5例应用恩替卡韦治疗的慢性HBV感染者发生HBV逆转录酶区单独A181位点突变的分析

A181 site mutation in HBV reverse transcriptase region on chronic HBV-infected patients during Entecavir therapy

目的探讨恩替卡韦与HBV逆转录酶区单独A181位点突变的关系。方法对5例应用恩替卡韦治疗后逆转录酶区出现单独A181位点突变的慢性HBV感染者做回顾性调查与随访,并分析其突变前后病毒学指标的变化。结果 5例应用恩替卡韦治疗的慢性HBV感染者中,3例发生逆转录酶区A181V突变的病例均对恩替卡韦产生了应答,2例发生逆转录酶区A181T突变的病例血清HBV DNA也出现了明显下降。结论 5例应用恩替卡韦治疗的慢性HBV感染者逆转录酶区的单独A181位点的突变为自然产生,HBV逆转录酶区发生自然突变的临床意义需要进一步明确。

Objective To explore the relationship between A181 site mutation in HBV reverse transcriptase（rt） region（rtA181V） and Entecavir therapy on chronic HBV-infected patients.Methods Five chronic HBV-infected patients with only A181 site mutation during Entecavir treatment were reviewed retrospectively and followed.Virological and biochemical response were analyzed pre-and post-mutation.Results From the total of 5 patients,3 responded well to the treatment,and the serum level of HBV DNA declined significantly in 2 of the 3 patients.Conclusion The A181 site mutation in HBV reverse transcriptase of 5 patients may be a spontaneous mutation.The significance of natural mutation in the HBV reverse transcriptase region needs to be identified.