Genotypes and resistance loci in patients with chronic hepatitis B achieving virologic breakthrough in treatment with lamivudine combined with adefovir after developing drug resistance in treatment with lamivudine alone
10.3969/j.issn.1001-5256.2016.03.016
- VernacularTitle:拉米夫定耐药后联合阿德福韦酯治疗发生再耐药的慢性乙型肝炎患者的基因型及耐药位点分析
- Author:
Dongqiang YANG
1
;
Fang CHEN
;
Yi KANG
Author Information
1. Center of Infectious Diseases, Henan Provincial People′s Hospital, Zhengzhou 450003, China
- Publication Type:Research Article
- Keywords:
hepatitis B, chronic;
lamivudine;
adefovir;
genotype;
point mutation
- From:
Journal of Clinical Hepatology
2016;32(3):480-483
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate the genotypes and resistance loci in patients with chronic hepatitis B(CHB) achieving virologic breakthrough in the treatment with lamivudine (LAM) combined with adefovir (ADV) after developing drug resistance in the treatment with LAM alone. MethodsA total of 89 CHB patients who were admitted to Henan Provincial People′s Hospital and treated with LAM and ADV as the antiviral therapy after developing drug resistance in the treatment with LAM alone from June 2010 to June 2013 were enrolled, and their serum samples were collected. Quantitative real-time PCR was used for hepatitis B virus (HBV) detection, and sequencing was applied to determine the genotype and detect the resistance loci rtN236T, rtA181V, rtM204V, and rtL180M. The t-test was applied for comparison of continuous data between groups, and the chi-square test was applied for comparison of categorical data between groups. ResultsLAM rtM204V mutation was detected in all the 89 patients after treatment with LAM alone. After the combination therapy with LAM and ADV, ADV rtN236T mutation was detected in 9 patients, ADV rtA181V mutation in 5 patients, and rtN236T+rtA181V mutation in 8 patients, with an overall ADV resistance rate of 24.7% (22/89). As for HBV genotyping, 82 patients had genotype C, and rtA181V+rtN236T mutation was detected in 8 patients; 7 patients had genotype B. ConclusionCompared with the patients with HBV genotype B, the patients with genotype C are more susceptible to rtA181V+rtN236T mutation during the combination therapy with LAM and ADV after developing drug resistance in the treatment with LAM alone.
