阿德福韦酯基因型耐药及其不同位点变异相关因素分析

发布时间：2018-02-09 22:51

本文关键词： 阿德福韦酯肝炎病毒乙型耐药影响因素　出处：《青岛大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：探讨阿德福韦(阿德福韦酯,ADV)抗病毒治疗对乙肝病毒(hepatitis B virus,HBV)感染病人发生基因型耐药及其不同位点变异的影响。方法：本研究应用焦磷酸测序法,对83例服用ADV(包括拉米夫定序贯ADV)48周以上且出现病毒学突破的病人进行基因耐药检测。同时检测HBV DNA、HBsAg、 HBeAg、HBV基因型及肝功能相关指标(ALT、AST、TBIL),行肝脏B超和CT检查。结果：(1)83例病毒学突破(VB)病例中,40例发生ADV.耐药相关变异(变异组),43例未发生ADV耐药相关变异(未变异组)；单因素分析后将两组不同年龄段、ADV抗病毒疗程、伴rtL180M变异纳入多因素分析；Logistic回归分析显示,年龄40岁、ADV长疗程治疗、伴rtL180M变异是ADV耐药相关位点变异的独立危险因素(P均0.05)。(2)变异组中rtA181T变异14例,rtN236T变异12例,两组AST、HBV基因型相比有统计学差别(P0.05),Logistic回归分析显示,B基因型发生rtN236T变异的可能性大(P=0.05)。结论：(1)年龄40岁、ADV长疗程治疗、伴rtL180M变异的乙型肝炎患者更有可能发生ADV相关耐药位点变异。(2)HBV B基因型较C基因型更有可能发生rtN236T变异。
[Abstract]:Objective: to investigate the effect of antiviral therapy of adefovir (ADV) on genotype resistance and variation of different loci in patients with hepatitis B virus infection. Methods: pyrosequencing was used in this study. Gene resistance was detected in 83 patients who took ADV (including lamivudine sequential ADV)48 for more than weeks and had virological breakthrough). HBV DNA HBsAg, HBeAgN HBV genotype and liver function related indexes were detected. Liver B ultrasound and CT were performed. Results among 83 cases of virological breakout, 40 cases developed ADV.Drug-resistance-related variation was found in 40 cases (43 cases in the variant group did not have the mutation group). After univariate analysis, the two groups were treated with anti-virus course of anti-ADV in different age groups. Logistic regression analysis showed that the age of 40 years old was 40 years old and the independent risk factor of ADV resistance-related locus mutation was rtL180M mutation (P < 0.05). There were 12 cases of rtA181T mutation in 14 cases of rtA181T mutation in the variant group, which was combined with multivariate analysis of multivariate analysis and logistic regression analysis (logistic regression analysis) showed that there were 12 cases of rtA181T mutation in the age of 40 years old. There was statistical difference between the two groups in the genotype of rtN236T. Logistic regression analysis showed that there was a great possibility of rtN236T variation in genotype B. ConclusionThe patients with rtL180M mutation were more likely to develop ADV related drug resistance locus variation than genotype C to develop rtN236T mutation in 40 years old patients with long course of treatment of ADV.ConclusionThe patients with rtL180M mutation were more likely to develop ADV related drug resistance locus variation.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R512.62

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