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初治慢性乙型肝炎患者的HBV基因分型及耐药突变监测

Genotyping of HBV and tracking of resistance mutations in treatment-naïve patients with chronic hepatitis B.

作者信息

Pacheco Sidelcina Rugieri, Dos Santos Maria Isabel Magalhães Andrade, Stocker Andreas, Zarife Maria Alice Sant'Anna, Schinoni Maria Isabel, Paraná Raymundo, Dos Reis Mitermayer Galvão, Silva Luciano Kalabric

机构信息

Laboratory of Pathology and Molecular Biology, Research Site Gonçalo Muniz, Foundation Oswaldo Cruz (CPqGM/Fiocruz-BA).

Federal University of Bahia.

出版信息

Infect Drug Resist. 2017 Jul 5;10:201-207. doi: 10.2147/IDR.S135420. eCollection 2017.

Abstract

BACKGROUND AND AIMS

Resistance mutation analogs to nucleos(t)ides have been described in treatment-naïve patients with chronic hepatitis B (CHB), with clinical implications. The aim of this study was to investigate primary resistance mutations and genotypes circulating in patients naïve to chronic hepatitis B, in the Northern and Northeastern regions of Brazil.

METHODS

We conducted a study of resistance mutations and genotypic characterization of hepatitis B virus (HBV) in 189 treatment-naïve patients chronically infected with HBV.

RESULTS

Drug resistance-associated mutations located in the RT domain of the P gene (rtHBV) were found in 6% of the treatment-naïve patients from the Northeastern Region. The mutations were rtA194T, rtL180M + rtM204V, rtS202I, rtM204I, and rtA181S. No patient in the Northern Region had the resistance mutation. In the gene S region, the frequency of vaccine escape mutations was 2.4% in the Northeastern Region and 8.6% in the Northern Region.

CONCLUSION

This information before the start of treatment may contribute to clinical decision making, reducing treatment failure and the risk of progression to cirrhosis and hepatocellular carcinoma for CHB.

摘要

背景与目的

在未经治疗的慢性乙型肝炎(CHB)患者中已发现核苷(酸)类似物耐药突变体,具有临床意义。本研究旨在调查巴西北部和东北部地区初治慢性乙型肝炎患者中存在的原发性耐药突变和基因型。

方法

我们对189例慢性感染乙型肝炎病毒(HBV)的初治患者进行了HBV耐药突变和基因分型特征研究。

结果

在来自东北地区的6%的初治患者中发现了位于P基因RT结构域(rtHBV)的耐药相关突变。这些突变包括rtA194T、rtL180M + rtM204V、rtS202I、rtM204I和rtA181S。北部地区没有患者出现耐药突变。在基因S区,疫苗逃逸突变的频率在东北地区为2.4%,在北部地区为8.6%。

结论

治疗开始前的这些信息可能有助于临床决策,减少CHB的治疗失败以及进展为肝硬化和肝细胞癌的风险。

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