唐山地区CHB患者HBV基因型与耐药种类和耐药位点的分析研究

发布时间：2018-05-23 15:58

本文选题：乙型肝炎病毒 + 基因分型　；参考：《中华医院感染学杂志》2017年23期

【摘要】：目的探讨唐山地区慢性乙型肝炎病毒(CHB)患者乙型肝炎病毒(HBV)基因分型,核苷酸类抗病毒药物的耐药种类分布和耐药位点的相关性。方法选择2009年10月-2014年4月就诊于唐山市传染病医院门诊和住院的467例慢性乙型肝炎病毒患者,通过使用毛细管电泳仪采用双脱氧终止法测序技术,对患者血清进行HBV基因分型和耐药位点的检测,使用统计学软件对数据进行统计分析。结果唐山地区CHB患者的467例样本中检测出HBV基因型445例,其中B基因型64例占14.38%,C基因型380例占85.39%,D基因型1例占0.22%;共检出耐药患者283例,其中对恩替卡韦、拉米夫定和替比夫定多药耐药的160例占56.54%;对阿德福韦酯的主要耐药位点是rtA181V/T/S突变,其次是rtA181V/T/S和rtN236T同时突变,B基因型与C基因型对阿德福韦酯的耐药位点突变分布比较差异有统计学意义(P0.05);对拉米夫定、恩替卡韦和替比夫定多药耐药的主要耐药位点是rtL180M和rtM204I/V/S同时突变,其次是单独rtM204I/V/S突变。结论唐山地区HBV感染者的基因型主要以C基因型为优势基因型;通过对耐药位点的分析,B基因型CHB患者应用阿德福韦酯不易耐药,HBV基因型B型和C型的CHB患者对拉米夫定、恩替卡韦和替比夫定耐药的多药耐药位点分布无差异。
[Abstract]:Objective to investigate the genotyping of hepatitis B virus (HBV) in patients with chronic hepatitis B virus (CHB) in Tangshan area, the distribution of nucleotide antiviral drugs and the correlation of drug resistance sites. Methods from October 2009 to April 2014, 467 patients with chronic hepatitis B virus were selected from outpatient and inpatients in Tangshan Infectious Disease Hospital. HBV genotyping and drug resistance loci were detected in patients' serum, and statistical software was used to analyze the data. Results out of 467 patients with CHB in Tangshan area, 445 HBV genotypes were detected, of which 64 were genotype B (14.38C), 380 (85.39D), 1 (0.22). Lamivudine and tibivudine multidrug resistance occurred in 160 cases (56.54). The main resistance site to adefovir was rtA181V/T/S mutation. Secondly, there was significant difference in the mutation distribution of the drug resistance sites of rtA181V/T/S and rtN236T gene B and C to adefovir ester (P 0.05), and to lamivudine, to adefovir dipivoxil (P 0.05), to lamivudine (P 0.05), to lamivudine. The main resistance sites of entecavir and tibivudine multidrug resistance were rtL180M and rtM204I/V/S mutation, followed by single rtM204I/V/S mutation. Conclusion the genotype of HBV infection in Tangshan area is mainly genotype C, and by analyzing the drug resistance sites, the patients with CHB with adefovir dipivoxil are treated with lamivudine. There was no difference in the distribution of multidrug resistance sites between entecavir and tibivudine.
【作者单位】：唐山市传染病医院检验科;唐山市人民医院检验科;
【基金】：唐山市科技局计划基金资助项目(13130239b) 河北省卫生厅计划基金资助项目(20142676)
【分类号】：R512.62

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