乙型肝炎病毒BCP变异与拉米夫定治疗后HBVDNA反弹关系的研究

Study of the relationship between BCP mutation in the hepatitis B virus gene and HBVDNA rebound after lamivudine therapy

目的探讨HBV BCP变异与拉米夫定抗病毒治疗后HBVDNA反弹的关系。方法应用PCR-序列分析法,检测拉米夫定治疗(100mg/d)1年以上,达到病毒学应答半年以上,再出现HBV DNA反弹(HBV DNA拷贝数≥1.0×104拷贝/ml)的27例乙型肝炎患者(治疗组),以及19例从未用过抗病毒治疗患者(对照组)的HBV C区基本核心启动子(BCP)的突变位点。结果1.治疗组HBVDNA反弹的27例BCP(A1762T+G1764A)变异检出率44.44%(12/27)高于对照组26.32%(5/19),但无统计学差异,P>0.05。2.4例HBVDNA反弹患者治疗前未检出BCP(A1762T+G1764A)变异,治疗后有2例检出BCP(A1762T+G1764A)变异。结论BCP(T1762/A1764)变异可能与拉米夫定治疗后HBVDNA反弹有关。

Objective To investigate the relationship of Hepatitis B virus BCP mutation in the hepatitis B virus （HBV） genome and HBVDNA rebound after with lamivudine therapy. Methods With inspected twenty - seven patients （therapy group, HBVDNA 〉 104 copie4/ml） with HBVDNA rebound after respond to virus beyond 6 months with infecting hepatitis B received ]amivudine （100mg/day） oral application for at least 12 months and nineteen patients（ control group） with infecting hepatitis B without treated with the drug of antivirus, we have examined mutation in the Basal Core Promoter（BCP） of the Hepatitis B virus （HBV） of two group by PCR - gene sequence analysis. Results 1. The rate of BCP （A1762T ＋ G1764A） mutations were 44. 44% （12/27） in HBVDNA - negative group beyond control group 6. 32% （5/19）, but it has not statistic difference （P 〉0. 05）. 2. In the therapy group, BCP（A1762T ＋ G1764A）mutation were not examined in four patients before therapy, but it were examined in two patients after therapy. Conclusion BCP（T1762/A1764）mutation may be associated with HBVDNA rebound after ]amivudine therapy.