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目的 研究乙型肝炎病毒基因组X区和前C/C区多部位变异对干扰素 (IFN)治疗的影响。方法 利用套式聚合酶链反应产物直接测序技术 ,测定 1 7例慢性乙型肝炎患者IFN治疗前病毒核苷酸序列。结果 5例T1 76 2 A1 76 4变异株感染者均对IFN治疗有应答 ,而在 1 2例无T1 76 2 A1 76 4 突变患者中仅 3例有应答。在 8例A1 896 变异株感染者中 ,5例同时伴C区B细胞表位aa1 0 7～ 1 1 8突变 ,其中 4例对治疗无应答 ,仅 1例有应答 ;1例同时伴C区 5个淋巴细胞表位突变者无应答 ;2例分别伴 1个和 2个C区淋巴细胞表位突变者对治疗有应答。结论 T1 76 2 A1 76 4 变异者疗效好 ,而A1 896 变异者疗效不一致可能与C区淋巴细胞表位突变有关
Objective To study the effect of hepatitis B virus genomic X-region and pre-C / C multi-site mutation on interferon (IFN) therapy. Methods Direct sequencing of nested polymerase chain reaction (PCR) products was used to determine the nucleotide sequence of virus before treatment of IFN in 17 chronic hepatitis B patients. Results Five patients with T1 76 2 A1 76 4 infection responded to IFN treatment, whereas only 3 of 12 patients without T1 76 2 A1 76 4 response responded. Among 8 cases of A1 896 mutants infected, 5 cases were accompanied by aa1 0 7 ~ 1 18 mutation of B cell epitopes in C area, of which 4 cases did not respond to treatment and only 1 case had response. One case was accompanied by C region Five lymphocyte epitope mutants had no response; two patients with mutations in one and two C-region lymphocyte epitopes, respectively, responded to treatment. Conclusion Variants T1 76 2 A1 76 4 have good curative effect, whereas those with A1 896 variability may be related to the mutation of lymphocyte epitopes in C area