HBV YMDD外基因变异对核苷类耐药影响的临床研究

The Clinical Study of the Influence on Drug Fast of Nucleotide of outer HBV YMDD Genovariation

目的：探讨YMDD变异阴性的拉米夫丁耐药患者体内HBV逆转录酶RT区基因是否有变异。方法：采用荧光PCR技术检测拉米夫丁耐药患者HBV YMDD基因情况，用PCR产物直接测序分析RT区基因序列。结果：7份标本均测出YMDD阳性，无发生YMDD变异，2例发生rtL80V／I变异，1例发生rtV173L，其余均无发生RT区基因变异。结论：部分拉米夫丁临床耐药现象的出现可能与HBV RT区基因变异无关。

Objective To probe into the existence of genovariation of RT district in HBV reverse transcriptase in the patients that are drug fast to Lamivudine and negative on YMDD variant. Methods To detect HBV YMDD gene in the patients who are drug fast to Lamivudine by PCR-fluorescent quantitation; to analyze the gene order of RT district through direct sequencing to PCR products. Results There are seven specimens that are YMDD positive, and no YMDD variant. Also, two specimens generate rtL80V/I mutation, and one specimen generates rtV173L mutation. There is no YMDD variant in RT district in the rest of the specimens. Conclusion A part of drug fast of lamivudine isn＇t likely to be related to genovariation of HBV RT district.