慢性乙型肝炎患者HBV前C基因突变与干扰素关系的初步研究

EFFECTS 0F INTERFER0N TREATMENT 0N MUTATI0N 0F HBV PREC0RE GENOME

应用ＰＣＲ技术扩增ＨＢＶＤＮＡ前Ｃ和部分Ｃ区基因，快速检测ＨＢＶ前Ｃ终止密码突变方法，作者对慢性乙肝患者干扰素治疗与ＨＢＶ前Ｃ突变关系作了初步研究。６例干扰素治疗后４例ＨＢＶＤＮＡ转阴，２例阳性者均检出突变株。１１例非干扰素治疗者中，检出突变株３例。１例干扰素治疗一个月后ＨＢｅＡｇ转阴，优势病毒株已由突变株与野生株共存状态替代原有野生株，由此提示，干扰素治疗后ＨＢｅＡｇ转阴，并不意味着ＨＢＶ被清除，而有潜在ＨＢＶ前Ｃ突变的可能。

he HBV precore mutation was investigated in chronic HBV infective patients with interferon treatmentas wsing a rapid PCR method.6cases were treated with recombinant IFNal3 × 106u/day for l4 weeks。 4 cas-es HBV DNA was undetectable after treatment. Precore mutant was detected in other 2 cases with HBV DNAstill positive。 Among 11 non-IFN treatment patients, 3 mutants were detected。HBeAg in one case became negative after IFN treatment, the original wild strain was replaced by a co-ex-istence, status of mutant and wild strain。 Results suggest that a HBe negative seroconversion after INF treat-ment does not necessarily implicate a complete clearance of HBV, and the possibility of mutation of precoremight still exist。