A study of the variable sites on RT area of polymerase from CHB patients getting single drug treatment of Adefovir dipivoxil and its clinical significance
10.3760/cma.j.issn.1003-9279.2014.01.013
- VernacularTitle:阿德福韦酯单药治疗的慢乙肝患者聚合酶RT区变异位点及临床意义
- Author:
Liangda ZHENG
1
;
Yanting BAO
;
Gongying CHEN
;
Jie WANG
;
Xiang ZHOU
;
Ke GE
Author Information
1. 浙江中医药大学
- Keywords:
Hepatitis B;
Adefovir;
Carcinoma,hepatocellular
- From:
Chinese Journal of Experimental and Clinical Virology
2014;28(1):38-40
- CountryChina
- Language:Chinese
-
Abstract:
Objective A study on the loci variation characteristics of polymerase on area RT and it's clinical significance while a failure using Adefovir monotherapy antiviral treatment,by analyzing the HBV polymerase reverse transcription (RT) gene sequence of the serum from the chronic hepatitis B patients.Method By using retrospective analysis on the loci variation characteristics,clinical significance of polymerase on area RT and follow-up data from the 44 patients identified genetic mutations through the gene sequence of the HBV polymerase area RT,who had a virus re-activation after getting ADV mono therapy antiviral treatment.Result The 44 patients with Adefovir mono therapy,who had the mutation in area RT with the shortest treatment time eight months,up to five years,an average of(32.2 ± 6.7) months.The level fluctuations of the virus is between 103 copies/ml-108 copies/ml.After virological breakthrough,in these 44 cases,11 as A181T (25.0％),8 as A181V (18.2％),10 as 181T/N236T(22.7％),6 as A181V/N236T (13.6％),9 as N236T(20.4％); 40 cases (90.9％) appeared a biochemistry breakthrough,alanine aminotransferase index fluctuation during 37 IU/L-946 IU/L; Remedial treatment using combination lamivudine 23 cases,6 patients with jointing entecavir,than,1 case for jointing telbivudine,change single drug lamivudine in 4 cases,10 cases of single drug entecavir.Prognosis of severe disease (3 cases),and through the remedial treatment,42 cases was recovered.Conclusion ① RT area A181T (A181T/ N236T) variation accounted about a half of total(47.7％),after the drug resistance of the adefovir,2 years of follow-up,the incidence of liver cancer shows a higher trend than patients without A181T.②Conditions allowed,strong inhibitory effect medicines during tinitial therapy should be preferred,to low the incidence of drug-resistant HBV drug,avoid adverse events.
