32例慢性乙型肝炎患者HBV P区的多位点耐药突变分析.pdfVIP

．病毒病诊断与治疗． 32例慢性乙型肝炎患者HBVP区的 多位点耐药突变分析 叶非，李晓鸥，过建春，武静 【摘要】 目的深入了解核苷(酸)类似物对乙型肝炎病毒基因组P区耐药性突变的影响，分析 其对该区诱导耐药突变的作用。方法 对服用核苷(酸)类似物并且发生病毒学突破的患者，采用 PCR产物直接测序法，进行HBV基因组P区耐药性基因测序分析。结果发现P区可出现多点耐 药突变。导致临床上发生交叉耐药和多重耐药。结论 应选用高耐药基因屏障的药物进行初始抗病 毒治疗。对长期服用核苷(酸)类似物的患者，应定期监测HBVDNA，以便早期发现病毒学突破并及 时干预。 【主题词】肝炎病毒，乙型；药物耐受性；突变 of multi-locimutaionofPar明ofHBV in32 withchronic Analysisdrug·resistant genomepatients B YE Medical hepatitis Fei‘。LIXiao—OU，GUOJian-chun，WUJing．’ZhejiangUniversity School， ’ 3 Hangzhou10008，China author：12xiao-OU，Email：lixiaoousl@163．corn Corresponding Inorderto of toHBV understandtheeffectsnueleosideanalogues 【Abstract】Objective deeply DNA initiateastateof resistanceduetoHBV mutation．Methods area，which drug genome polymerase methodto ofPareaHBV ofthe PCR direct testthe of Using productsequencing genesequence genome who nucleoside and of More taking analogues signsvirologicbreakthrough．Results patients showing in resistancemutationscanbefindHBVDNA cross resistance polymerasearea，whichcausingclinicallydrug and resistance．ConclusionWeshouldchoose barrierfortheinitialtreatment．And multiple highergenetic the ofnueleoside be monitoredserumHBVDNA patients analogues，should level， long-termusing regularly inorderfor detectionof and intervention． early virologicalbreakthroughtimely B Muta