HBV基因分型和耐药突变基因检测

摘要

Objective To investigate the distribution of hepatitis B virus(HBV) genotypes ,drug resistance situation of hepatitis B patients and the relation between HBV genotype with drug resistance and mutation sites .Methods Three hundred serum samples of HBV patients were collected and HBV‐DNA was extracted by adopting the centrifugal column method .The HBV genotype and drug resistant mutant were detected by using PCR‐reverse dot blot hybridization method .Results In 300 cases of HBV‐DNA posi‐tive ,genotye B ,C ,B/C and other undetected genotypes were detected out ,but genotype D was not detected out ,in which genotype C was predominant ,accounting for 81 .8% ;in the HBV patients ,the resistant drugs were dominated by‐lamivudine and telbivudine , accounting for 43 .6% ;the HBV drug resistant mutation genotypes were mainly rt204I(24 .35% ) ,rt204V (17 .39% ) and rt180M (17 .39% );the drug resistance mutation rates of genotype B and C were 30 .77% and 42 .42% respectively ;the difference was sta‐tistically significant(P<0 .05) .Conclusion HBV genotype C in Dongying area is more than genotype B ,genotype C is prone to produce drug resistance ,rt204I ,rt204V and rt180M gene mutations are common ,lamivudine and telbivudine combined resistance is common ,the suitable treatment scheme should be selected according to genotyping and drug resistance mutations results .%目的：探讨东营地区乙型肝炎病毒（HBV ）基因型分布，乙型肝炎患者耐药情况，HBV基因型别与耐药以及突变位点关系。方法收集乙型肝炎患者血清300例，采用离心柱法提取HBV‐DNA ，聚合酶链反应（PCR）‐反向点杂交法检测 HBV分型和耐药突变。结果300例 HBV‐DNA阳性患者中，检出B型、C型、B／C型及其他未检测出的基因型，未检出D型分型，检出结果中以C型为主，占81．8％；HBV患者耐药药物以拉米夫定和替比夫定的联合耐药为主，占43．6％；HBV耐药突变基因型主要为rt204I（24．35％）、rt204V （17．39％）及rt180M （17．39％）；B型和C型的耐药突变率分别为30．77％和42．42％，差异有统计学意义（P＜0．05）。结论东营地区HBV基因C型多于B型，C型容易产生耐药，以rt204I ，rt204V及rt180M基因突变型多见，拉米夫定和替比夫定的联合耐药多见，应根据基因分型和耐药突变结果对乙型肝炎患者选择适合的治疗方案。