Alacam Sema, Karabulut Nuran, Yolcu Ayfer, Onel Mustafa, Atasoy Alp, Kaymakoglu Sabahattin, Agacfidan Ali
Istanbul Faculty of Medicine, Department of Medical Microbiology, Division of Virology and Fundamental Immunology, Istanbul University, 34093, Istanbul, Turkey.
Istanbul Faculty of Medicine, Department of Gastroenterohepatology, Istanbul University, Istanbul, Turkey.
Folia Microbiol (Praha). 2019 Mar;64(2):237-243. doi: 10.1007/s12223-018-0650-z. Epub 2018 Sep 26.
Mutations occurring in viral polymerase gene of hepatitis B virus (HBV) due to the use of nucleos(t)id analogs reduce the activity of the drugs by causing antiviral resistance. In this study, it was aimed to evaluate mutations responsible for drug resistance and drug resistance mutation rates in patients followed up by the diagnosis of chronic hepatitis B (CHB). A total of 318 CHB patients were included in the study. HBV mutations were detected using the INNO-LiPA commercial kit based on the reverse hybridization principle. Drug resistance mutation was detected in 46.86% (149/318) of the patients. The rates of drug resistance were found 36.79% (117/318) for lamivudine resistance, 12.58% (40/318) for entecavir (ETV), and 7.86% (25/318) for adefovir. In 10 patients, the possible tenofovir (TDF) resistance (3.14%) was found. Single-drug and double-drug resistances were detected in 34.59% and in 11.01% of the patients, respectively. Triple drug resistance was detected in only 1.26% of the patients. Unlike various studies in Turkey and in other countries, remarkable resistance to ETV and TDF were found in this study. The high rate of the probable TDF resistance was striking, with 3.14%.
由于使用核苷(酸)类似物而在乙型肝炎病毒(HBV)的病毒聚合酶基因中发生的突变,通过引起抗病毒耐药性而降低了药物的活性。在本研究中,旨在评估慢性乙型肝炎(CHB)诊断后随访患者中导致耐药性的突变和耐药突变率。共有318例CHB患者纳入本研究。使用基于反向杂交原理的INNO-LiPA商业试剂盒检测HBV突变。46.86%(149/318)的患者检测到耐药突变。拉米夫定耐药率为36.79%(117/318),恩替卡韦(ETV)耐药率为12.58%(40/318),阿德福韦耐药率为7.86%(25/318)。在10例患者中发现了可能的替诺福韦(TDF)耐药(3.14%)。分别在34.59%和11.01%的患者中检测到单药和双药耐药。仅在1.26%的患者中检测到三药耐药。与土耳其和其他国家的各种研究不同,本研究中发现对ETV和TDF有显著耐药性。可能的TDF耐药率高达3.14%,令人瞩目。