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目的 :进一步研究乙肝病毒 (HBV)耐高效抗逆转录疗法 (HAART)的耐药机制。方法 :用 HBV- DNA荧光定量试剂盒 ,定量检测 36例 HAART治疗的 HIV/ HBV重叠感染者中 HBV- DNA,用 HBV- DNA C区和 P区引物常规扩增 HBV- DNA C区和 P区产物 ,PCR产物纯化后测序 ,用 BL AST软件分析序列 ,与国际 HBV基因库对比。结果 :36例 HAART治疗的 HIV/ HBV重叠感染者中 ,HBV- DNA阳性 4例 (11.1% ) ,血清中 HBV- DNA拷贝数 3例在 10 4copies/ ml级 ,1例在 10 7copies/ ml级。对 1例 HBV- DNA在 10 7copies/ ml级标本进行 HBVDNA C区和 P区序列测定 ,用 BL AST软件与国际基因库对比 ,结果 ,C区 nt 2 4 12位 T→ C,nt 2 4 13位 T→ C,P区 nt 74 1位A→ G(YMDD→ YVDD)。结论 :HAART治疗的 HIV/ HBV重叠感染者 ,HBV耐药可能与 HBV- DNA C区和 P区联合变异有关。
Objective: To further study the mechanism of drug resistance of Hepatitis B virus (HBV) resistant high-efficiency anti-transcriptional therapy (HAART). Methods: HBV-DNA was quantified in 36 cases of HAART-treated HIV / HBV coinfected patients by HBV-DNA Fluorescence Quantification Kit. HBV-DNA C region and P region were routinely amplified by HBV-DNA C region and P region primer The PCR products were purified and sequenced. The sequences were analyzed by BLAST software and compared with the international HBV gene bank. Results: Of the 36 HAART-treated HIV / HBV co-infected patients, HBV DNA positive was found in 4 (11.1%) patients, HBV DNA copy number in serum was 3 4 cases / ml and 1 case was 107copies / ml . The HBVDNA C and P region sequences were determined in 1 case of HBV-DNA in 10 7 copies / ml samples. The BLAST software was used to compare with the international gene bank. As a result, nt 2 4 12 T → C, nt 2 4 13 Bit T → C, P region nt 74 1 bit A → G (YMDD → YVDD). Conclusion: The drug resistance of HBV infected by HAART in patients with HIV / HBV overlap may be related to the combined mutation of HBV DNA C region and P region.