阿德福韦酯治疗慢性乙型肝炎过程中乙型肝炎病毒基因型变化情况分析

HBV genotype change in CHB patients during adefovir dipivoxil treatment

目的研究阿德福韦酯(adefovir dipivoxil,ADV)治疗慢性乙型肝炎(chronic hepatitis B,CHB)过程中乙型肝炎病毒(hepatitis B virus,HBV)基因型变化情况。方法选取16例应用ADV治疗的CHB患者作为研究对象,用一片段PCR法扩增了用药前(baseline,BL)、用药后第28周、52周、92周时的HBV全基因组,克隆后进行全基因组序列测定及基因型分型。结果16例CHB患者治疗开始时(baseline,BL)的HBV基因型分布为:B型9例,C型7例,未发现A、D、E、F基因型。但有5例患者在接受ADV治疗后的28周、52周、92周,基因型发生了变化即从B型变为C型,或从C型变为B型。结论本研究发现,在ADV治疗CHB过程中,31.25%患者体内的HBV基因型发生了变化。这种变化产生的原因及其生物学意义,有待于进一步研究。

Objective To study HBV genotype change in adefovir dipivoxil treatment CHB patients.Methods 16 CHB patients were treated with ADV for 92 weeks.Blood samples were collected at weeks 0,28,52 and 92.HBV genomes were retrieved with full-length PCR from those samples,sequenced and genotyped.Results The HBV genotypes at the beginning of the treatment in the 16 CHB patients were:9 patients were genotype B,7 patients were genotype C.Genotypes A,D,E and F were not found in those patients.HBV genotypes of 5 patients switched from genotype B to genotype C,or from C to B,at week 28,52 or 92.Conclusion The HBV genotypes in some CHB patients changed during adefovir dipivoxil treatment.Further investigation will be required for the mechanism and biological significance of the genotype change.