恩替卡韦治疗不同乙型肝炎病毒基因型慢性乙型肝炎疗效分析

Efficacy of Entecavir in Treating Chronic Hepatitis B with Different Hepatitis B Virus Genotypes

目的探讨恩替卡韦治疗不同乙型肝炎病毒(HBV)基因型慢性乙型肝炎疗效。方法选择上海市杨浦区中心医院安图分部2012年1月至2014年12月收治的HBV患者200例,在基因分型后,对其进行恩替卡韦治疗,观察不同基因型患者的疗效。结果第24周,B基因型患者HBV DNA阴性转变率为82.35%,C基因型患者则为73.47%;B基因型患者ALT复常率为78.43%,C基因型患者为70.41%。第96周,B,C基因型患者ALT复常率为81.37和71.43%;HBV DNA阴性转变率分别为89.22%和83.67%,HBe Ag阴性转变率分别为13.73%和10.20%;HBe Ag发生血清学转换率分别为10.78%和7.14%。第24,96周临床疗效比较均无显著差异(P>0.05)。结论关于HBV基因型差异对恩替卡韦的抗病毒效果是否有影响尚需进一步探讨,以便更好地指导HBV抗病毒药物治疗与临床疗效的判断。

Objective To investigate the clinical effect of chronic hepatitis B with different hepatitis B virus（ HBV） genotypes.Methods Totally 200 HVB patients admitted to Shanghai Yangpu Central Hospital（ Antu Branch） from January 2012 to December2014 were selected. After genotyping, the patients were treated with entecavir, the efficacy of different genotypes was observed. Results In the 24 th week,the HBV DNA negative conversion rate of the B genotype was 82. 35%,and 73. 47% of the C genotype. Meanwhile,the ALT recurrence rate was also higher, the B genotype was 78. 43%, and the C genotype was 70. 41%. Until the 96 th week after treatment, the recurrence rates of ALT in patients with B and C genotypes were 81. 37% and 71. 43%, respectively, and the negative conversion rates of HBV and DNA were 89. 22% and 83. 67%,respectively,the negative transformation rates of HBe Ag were 13. 73% and10. 20%, respectively, the seroconversion rates of HBe Ag were 10. 78% and 7. 14%, respectively. There was no significant difference in clinical efficacy in the 24 th, 96 th weeks（ P〈0. 05）. Conclusion Whether or not the genotype of HBV affects the antiviral effect of entecavir remains to be explored,in order to better understand the antiviral treatment and clinical efficacy of HBV.