75-80. doi: 10.12659/msm.881965.
Lamivudine (LMV), as the preferred oral drug for use in treatment of HBV, always results in development of resistance mutations after long-term treatment. In this study we investigated chronic hepatitis B (CHB) patients in southern China to determine whether different HBV genotypes affect the incidence of LMV resistance mutations.
MATERIAL/METHODS: The study recruited 185 CHB patients living in southern China. Enzyme-linked immunosorbent assay was used to test for HBV serological markers, and HBV DNA was quantified by real-time PCR. Sequencing was performed to detect HBV genotypes and mutations.
There were 49.19% (91/185) CHB patients with HBV resistant to LMV. Only 2 genotypes were found: B and C; 62.16% (115/185) of patients were infected with genotype B HBV and 37.84% (70/185) of patients were infected with genotype C HBV. The incidence rate of LMV resistance was not significantly different between genotype B and C (49.57% vs. 48.57%, P>0.05). For the mean age and sex ratio, no significant difference was found. The pattern of rtM204I alone was predominantly observed (36.26%, 33/91), followed by rtM204V+rtL180M (23.08%, 21/91). The overall incidence rate of rtM204I mutation in genotype B (45.61%, 26/57) was more frequent than that in genotype C (20.59%, 7/34) (45.61% vs. 20.59%, P<0.05), but the incidence rate of other mutation patterns was not significantly different between genotypes B and C.
Our results emphasize that a LMV resistance test before treatment is of great importance in rational and optimal CHB therapy.
拉米夫定(LMV)作为治疗乙型肝炎病毒(HBV)的首选口服药物,长期治疗后总会导致耐药突变的产生。本研究旨在调查中国南方的慢性乙型肝炎(CHB)患者,以确定不同的 HBV 基因型是否会影响 LMV 耐药突变的发生率。
材料/方法:本研究招募了 185 名居住在中国南方的 CHB 患者。采用酶联免疫吸附试验检测 HBV 血清学标志物,实时 PCR 定量检测 HBV DNA。测序用于检测 HBV 基因型和突变。
有 49.19%(91/185)的 CHB 患者对 LMV 耐药。仅发现 2 种基因型:B 和 C;62.16%(115/185)的患者感染 B 型 HBV,37.84%(70/185)的患者感染 C 型 HBV。B 型和 C 型 LMV 耐药的发生率无显著差异(49.57%比 48.57%,P>0.05)。在平均年龄和性别比例方面,无显著差异。主要观察到 rtM204I 单一突变模式(36.26%,33/91),其次是 rtM204V+rtL180M(23.08%,21/91)。B 型基因型中 rtM204I 突变的总发生率(45.61%,26/57)高于 C 型基因型(20.59%,7/34)(45.61%比 20.59%,P<0.05),但 B 型和 C 型基因型之间其他突变模式的发生率无显著差异。
我们的研究结果强调,在合理和优化的 CHB 治疗之前,进行 LMV 耐药检测非常重要。