阿德福韦酯抗病毒治疗1a后乙肝病毒基因型变化情况的观察

观察阿德福韦酯抗病毒治疗1 a后慢性乙肝患者体内HBV基因型变化情况.随机选择152例慢性乙肝患者作为研究对象,其中52例患者作为抗病毒治疗组,口服阿德福韦酯进行抗病毒治疗,另外100例患者作为对照组,口服护肝片进行护肝治疗,2组病人治疗周期均为1 a,分别在用药后第3、6、12个月进行随访,随访内容包括患者的依从性和不良反应、HBeAg/HBeAb、肝功能、HBV DNA定量检测,并采用多对型特异性引物巢武PCR基因分型技术动态监测治疗期间HBV基因型的变化情况.治疗1 a后,抗病毒治疗组中有1例患者体内HBV基因型发生改变,由治疗前的B型变为B/C混合型,并且病情出现反弹和加重.对照组未发现HBV基因型改变.2组HBV基因型变化率(1.9％和0％)之间没有显著性差异(P＞0.05).慢性乙肝患者体内HBV基因型可发生改变,而且1 a内即可发生,抗病毒治疗可能是促进HBV基因型改变的相关因素.HBV基因型转变可导致患者病情反弹和加重.

Genotypic Changes of HBV One Year after Adefovir Dipivoxil Antiviral Treatment

HBV genotypic changes in vivo of chronic hepatitis B patients one year after adefovir dipivoxil(AD) treatment were observed.152 cases of chronic hepatitis B patients were randomly chosen.52 among them was taken as antiviral treatment group,treated with AD orally,and another 100 was taken as control group,treated with liver protecting tablet(huganpian in Chinese pinyin),both groups were treated for one year period,and respectively visited the patients 3rd,6th,12th month after the treatment,the visiting content including the obedience and harmful reaction of the patients,HbeAG/HbeAb,liver function,HBV,DNA quantitative test and determination.Nested PCR with multiple pairs of genotype-specific primers was used to test and determine dynamically the changes of the HBV genotypes during the treatment.The results showed that one year after the treatment,the HBV genotype in vivo of one patient in antiviral treatment group had changed,changed from genotype B to a mixed genotype of B/C and the patient’s condition rebounded and worsened.While in control group,no changes was found in patients’ HBV genotype.There was no significant differences(P>0.05) between changing rate of HBV genotypes in two groups(1.9% and 0%).Therefore,HBV genotype in vivo in chronic HB patient could change,and it could easily happen within one year.Antiviral treatment probably was the relative factor of the enhancement of the changes of HBV genotype.The swift of HBV genotype could result in the relapse and worsening of the patient’s condition.