A retrospective study on the viral characteristics and antiviral therapeutic regimens effect in chronic hepatitis B patients with rtA181 mutations
10.3760/cma.j.issn.1003-9279.2014.06.006
- VernacularTitle:HBV rtA181位点突变的病毒学特点及临床耐药研究
- Author:
Jing WU
1
;
Xiaoxiao HUANG
;
Shourong LIU
Author Information
1. 310023,杭州市西溪医院(原杭州第六人民医院)
- Keywords:
Hepatitis B virus;
Nucleotides;
Drug resistance;
Mutation
- From:
Chinese Journal of Experimental and Clinical Virology
2014;28(6):416-419
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the mutation patterns of hepatitis B virus in chronic hepatitis B patients with rtA181 mutations.Methods Forty-five chronic hepatitis or cirrhosis patients undergoing nucleos(t)ide analogues treatment were found HBV rtA181 locus mutation.Their serum HBV DNA levels were detected,HBV P gene was amplified and PCR products were sequenced to analyze genotype as well as mutation patterns.The information of medication history,salvage regimen and efficacy were collected.Results Three mutation forms of HBV rtA181 were found in 45 cases which were rtA181T 66.67％ (30/ 45),rtA181V 31.11％ (14/45) and rtA181S 2.22％ (1/45) respectively.The rate of HBV genotype C was higher than that of genotype B in rtA181T carriers (P ＜ 0.05).Thirteen kinds of patterns involved rtA181 of HBV mutations were found.Multi-site rtA181 mutations occurred 57.78％ (26/45).rtA181 combined with rt236 occurred 40.00％ joint (18/45),rtA181 combined with rtM204 mutation occurred 22.2％ (10/45),and the patients with multi-site rtA181 mutations seemed have higher viral load distribution,but the difference was not statistically significant (P ＞ 0.05).Nor the rtA181 mutation form either the HBV genotype correlated with multi-site rtA181 mutation (P ＞ 0.05); Most of patients (97.78％,44/45) with rtA181 mutation had lamivudine and (or) adefovir treatment history,the other one only had telbivudine antiviral treatment previously.Some kinds of subsequent salvage antiviral treatment strategy obtained 2 lg HBV DNA decrease in a month,such as plusing or switching to entecavir,lamivudine & adefovir,and telbivudine & adefovir.Long follow-up study indicated plusing (or) switching to entecavir can achieve significant sustained response of the salvage treatment to rtA181 mutation.Conclusions HBV rtA181 mutation patterns varied,correlated with long-term lamivudine,adefovir or telbivudine monotherapy or sequential treatment.The subsequent salvage therapy should be focused on plusing or switching to entecavir.
