乙型肝炎病毒RT区变异及其与基因型分布的关系

目的：探讨大样本乙型肝炎病毒（HBV）感染患者RT区耐药位点变异的流行情况，及各耐药位点变异与HBV基因型的关系。方法：采用P区测序法对1117例慢性乙型肝炎患者的血清病毒进行P区测序、进化树分型。结果：RT区耐药位点变异发生率与基因型关系密切，在基因型C患者中的变异发生率远远高于基因型B患者（P=O．000）。Rt180、rtM204V、rtM204I、rt181、rt213位点变异均与基因型c有关（P〈O．05）。主要的三种变异类型rt180＋rtM204V、rtM204I、rt180＋rtM204I间基因型分布存在显薯差异（P=0．003）。不同HBeAg状态下，耐药变并的发生有显著差并（P=O．020），特别是rt181和rt236位点变畀。结论：HBV基因型影响RT区耐药变异发生率及变异类型。且耐药变异发生率也与HBeAg状态有关。

Mutation in the RT Region of Hepatitis B Virus and Its Relationship with HBV Genotypes Distribution

Objective： To investigate the prevalence of resistance mutations in the RT region in a large sample of patients with hepatitis B virus （HBV）, and the relationship between resistance mutation and HBV genotypes. Methods： RT region of I-IBV gene in 1117 patients was sequenced and HBV genotypes were analyzed by phylogenetic tree. Results： The resistance mutation rate in the RT re- gion was closely related to HBV genotypes, and it was obviously higher in genotype C than in genotype B （P=0.000）. The variation of rtl80, rtM204V, rtM204I, rtl81, rt213 position was related with genotype C （P〈0.05）. The distribution ofHBV genotypes in three major types of variation, rtl80＋rtM204V, rtM204I, rtl80＋rtM204I, was obviously different （P=0.003）. HBeAg is relevant to the originate of drug resistance mutation （P = 0.020）, especially rtl81 and rt236 position. Conclusions： HBV genotypes influenced the incidence and types of resistance variation in RT region, and resistance variation incidence was also related to HBeAg state.