阿德福韦酯抗乙型肝炎病毒的耐药研究进展

The resume of Adefovir-resistance in anti-HBV therapy

阿德福韦酯是继拉米夫定后抗乙型肝炎病毒(HBV)的又一种核苷类似药物,属于逆转录酶抑制剂。阿德福韦酯抗HBV的耐药变异率低,目前发现的耐药位点主要为rtN236T和rtA181V/T。如果阿德福韦酯发生耐药,可导致HBV DNA的反弹及肝功能异常,因此对阿德福韦酯耐药的预防及耐药的处理显得尤为重要。目前对耐药的基础研究主要在分子水平,而临床研究包括联合用药,药物替代疗法和免疫调节等。

Adefovir dipivoxil following Lamivudine is one of the nucleoside analogue inhibiting hepatitis virus replication. It is one of the reverse-transcriptase inhibitor and has a lower frequency of resistance. Rtn236T and rtA181V/T are the main Adefovir-resistance mutation. It is very important to find some effective ways to prevent or deal with the resistance for the Adefovir-resistance, which can lead to viral breakthrough and fatal liver failure. Existing ways include foundation research and clinical research. The foundation research is focusing on the molecular level of antiviral therapy, and the clinical research consist of combination chemotherapy, alternative therapy and immunomodulating therapy of HBV infection.