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Evolution of hepatitis B virus quasispecies during sequential therapy in patients with lamivudine-resistant hepatitis B virus infection
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- Author:
- No author available
- Journal Title:
- WORLD CHINESE JOURNAL OF DIGESTOLOGY
- Issue:
- 8
- DOI:
- 10.3969/j.issn.1009-3079.2010.08.006
- Key Word:
- 拉米夫定;耐药;乙型肝炎病毒;准种
Abstract： 目的:探讨拉米夫定(LAM)耐药后序贯治疗中HBV准种的演变特点.方法:收集7例拉米夫定耐药患者序贯治疗中的血清,对HBV聚合酶基因逆转录酶区进行PCR扩增克隆并测序,结合临床用药分析序列突变,探讨其演变特征.结果:患者1、4、5在序贯治疗中LAM耐药变异株一直存在,主要以M204I+L80I、M204I+L80I+L180M、M204V+L180M+G173L、M204V+L180M为主,所占比例在不断发生变化,患者2、3在序贯治疗中检测出野生株,但患者2在后续治疗中又选择出LAM耐药变异株.患者6在ADv联合ETV治疗时、患者7在单用ADV治疗时测时分别测出双重耐药株M204v+L180M+G173L+T184A和M204V+180M+G173L+236D.结论:拉米夫定耐药后序贯治疗中原耐药突变不易消失,且容易在此基础上筛选出交叉耐药株或多重耐药株,他的出现影响序贯治疗的应答甚至导致序贯治疗的失败.
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