慢性HBV携带者YMDD自然变异的追踪研究

Tracing study on spontaneous HBV YMDD mutation in chronic HBV carriers

目的探讨慢性HBV携带者YMDD自然变异随时间的推移发生变化的情况。方法随机选择未经抗病毒治疗的慢性HBV携带者103例,分别在开始、1年、2年时观察血清HBV DNA、HBV血清学标志物、肝功能、YMDD变异的变化情况。结果在开始检测的103例慢性HBV携带者中,YMDD阳性27例,观察2年后4例转为非活动性HBsAg携带者且YMDD转为阴性;76例YVDD变异阴性的患者中,观察2年后1例病毒水平增高并出现YMDD变异。结论 YMDD自然变异株在慢性HBV携带者中相对较稳定,YMDD自然变异株可随野生株的消失而消失。

Objective To investigate the diversification of spontaneous HBV YMDD motif mutation in chronic HBV carriers in two years.Methods One hundred and three cases of chronic HBV carriers who were received antivirus therapy were enrolled in the study.The diversification of HBV DNA,HBV M,liver function and YMDD mutations were observed at baseline,1 year and 2 years after baseline respectively.Results Among the 103 chronic HBV carriers,spontaneous YMDD variants were detected in 27 cases（26.21%）,and after 2-year observation,4 cases transformed to inactive HBsAg carriers and the YMDD were negative at the same time;of all the 76 cases without spontaneous YMDD variants,after 2-year observation 1 case transformed to be with YMDD variants because the load of HBV was higher than before.Conclusion The spontaneous HBV YMDD motif mutation were stabile in chronic HBV carriers,while the spontaneous YMDD variants could vanish with the disappearance of HBV wild strain.