河北省石家庄地区HBV基因分型及耐药突变分析

doi:10.3969/j.issn.1007-3205.2021.07.022

摘要/Abstract

摘要： 目的探讨石家庄地区经各种核苷(酸)类似物治疗的慢性乙型肝炎(chronic hepatitis B，CHB)患者乙型肝炎病毒(hepatitis B virus，HBV)基因型、基因耐药突变位点分布和基因耐药情况。
方法选择CHB患者1 157例，收集患者的基本资料，采用基因测序技术检测患者基因分型和基因耐药突变位点，对检测结果进行统计分析。
结果石家庄地区CHB患者的基因分型以C型为主，少量为B型。石家庄地区CHB患者中HBV基因分型B型和C型分布比例差异无统计学意义(P＞0.05)；不同年龄间HBV基因分型B型和C型分布比例差异有统计学意义（P＜0.05），41~60岁患者HBV基因分型C型占比最高。未发生基因突变172例，单基因位点突变393例，2个基因位点突变361例，3个基因位点突变174例，4个基因位点突变42例，5个基因位点突变10例，6个基因位点突变3例，7个基因位点突变1例，9个基因位点突变1例；基因型分布特点随突变位点数的增多HBV基因分型B型和C型比例差异无统计学意义(P＞0.05)。发生突变的985例患者共检出1 889个突变位点，检测的14个基因位点中，M204I/V/S、L180M、A181V/T/S突变率为14个基因位点发生突变的前3位，不同基因位点中HBV基因分型B型和C型比例差异无统计学意义(P＞0.05) 。发生突变的985例患者对拉米夫定(lamivudine，LAM)，替比夫定(telbivudine，LDT)，阿德福韦酯(adefovir，ADV)及恩替卡韦(entecavir，ETV)4种核苷(酸)类似物耐药模式共检出11种，其中对单一药物发生耐药有3种模式，对2种药物发生耐药的有4种模式，对3种药物发生耐药有3种模式，还有一种是对4种药物均发生耐药。不同耐药模式患者HBV基因分型B型和C型比例差异无统计学意义(P＞0.05)。
结论石家庄地区CHB患者感染的基因分型以C型为主，且发生的基因耐药突变以多重耐药为主。

关键词: 乙型肝炎病毒, 基因分型, 抗药性, 突变

Abstract: Objective To analyze the HBV genotype, distribution of drug-resistant mutation sites and drug resistance of chronichepatitis B(CHB) patients treated with various nucleoside(acid) analogues in Shijiazhuang area.
Methods A total of 1 157 patients with CHB were selected, and their basic data were collected. Genotyping and gene resistance mutation sites of the patients were detected by gene sequencing technology, and the results were statistically analyzed.
Results Genotypes of CHB patients in Shijiazhuang were mainly C-type and a small number were B-type. There was no statistical significance in the distribution proportion of HBV genotypes B and C in CHB patients in Shijiazhuang area(P＞0.05). There were statistically significant difference in the distribution proportion of HBV genotypes B and C among different ages(P＜0.05). The HBV genotype C was the highest in patients aged 41 to 60 years. There were 172 cases with no mutation, 393 cases with single mutation, 361 cases with 2 gene loci mutation,174 cases with 3 gene loci mutation, 42 cases with 4 gene loci mutation, 10 cases with 5 gene loci mutation, 3 cases with 6 gene loci mutation, 1 case with 7 gene loci mutation and 1 case with 9 gene loci mutation. There was no significant difference in genotype distribution with the proportion of B and HBV genotype C(P＞0.05). A total of 1 889 mutation loci were detected in 985 patients with mutations. Among the 14 gene loci detected, the mutation rates of M204I/V/S, L180M and A181V/T/S were the top three mutation loci. There was no significant difference in the proportion of HBV genotypes B and C among different loci(P＞0.05). In 985 patients with mutations, a total of 11 nucleoside(acid) resistance patterns were detected for lamivudine(LAM), telbivudine(LDT), adefovir(ADV) and entecavir(ETV). There were three patterns of resistance to a single drug, four patterns of resistance to two drugs, three patterns of resistance to three drugs, and one pattern of resistance to all four drugs. There was no statistical significance in the proportion of HBV genotypes B and C among patients with different drug resistance patterns(P＞0.05).
Conclusion The genotypes of CHB patients in Shijiazhuang area are mainly type C, and the gene resistance mutations are mainly multi-drug resistance.

Key words: hepatitis B virus, genotyping, drug resistance, mutation

侯军良, 冯爱东, 刘腾飞, 许怡, 张海从, 杨莉. 河北省石家庄地区HBV基因分型及耐药突变分析[J]. 河北医科大学学报, 2021, 42(7): 851-855.

HOU Jun-liang, FENG Ai-dong, LIU Teng-fei, XU Yi, ZHANG Hai-cong, YANG Li. The analysis of HBV genotyping and drug resistant mutation in Shijiazhuang area, Hebei province[J]. Journal of Hebei Medical University, 2021, 42(7): 851-855.

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河北省石家庄地区HBV基因分型及耐药突变分析

The analysis of HBV genotyping and drug resistant mutation in Shijiazhuang area, Hebei province

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