肝组织 cccDNA 动态变化评价 HBV 基因型与恩替卡韦抗病毒疗效的关系

摘要

Objective To evaluate the relationship between hepatitis B virus (HBV) genotypes and entecavir effica-cy.Methods A total of 88 HBeAg -positive patients with chronic hepatitis B (CHB) were randomly selected and ad-ministrated with entecavir for 96 weeks.Their HBV genotypes were determined before treatment.Meanwhile, the levels of HBV covalently closed circular DNA (cccDNA), serum HBV cccDNA, HBV DNA, HBsAg, and HBeAg in the liver as well as hepatic function were detected immediately, 24, 48 and 96 weeks after treatment.Results No statistical difference was detected as to the levels of ALT, cccDNA and serological indexes between CHB patients with genotypes B and C (P >0.05).After 96 weeks of treatment, patients carrying genotype B presented remarkable lower quantities of cccDNA and substantially reduced rates of serological responses than genotype C carriers (P <0.05).Conclusion There is not direct relationship between HBV genotype and the level of cccDNA, serological indexes and liver function in CHB patients of Xuzhou.Entecavir produces superior anti -viral efficacy in genotype B carriers than those carrying geno-type C.It is of importance to determine HBV genotypes and the level of cccDNA in the liver, and related serological in-dexes for improvement of clinical efficacy of CHB treatment.%目的：评价乙型肝炎病毒（HBV）基因型与恩替卡韦抗病毒疗效的关系。方法对随机选取的88例HBV e 抗原（HBeAg）阳性的慢性乙型病毒性肝炎（CHB）患者给予恩替卡韦抗病毒治疗96周，治疗前确定 HBV基因型，分别于治疗前及治疗后24、48、96周检测肝组织 HBV 共价闭合环状 DNA（cccDNA）、血清 HBV cccDNA、HBV DNA、HBV 表面抗原（HBsAg）、HBeAg 定量、肝功能等指标。结果本组 B、C 基因型 CHB 患者谷氨酸氨基转移酶（ALT）水平、肝组织 cccDNA 及血清学指标含量的差异无统计学意义（P ＞0．05）；B 型与 C 型基因患者在恩替卡韦治疗96周时，肝组织 HBV cccDNA、血清学应答率的差异有统计学意义（P ＜0．05），B 型下降幅度大于 C型。结论徐州地区 CHB 患者 HBV 基因型与肝组织 HBV cccDNA 含量、血清学指标及肝功能水平无直接关系。恩替卡韦的抗病毒疗效 B 基因型优于 C 基因型。检测 HBV 基因型及肝组织 HBV cccDNA、相关血清学指标对于临床优化 CHB 抗病毒治疗方案、评价疗效有重要意义。