重视乙型病毒性肝炎病毒基因变异的研究和转化应用

摘要

China is among the middle-high endemic regions of HBV infection.The pathological outcomes of chronic HBV infection have been shown to be greatly influenced by several important factors,including HBV genotype,sub-genotype and gene viability mutation.HBV genome mutation,on the one hand,could alter its replication and secretion and thus change viral pathogenicity.In addition,host immune microenvironment and host-virus interaction,disease progression and the effect of antiviral therapy could be adapted at the same time.The detection of HBV genotypes,genetic subtypes and the key hotspot mutation is helpful to clinical risk assessment and prognosis prediction of HBV-related end-stage liver diseases (cirrhosis and hepatocellular carcinoma),it is also helpful to auxiliary predict the liver diseases recurrence and metastasis after treatment.Thus persistent care should be taken on the HBV mutation and its clinical translation so as to provide solid evidences for the personalized,standardized and fine management of HBV-related liver diseases.%我国仍属于HBV感染的中高流行区,HBV基因型、基因亚型和基因突变等是影响慢性HBV感染者病理转归的重要因素.HBV基因变异一方面通过改变病毒的复制、分泌,改变其致病性,另一方面则可通过改变宿主免疫微环境、改变与宿主的相互作用,影响疾病病程及抗病毒疗效等.HBV基因型、基因亚型以及关键热点突变位点的变异或缺失检测有助于判断HBV感染者罹患肝硬化和肝癌危险度及治疗后复发转移等预后的辅助预测.应持续重视HBV基因变异与临床致病性的相关研究,并注重转化应用,为临床HBV相关肝病的个体化、规范化、精细化管理提供依据.