Relationship between HBV genotype and curative effects of entecavir in treatment of chronic hepatitis B patients
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摘要: 目的: 探讨慢性乙型肝炎(CHB) 患者基因型与恩替卡韦(博路定)抗病毒治疗疗效、病毒变异间的关系。方法: 对2010-01-01-2011-12-31接受治疗的的CHB 患者首先进行基因型检测,选择B和C型患者共168 例,研究其恩替卡韦抗病毒治疗24周及96周后丙氨酸氨基转移酶(ALT)、乙型肝炎病毒基因(HBV-DNA)低于检测下限率 (20 U/ml)、乙肝 e 抗原 (HBeAg) 血清学转换率以及治疗结束(96W)后HBV P基因的变异情况。结果: 168 例患者中 B 基因型有 98 例(58.33%),C 基因型 70 例(占 41.67%)。恩替卡韦抗病毒治疗24周时和96 周时,B型与C型患者ALT复常率、HBV-DNA低于检测下限率和HBeAg血清学转换率间差异无统计学意义 (P>0.05);但治疗96周时B型和 C 型感染者间均较治疗 24 周时有显著提高;治疗结束时,B型感染者发生基因变异 1 例,C 型感染者发生变异7例,两者比较差异有统计学意义(连续校正χ2=5.415,P<0.05)。结论: HBV-DNA与恩替卡韦抗病毒疗效间无明显关系,延长疗程可明显提高其疗效,但随着疗程的增加,C型CHB 患者P基因变异率明显高于B型。
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Key words:
- hepatitis B virus /
- entecavir /
- genotype /
- curative effect
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[1] 中华医学会肝病学分会、感染病学分会.慢性乙型肝炎防治指南[J].中华肝脏病杂志,2011, 19(1):13-24.
[2] Shi YH. Correlation between hepatitis B virus genotypes and clinical outcomes[J]. Jpn J Infect Dis,2012,65:476-482.
[3] Pezzano SC, Torres C, Fainboim HA, et al. Hepatitis B virus in Buenos Aires, Argentina:genotypes, virological characteristics and clinical outcomes[J]. Clin Microbiol Infect,2011,17:223-231.
[4] Sugauchi F, Orito E, Ichida T, et al. Hepatitis B virus of genotype B with or without recombination with genotype C over the precore region plus the core gene[J]. J Virol, 2002, 76:5985-5992.
[5] Singla B, Bhattacharyya R, Chakraborti A, et al. Response to potent anti-HBV agents in chronic hepatitis B and combined effect of HBV reverse transcriptase mutations[J]. Gene,2015,567:22-30.
[6] Neumann-Fraune M, Beggel B, Kaiser R, Obermeier M. Hepatitis B virus drug resistance tools:one sequence, two predictions[J]. Intervirology, 2014,57:232-236.
[7] 杨丽敏,彭勋,赵艳茹,等.不同HBV基因型感染慢性乙型肝炎患者对核苷(酸)类药物治疗的应答反应比较[J].实用肝脏病杂志, 2012, 15(2):120-122.
[8] 徐严,张永贵,季尚玮,等.乙型肝炎病毒基因型检测的临床意义[J].中国实验诊断学,2010,14(1):61-63.
[9] Lo AO, Wong GL. Current developments in nucleoside/nucleotide analogues for hepatitis B[J]. Expert Rev Gastroenterol Hepatol,2014,8:607-622.
[10] Tong MJ, Pan CQ, Hann HW, et al. The management of chronic hepatitis B in Asian Americans[J]. Dig Dis Sci, 2011, 56:3143-3162.
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