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中国中部初治慢性乙型肝炎患者中与核苷(酸)类耐药相关的乙肝病毒DNA聚合酶基因突变的流行情况

Prevalence of mutations in HBV DNA polymerase gene associated with nucleos(t)ide resistance in treatment-naive patients with Chronic Hepatitis B in Central China.

作者信息

Zhao Youyun, Wu Jianhua, Sun Lijun, Liu Guangzhong, Li Bo, Zheng Yi, Li Xiaodong, Tao Junxiu

机构信息

Department of Clinical Laboratory, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China; Department of Clinical Laboratory, Hubei University of Traditional Chinese Medicine, Wuhan, China.

Department of Clinical Laboratory, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China.

出版信息

Braz J Infect Dis. 2016 Mar-Apr;20(2):173-8. doi: 10.1016/j.bjid.2015.12.006. Epub 2016 Feb 12.

Abstract

OBJECTIVE

There are a lot of disagreements in the studies on hepatitis B virus (HBV) DNA polymerase mutation rate associated with nucleos(t)ide analogues (NAs) in treatment-naive chronic hepatitis B (CHB) patients. This is the first study aimed to investigate the prevalence of spontaneous HBV resistance mutations in Central China.

METHODS

This study included treatment-naive patients with CHB from June 2012 to May 2015 receiving care at the Institute of Liver Disease in Central China. All patients completed a questionnaire covering different aspects, such as family medical history, course of liver disease, medication history, alcohol use, among others. Mutations in HBV DNA polymerase associated with NAs resistance were detected using INNO-LiPA assay.

RESULTS

269 patients were infected with HBV genotype B (81.4%), C (17.9%), and both B and C (0.7%). Mutations in HBV DNA polymerase were detected in 24 patients (8.9%) including rtM204I/V (n=6), rtN236T (n=5), rtM250V (n=2), rtL180M (n=2), rtT184G (n=1), rtM207I (n=1), rtS202I (n=1), rtM204V/I & rtL180M (n=5), and rtM204I & rtM250V (n=1).

CONCLUSION

Spontaneous HBV resistance mutations in HBV DNA polymerase were found in treatment-naive patients with CHB in Central China. These findings suggest that we should analyze HBV DNA polymerase resistance mutation associated with NAs before giving antiviral therapy such as lamivudine (LAM), adefovir (ADV), and telbivudine (LdT).

摘要

目的

在初治慢性乙型肝炎(CHB)患者中,关于乙型肝炎病毒(HBV)DNA聚合酶与核苷(酸)类似物(NAs)相关的突变率研究存在诸多分歧。本研究首次旨在调查中国中部地区HBV自发耐药突变的流行情况。

方法

本研究纳入了2012年6月至2015年5月在中国中部地区肝病研究所接受治疗的初治CHB患者。所有患者均完成了一份涵盖不同方面的问卷,如家族病史、肝病病程、用药史、饮酒情况等。采用INNO-LiPA分析法检测与NAs耐药相关的HBV DNA聚合酶突变。

结果

269例患者感染了HBV基因型B(81.4%)、C(17.9%)以及B和C混合型(0.7%)。在24例患者(8.9%)中检测到HBV DNA聚合酶突变,包括rtM204I/V(n = 6)、rtN236T(n = 5)、rtM250V(n = 2)、rtL180M(n = 2)、rtT184G(n = 1)、rtM207I(n = 1)、rtS202I(n = 1)、rtM204V/I & rtL180M(n = 5)以及rtM204I & rtM250V(n = 1)。

结论

在中国中部地区的初治CHB患者中发现了HBV DNA聚合酶的自发HBV耐药突变。这些发现表明,在给予拉米夫定(LAM)、阿德福韦(ADV)和替比夫定(LdT)等抗病毒治疗之前,我们应该分析与NAs相关的HBV DNA聚合酶耐药突变。

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