核苷和核苷酸类药物治疗慢性乙型肝炎过程中耐药突变株动态演变特征的研究进展

Research progress in dynamic evolution characteristics of nucleos( t) ide analogue-resistant mutants

核苷和核苷酸类药物长期单药抗HBV治疗过程中易导致病毒发生耐药突变,可能与慢性乙型肝炎的重症化和原发性肝癌的发生相关,是目前研究热点之一。深入理解耐药变异株在长期抗病毒治疗中的演变特征,在基因型耐药发生至病毒学突破发生的时间间隔内,选择适用于临床耐药的监测方法,动态监测耐药株在准种池中的比例变化,及时更改治疗方案,对慢性乙型肝炎的优化治疗有重要的指导意义,同时也有助于研发高效的抗病毒药物。

Long-term antiviral therapy with nucleos（t）ide analogues against hepatitis B virus may lead to the occurrence of drug-resistant viral mutations.As a challenging topic in antiviral research,the problem of drug-resistant mutations may be associated with the aggregation of chronic hepatitis B and the development of primary hepatic carcinoma.In-depth understanding of the evolution characteristics of drug-resistant mutants during long-term antiviral therapy will allow a selection of appropriate clinical drug resistance monitoring approach.Within the time interval between the occurrence of genotypic resistance and virological breakthrough,dynamic monitoring of variations in the propor-tion of drug-resistant variants in the quasispecies pool and timely change of the therapeutic regimen will help to optimize the treatment of chronic hepatitis B and develop effective antiviral drugs.