未经抗病毒治疗的慢乙肝患者YMDD变异基因的检测及分析

Detection of YMDD motif Mutations in the Lamivudine-Untreated Chronic Hepatitis B

目的 :为了解未经拉米呋定及干扰素抗病毒治疗的慢性乙型肝炎患者中是否存在HBVYMDD基因变异。方法 :应用微板核酸杂交 -核酸定量法检测 2 9例病史超过半年以上、肝功能异常的慢性乙肝患者的HBV -DNA及YMDD变异基因。结果 :2 9例慢性乙肝患者YMDD变异阳性 6例 ,阴性 2 3例 ,阳性率为 2 0 .6 9%。 6例变异中 4例为YIDD阳性 ,2例为YVDD阳性 ,均为YMDD野毒株和变异株混合存在。 5例抗 -HBe阳性 ,1例HBeAg阳性。结论 :显示在未经抗病毒治疗的慢乙肝患者中存在YMDD变异株 ,其与野生株一样是自然存在。加以重视并提高检测方法的灵敏度 ,有助于提高YMDD变异基因检测的阳性率。

Objective:To explore the possibility of a YMDD mutations in the lamivudine untreated patients with chronic hepatitis B. Methods:HBV DNA and YMDD mutant were analyed by sandwich hybridization on microplate. Results:Mutations were detected in six of 29 samples:YIDD in four samples and YVDD in two samples. The mutations positive rates were 20.69%. All of these six samples were YMDD+YMDD mutatants. Five in 6 samples were anti HBe positive. Another one was HBeAg positive. Conclusion:The results showed that YMDD mutant viruses ,like the YMDD wild type, are naturally present in the lamivudine untreated patients with chronic hepatitis B.