HBV和HCV耐药与检测监控中的问题与应对策略

摘要

抗HBV核苷(酸)类似物临床试验的长期随访和临床应用研究的积累,使得我们认识到,耐药已成为抗病毒治疗中的主要问题,早期发现HBV基因型耐药是及时改变治疗策略的主要方法和基础,新一代测序技术的发展将可能更早预测耐药的发生.直接抗HCV小分子化合物的诞生,与生俱来地带来了HCV耐药问题,但是,直接抗HCV药物相关的耐药突变,在不同治疗方案中的意义还需要进行更多的研究,耐药突变检测的方法也需要进一步研究,才能适于临床应用.%Both long term follow up and real world research on chronic hepatitis B have accumulated data on nucleos (t) ide analogues in anti-HBV treatment,which shows that resistance mutation turns out to be the major obstacle in achieving response.Identification of genotypic resistance at early stage is key to improve strategy.Deep-sequencing will be helpful to predict resistance earlier.Direct acting autiviral agents on hepatitic C virus tell us resistance at the very beginning,however,more data is still needed to elucidate how to use resistance monitoring of anti-HCV treatment.