干扰素疗法与HBV前C区点突变关系的初步研究

Alpha Interferon Therapy and Hepatitis B Virus Pre core Gene Mutation

用错配引物聚合酶链反应结合限制性片段长度多态性分析（ｍｐＰＣＲ－ＲＦＬＰ）对１５例血清ＨＢｅＡｇ阳性、ＨＢＶ－ＤＮＡ斑点杂交阳性的慢性乙型肝炎患者进行了干扰素疗法与ＨＢＶ前Ｃ区基因１８９６位点突变之间关系的观察。结果显示，治疗前后ＨＢＶ野生株（Ｗ）和突变株（Ｍ）的变化有四种类型，即Ｗ→Ｗ（８例）；Ｗ＋Ｍ→Ｗ＋Ｍ（３例）；Ｗ→Ｗ＋Ｍ（３例）；Ｗ＋Ｍ→Ｗ（１例）。以ＨＢｅＡｇ阴转率和ＨＢＶ－ＤＮＡ阴转率为指标分析干扰素疗效，ＨＢＶ野生株感染组和野生株与突变株混合感染组之间无显著性差异（Ｐ＞０．０５）。结论：干扰素治疗后部分患者可发生ＨＢＶ前Ｃ区基因点突变。该突变株的存在似不影响干扰素的疗效。

The influence of α interferon(IFN) therapy on hepatitis B virus(HBV) pre core gene point mutation(nt. 1896) was evaluated in 15 cases of chronic hepatitis B with serological markers of HBeAg and HBV DNA by the method of miss matched primers polymerase chain reaction (mp PCR) plus restriction fragment length polymorphism(RFLP) analysis. The results showed four patterns of changes of HBV strains before and after IFN therapy, i.e.(1)consistent wild strain alone(8 cases); (2)consistency of mixed wild strain and pre core mutant strain(3 cases); (3)wild strain alone to mixed wild strain and pre core mutant strain(3 cases); (4) mixed wild strain and pre core mutant strain to wild strain alone(1 case). There was no significant difference between wild strain infection and mixed strains infection in the disappearance rates of HBeAg and HBV DNA( P >0 05). In conclusion, HBV pre core mutants could emerge in some patients after IFN therapy and the existence of these mutants might exert no unfavorable influence on the efficacy of IFN therapy.