Objective To explore the offects of mutations in tyrosine-methionine-aspartic acid-aspartic acid (YMDD) motif of the polymerase in the hepatitis B virus (HBV) genome on lamivudine antiviral therapy. Methods Partial HB...Objective To explore the offects of mutations in tyrosine-methionine-aspartic acid-aspartic acid (YMDD) motif of the polymerase in the hepatitis B virus (HBV) genome on lamivudine antiviral therapy. Methods Partial HBV DNA segment containing the YMDD motif in the P gene wes obtained through amplifi- cation by polymerase chain reaction (PCR )from 19 chronic hepatitis B patients with serum HBV DNA positive at the 48th week treatment with lamivudine and subjected to automatic sequencing. Influences of vartants with YMDD mutations on lamivudine therapy were seen by observing the dynamic changes of serum HBV DNA and ALT levels. Results Serum HBV DNA breakthrough was found in 3 out of 10 individuals with detection of the YMDD mutations at the 48th week and in 5 at the 52th week, 2 of the 5 patients accompanied by serum ALT re-elevation, whereas of 9 subjects without YMDD mutations, 2 experenced an HBV DNA breakthrough at the 48th week and 1 of them had a conversion from HBV DNA positive DNA positive to negative at the 52th week. Patients with detectable HBV DNA level had a fluctuating level of serum ALT all time during the treatment. Conclusion Detection of mutations in the YMDD motif of polymerase gene in HBV genome during the lamivudine therapy will be helpful to monitoring its therapeutic outcomes.展开更多
目的采用实时定量PCR检测接受与未接受拉米夫定治疗的乙肝患者血清中乙肝病毒(HBV)突变情况,并将检测结果与临床指标进行相关性分析。方法采用touch-down PCR反应程序,并结合SYBR Green Ⅰ染料进行实时定量PCR,检测115份乙肝患者血清标...目的采用实时定量PCR检测接受与未接受拉米夫定治疗的乙肝患者血清中乙肝病毒(HBV)突变情况,并将检测结果与临床指标进行相关性分析。方法采用touch-down PCR反应程序,并结合SYBR Green Ⅰ染料进行实时定量PCR,检测115份乙肝患者血清标本(其中50名患者未服用过拉米夫定,65名患者服用过拉米夫定)。随机选择115份标本中的30份用同样的方法提取血清DNA,进行PCR扩增及测序,并与实时定量PCR检测结果进行比较。将乙肝病毒YMDD突变实时定量PCR检测结果与临床各指标之间进行相关性分析。结果115份血清标本中,75份含有野生型HBV(其中49份来自未接受过拉米夫定治疗的患者),40份含有YMDD突变的HBV(其中1份来自未接受过拉米夫定治疗的患者);180位点的突变检测中,98份标本含有野生型HBV,17份标本含有突变型HBV。随机选取的30份标本测序结果与实时定量PCR检测结果完全一致。乙肝病毒拉米夫定耐药突变与患者的性别、血清DNA水平、病毒基因型之间无相关性,而乙肝病毒YMDD变异与患者服用拉米夫定的时间长短有相关性,用药时间越长,发生突变的几率越大。乙肝患者服用拉米夫定后,180和204位点突变具有相关性。结论实时定量PCR可以高效、准确地检测拉米夫定治疗后乙肝病毒的耐药突变。展开更多
基金Partially supported by the National Natural Science Foundaion of China (39630280)
文摘Objective To explore the offects of mutations in tyrosine-methionine-aspartic acid-aspartic acid (YMDD) motif of the polymerase in the hepatitis B virus (HBV) genome on lamivudine antiviral therapy. Methods Partial HBV DNA segment containing the YMDD motif in the P gene wes obtained through amplifi- cation by polymerase chain reaction (PCR )from 19 chronic hepatitis B patients with serum HBV DNA positive at the 48th week treatment with lamivudine and subjected to automatic sequencing. Influences of vartants with YMDD mutations on lamivudine therapy were seen by observing the dynamic changes of serum HBV DNA and ALT levels. Results Serum HBV DNA breakthrough was found in 3 out of 10 individuals with detection of the YMDD mutations at the 48th week and in 5 at the 52th week, 2 of the 5 patients accompanied by serum ALT re-elevation, whereas of 9 subjects without YMDD mutations, 2 experenced an HBV DNA breakthrough at the 48th week and 1 of them had a conversion from HBV DNA positive DNA positive to negative at the 52th week. Patients with detectable HBV DNA level had a fluctuating level of serum ALT all time during the treatment. Conclusion Detection of mutations in the YMDD motif of polymerase gene in HBV genome during the lamivudine therapy will be helpful to monitoring its therapeutic outcomes.
文摘目的采用实时定量PCR检测接受与未接受拉米夫定治疗的乙肝患者血清中乙肝病毒(HBV)突变情况,并将检测结果与临床指标进行相关性分析。方法采用touch-down PCR反应程序,并结合SYBR Green Ⅰ染料进行实时定量PCR,检测115份乙肝患者血清标本(其中50名患者未服用过拉米夫定,65名患者服用过拉米夫定)。随机选择115份标本中的30份用同样的方法提取血清DNA,进行PCR扩增及测序,并与实时定量PCR检测结果进行比较。将乙肝病毒YMDD突变实时定量PCR检测结果与临床各指标之间进行相关性分析。结果115份血清标本中,75份含有野生型HBV(其中49份来自未接受过拉米夫定治疗的患者),40份含有YMDD突变的HBV(其中1份来自未接受过拉米夫定治疗的患者);180位点的突变检测中,98份标本含有野生型HBV,17份标本含有突变型HBV。随机选取的30份标本测序结果与实时定量PCR检测结果完全一致。乙肝病毒拉米夫定耐药突变与患者的性别、血清DNA水平、病毒基因型之间无相关性,而乙肝病毒YMDD变异与患者服用拉米夫定的时间长短有相关性,用药时间越长,发生突变的几率越大。乙肝患者服用拉米夫定后,180和204位点突变具有相关性。结论实时定量PCR可以高效、准确地检测拉米夫定治疗后乙肝病毒的耐药突变。