HBV基因型与核苷类似物抗病毒治疗关系的研究

The relationship between HBV genotypes and nucleoside analogues antiviral treatment

目的研究延安地区B、C基因型慢性乙型肝炎患者与核苷类似物抗病毒治疗疗效的关系。方法用PCR法鉴定延安地区慢性乙型肝炎患者的HBV基因型,选定B型、C型慢性乙型肝炎患者各60和120例,分为拉米夫定组与阿德福韦酯组,分别给予拉米夫定、阿德福韦酯抗病毒治疗,观察其应用一年抗病毒药物的疗效,对治疗期间的临床资料进行回顾性研究。结果①B型基因与C型基因在拉米夫定抗病毒治疗疗效比较,6、12个月病毒学应答率、血清学应答率之间存在明显的差异,有统计学意义(P<0.05);而6、12个月的生化学应答率差异无统计学意义(P>0.05)。②B型基因与C型基因在阿德福韦酯抗病毒治疗疗效比较:6、12个月生化学应答率、病毒学应答率、血清学应答率差异均无统计学意义(P>0.05)。结论延安地区慢性乙型肝炎患者中B基因型对拉米夫定的抗病毒疗效优于C基因型;B基因型、C基因型对于阿德福韦酯抗病毒疗效无区别,提示HBV基因型与核苷类似物抗病毒治疗有相关性。检测HBV基因型对于临床优化慢性乙型肝炎抗病毒治疗方案有一定的意义。

Objective To explore the relationship between the antiviral theray efficacy of nucleoside analogues and HBV genotypes.Methods HBV genotypes were identified in chronic hepatitis B patients by PCR method.60 cases of genotype B and 120 cases of genotype C were divided into the lamivudine group and the adefovir dipivoxil group,which were treated with lamivudine,adefovir dipivoxil antiviral therapy,respectively.The efficacy of antiviral drugs were observed for one year.The clinical data were studied retrospectively.Results The efficacy of lamivudine antiviral treatment between genotype B and genotype C： It had statistically significant differences in 6 months,12 months virologic response rate and serological response rates;It had no statistically significant differences in 6 months,12 months biochemical response rate.The efficacy of adefovir dipivoxil antiviral treatment between genotype B and genotype C： There was no statistically significant differences of biochemical response rates、virologic response rates,serological response rates in 6 months and12 months.Conclusion The lamivudine antiviral efficacy of chronic patients with genotyp B is superior to genotyp C;there was no difference of adefovir dipivoxil antiviral efficacy between genotype B and genotype C.It suggests that HBV genotype hascorrelation with Nucleoside analogue antiretroviral therapy,the detection of HBV genotypes have a certain significance to optimize antiviral treatment of chronic hepatitis B.