乙型肝炎病毒逆转录酶中突变的积累与未治疗的中国慢性乙

StephenW

Adv Clin Exp Med. 2017 Oct;26(7):1123-1129. doi: 10.17219/acem/63998.
Accumulation of mutations in reverse transcriptase of hepatitis B virus is associated with liver disease severity in treatment-naïve Chinese patients with chronic hepatitis B.Zhu B1, Wang T1, Wei X1, Zhuo Y1, Liu A1, Zhang G1.
Author information
1Infectious Disease Department of the First Affiliated Hospital of Xinxiang Medical University, Henan, China.

AbstractBACKGROUND: Mutations in reverse transcriptase (RT) of the hepatitis B virus (HBV) are demonstrated to be strongly associated with nucleos(t)ide analog resistance, which is supposed to be the biggest obstacle during the long-term anti-viral treatment of chronic hepatitis B. However, the presence of RT mutations in treatment-naïve chronic hepatitis B patients and its clinical significance are not well known.
OBJECTIVES: To investigate the significance of mutations in reverse transcriptase of the hepatitis B virus in treatment-naïve Chinese patients with chronic hepatitis B.
MATERIAL AND METHODS: In this study, 288 treatment-naïve chronic HBV patients were recruited and the RT region was sequenced. The results showed that 71 patients (24.65%) were found with RT mutations, within which there were no well-defined primary nucleotide analog-resistant mutations.
RESULTS: There were a total of 28 mutant sites, which formed three dominant mutant clusters: rt124-139, rt191-212 and rt225-229. Among these 71 patients, 63.38% (45/71) of patients had a single mutation while 19.72% (14/71), 12.68% (9/71) and 4.23% (3/71) of patients had 2, 3 or 4 mutations, respectively. Patients with RT mutations showed significantly decreased serum baseline HBV DNA loads (p = 0.0363) and blood platelet count (p = 0.0181) than patients without RT mutations. Patients with multiple mutant sites (≥ 2) had significantly decreased baseline HBV DNA loads (p = 0.0004) and blood platelet count (p = 0.0011) than patients with single mutant site. Moreover, the number of RT mutant sites is significantly associated with severity of liver fibrosis (p = 0.0128).
CONCLUSIONS: This study demonstrated that there was a prevalence of RT mutations in treatment-naïve chronic hepatitis B patients, which reflects a tougher liver environment for the virus and deeper liver injury for the host. Accumulation of RT mutations was associated with liver disease severity in treatment-naïve chronic hepatitis B patients.


KEYWORDS: hepatitis B virus; mutation; reverse transcriptase; treatment-naïve

PMID:29211361

StephenW

Adv Clin Exp Med。 2017年10月; 26（7）：1123-1129。 doi：10.17219 / acem / 63998。
乙型肝炎病毒逆转录酶中突变的积累与未治疗的中国慢性乙型肝炎患者的肝脏疾病严重程度有关。
朱B1，王T1，魏X1，卓Y1，刘A1，张G1。
作者信息

1
    新乡医学院第一附属医院感染科河南省

抽象
背景：

乙型肝炎病毒（HBV）的逆转录酶（RT）中的突变被证明与核苷酸（t）类似物抗性强烈相关，这被认为是慢性肝炎的长期抗病毒治疗期间最大的障碍B.然而，在未治疗的慢性乙型肝炎患者中存在RT突变及其临床意义尚不清楚。
目的：

探讨乙型肝炎病毒逆转录酶基因突变在中国初治慢性乙型肝炎患者中的意义
材料与方法：

在这项研究中，招募了288名未经治疗的慢性HBV患者，对RT区域进行测序。结果显示，71例（24.65％）发现有RT突变，其中没有明确的原发性核苷酸类似物抗性突变。
结果：

共有28个突变位点，形成三个显性突变簇：rt124-139，rt191-212和rt225-229。 71例患者中有63.38％（45/71）患者有单发突变，19.72％（14/71），12.68％（9/71）和4.23％（3/71）患者有2,3或4例突变，分别。 RT突变患者的血清基线HBV DNA载量（p = 0.0363）和血小板计数（p = 0.0181）显着降低。具有多个突变位点（≥2）的患者具有显着降低的基线HBV DNA载量（p = 0.0004）和血小板计数（p = 0.0011）。此外，RT突变位点的数量与肝纤维化的严重程度显着相关（p = 0.0128）。
结论：

这项研究表明，初治慢性乙型肝炎患者中存在RT突变的患病率，这反映出病毒的肝脏环境更加恶化，宿主的肝脏损伤更严重。慢性乙型肝炎患者中，RT突变的积累与肝病严重程度有关。
关键词：

乙肝病毒;突变;逆转录酶;初治

结论：
    29211361