乙型肝炎病毒基因型与YMDD变异的关系

Correlation of Hepatitis B Virus Genotypes and YMDD Mutant

目的:了解乙型肝炎病毒(HBV)基因型与YMDD变异之间的关系。方法:多对型特异性引物PCR扩增法对238例经拉米夫定治疗的慢性乙型肝炎患者进行HBV基因分型,直接序列分析;采用基因芯片检测YMDD及前C/BCP区变异。结果:238例患者中,检测出B基因型190例(79.8%),C基因型41例(17.2%),BC混合型7例(3.0%);发生YMDD变异44例,变异率为18.5%,其中B基因型33例,变异率为17.4%,C基因型8例,变异率为19.5%,BC混合型3例,变异率为42.4%,C基因型YMDD变异的发生率与B基因型相比,差异无显著性意义(P>0.05)。44例YMDD变异者中,30例同时存在L528M变异,7例联合前C区(nt1896)变异,13例联合BCP区(nt1762/1764)双重突变。结论:本地区慢性乙型肝炎患者中,优势基因型为B型和C型,经拉米夫定治疗后YMDD变异的发生率在B型和C型差异无显著性意义,同时伴有L528M及前C/BCP区多重变异。

Objective： To investigate the relationhsip between hepatitis B virus genotypes and YMDD mutant.Methods. Serum samples from 238 patients with chronic HBV infection who were treated with Lamivudine （100mg/d） for average 12 （9 - 24） months were collected and tested for HBV genotypes by the multiplex type- specific primers, direct sequence and gene chipsto detect YMI）D and pre- C/BCP mutants. Results： Of the 238 patients, 190 （79.8%） were genotype B, 41 （17.2%） were genotype C and 7 （3.0%） were mixed genotype B and C. Of the 238 patients, 44 appeared YMDD mutant, the rate of YMDD mutant was 18.5%. No significant difference of YMDD mutant was found between patients with genotype B and C （17.4% vs 19.5%, P〉0.05） . Among 44 patients with YMDD mutant, there were 30 patients with L528M mutant, 7 with pre- C （nt1896） mutant and 13 with double- mutant （nt1762/1764） in BCP domain. Conclusion： Genotype B and C were the dominant genotypes of HBV in this area. The emergence of YMDD mutant was not different between genotype B and C. The patients with YMDD mutant associated with L528M, pre C and BCP domains mutants.