Department of Infectious Diseases and Clinical Microbiology, Medical School of Erciyes University, 38039 Kayseri, Turkey.
World J Gastroenterol. 2011 Dec 7;17(45):4987-92. doi: 10.3748/wjg.v17.i45.4987.
To determine the distribution of viral genotypes for primary or acquired lamivudine resistance.
A total of 283 patients with chronic hepatitis B virus (HBV) infection (245 patients with chronic hepatitis B and 38 inactive hepatitis B surface antigen carriers) were included in the study. The HBV genotype was determined by using quantitative real-time polymerase chain reaction and sequence analysis, and tyrosine-methionine-aspartate-aspartate (YMDD) motif mutations were determined using the reverse transcriptase hybridization method.
Lamivudine resistance was determined in a total of 25 (10.7%) chronic hepatitis B patients. Eight subjects (4%) had primary resistance to lamivudine, and 17 (53.1%) had secondary resistance to lamivudine. Genotype D, which was isolated from 267 of the patients with chronic HBV infection, was the dominant genotype in Turkey.
Identification of YMDD motif mutations should have a positive impact on the selection of proper antiviral medication for patients, even for those who are nucleoside naïve.
确定原发性或获得性拉米夫定耐药的病毒基因型分布。
本研究共纳入 283 例慢性乙型肝炎病毒(HBV)感染者(慢性乙型肝炎患者 245 例,乙型肝炎表面抗原不活动携带者 38 例)。采用实时荧光定量聚合酶链反应和序列分析确定 HBV 基因型,采用逆转录酶杂交法确定酪氨酸-蛋氨酸-天冬氨酸-天冬氨酸(YMDD)基序突变。
在 25 例慢性乙型肝炎患者中检测到拉米夫定耐药。8 例(4%)患者对拉米夫定原发性耐药,17 例(53.1%)患者对拉米夫定继发性耐药。从 267 例慢性 HBV 感染者中分离出的基因型 D 是土耳其的主要基因型。
确定 YMDD 基序突变对选择适当的抗病毒药物治疗患者具有积极影响,即使对那些未接受核苷治疗的患者也是如此。