摘要
目的检测乙型肝炎病毒(HBV)核苷(酸)类似物(NAs)耐药位点突变情况,为优化治疗方案提供参考。方法提取血清HBV DNA,以巢式PCR扩增HBV基因P区片段后测序,通过序列分析软件Bioedit分析测序结果。结果在2 223例慢性乙型肝炎(CHB)患者血清标本中,1 202例(54.07%)检测出耐药突变,其中980例(44.08%)检测出主要耐药位点突变。在检测的病毒株中,多点突变多于单点突变。耐药突变多样,达32种模式,以rt M204I/V+rt L180M最常见,其次是rt A181T/V/S。各种药物耐药突变率LAM>ADV>ETV。多重耐药49例(2.2%)。结论核苷(酸)类似物耐药突变率高,突变组成复杂,加强耐药突变检测对临床用药具有指导意义。
Objective To detect the mutation status of hepatitis B virus （HBV） nucleoside （acid） analogues （NAs） -drug resistance sites, so as to provide reference for the optimization of treatment plan. Methods Serum HBV DNA was extracted, HBV gene P was amplified by nested PCR, and the results were analyzed by sequence analysis software Bioedit. Results Among 2 223 serum samples from the patients with chronic hepatitis B （ CHB）, the genetic mutations conferring resistance to NAs were detected in 1 202 （54.07%）specimens; out of those, the mutations of primary drug resistance sites were detected in 980 （44.08%） viral isolates. Muhiple - site mutations were detected more than single - site among the clinical HBV isolates. A complex composition of mutations was revealed. A total of 32 mutation modes were identified and the rtM204I/V ＋ rtL180M was the highest proportion, followed by rtA181T/V/S. The rates of drug resistance mutation were in the ranking of LAM 〉 ADV 〉 ETV. Muhidrug resistance mutations were detected in 49（2.2% ） patients. Conclusion The rate of NAs resistance mutation was high and the constitution of mutations was complicated. Therefore it is necessary to enhance the relevant mutations detection for the clinical rational drug use.
出处
《中国卫生检验杂志》
CAS
2015年第13期2242-2246,共5页
Chinese Journal of Health Laboratory Technology
基金
天津市科委面上项目(12JCYBJC3370)
