Genotypic resistance profile of hepatitis B virus (HBV)

StephenW

<http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2893.2010.01360.x/abstract>

Genotypic resistance profile of hepatitis B virus (HBV) in a large cohort of
nucleos(t)ide analogue-experienced Chinese patients with chronic HBV infection

Y. Liu1, C. Wang1, Y. Zhong1, X. Li1, J. Dai1, X. Ren1, Z. Xu1, L. Li1, Z. Yao1,
D. Ji1, L. Wang1, L. Zhang1, V. W. -S. Wong2, F. Zoulim3,4,5, D. Xu1

Article first published online: 6 SEP 2010
DOI: 10.1111/j.1365-2893.2010.01360.x
© 2010 Blackwell Publishing Ltd
Issue
Journal of Viral Hepatitis
Volume 18, Issue 4, pages e29–e39, April 2011

Summary.  The study investigated the hepatitis B virus (HBV) genotypic
resistance profile in 1803 nucleos(t)ide analogue (NA)-experienced Chinese
patients with chronic HBV infection. Serum HBV DNA was extracted, and the
reverse transcriptase region was analysed by a high-sensitive direct PCR
sequencing and verified by clonal sequencing if necessary. Drug-resistant
mutations were detected in 560 of the 1803 patients, including 214 of 490
patients who received lamivudine (LAM), 35 of 428 patients who received adefovir
(ADV), five of 18 patients who received telbivudine and 306 of 794 patients who
received various sequential/combined NA therapies. ADV-resistant mutations were
detected in 36 of 381 patients who received LAM and then switched-to ADV in
contrast to one of 82 patients who received ADV add-on LAM. Entecavir
(ETV)-resistant mutations were detected not only in LAM- and ETV-treated
patients but also in LAM-treated ETV-naïve patients. Double mutations rtM204I
and rtL180M were detected more frequently in genotype C than in genotype B
virus, and patients infected with this mutant had higher alanine transaminase
levels than those infected with mutant containing the rtM204I substitution
alone. Multidrug-resistant HBV strains were identified in eight patients,
including two novel strains with mutational patterns rtL180M + A181V + S202G +
M204V + N236T and rtL180M + S202G + M204V + N236T. The results provide new
information on HBV genotypic resistance profiles in a large cohort of Chinese
patients with chronic HBV infection and may have important clinical implication
for HBV drug resistance management in China.




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StephenW

基因型B型肝炎病毒（HBV）的电阻档在一个大学年
慢性乙肝病毒感染的核苷（酸）类似物的IDE经验丰富的中国病人

华刘一，王一三，华钟一，十，李一，学者戴一，十，任一，z的徐一湖丽1，z的姚一，
四吉一湖王一湖张一，五瓦特- S的。 Wong2，3,4,5号Zoulim，徐四一

文章首先发表时间：2010年9月6日
分类号：10.1111/j.1365-2893.2010.01360.x
© 2010布莱克韦尔出版有限公司
发行
作者：病毒性肝炎
18卷第4期，页e29，e39，2011年4月

综述。这项研究调查了乙型肝炎病毒（HBV）的基因型
在1803年抵抗核苷（酸）类似物的IDE（NA）的专页，有经验的中
例慢性HBV感染。血清乙肝病毒DNA的提取，以及
逆转录区域进行了分析一个高灵敏度直接PCR
测序和克隆测序必要时进行验证。耐药
基因突变进行检测的1803例560个，包括490 214
谁收到患者拉米夫定（林），35 428例接受阿德福韦谁
（2009/07），5 18例患者接受替比夫定谁和谁的794例306
收到各种顺序/结合治疗不适用。阿德福韦耐药突变
检测381例36谁收到林，然后切换到地;
相反，谁收到的82例腺病毒一附加林。恩替卡韦
（ETV）抗突变进行检测，不仅在林和教育电视处理
而且在林患者治疗的ETV，初治患者。双突变rtM204I
和rtL180M发现C型多于B型
病毒，这种突变与感染者有较高的谷丙转氨酶
感染水平比那些含有rtM204I替代突变
孤单。多药耐药HBV毒株确定了8例，
其中两次与rtL180M + A181V + S202G突变株+新模式
M204V + N236T和rtL180M + S202G + M204V + N236T。结果提供新的
对乙肝病毒基因型耐药概况的资料在一个中国的大型队列
慢性乙肝病毒感染者和可能具有重要的临床意义
中国乙肝病毒药物的抗药性管理。