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目的:观察恩替卡韦(entecavir,ETV)初治慢性乙型肝炎(chronic hepatitis B,CHB)患者体内乙型肝炎病毒(hepatitis B virus,HBV)基因型的变化情况.方法:选取中山大学附属第三医院随访门诊38例留有系列血清的ETV初治CHB患者为研究对象,其中14例留有基线血清,检测ETV初治基线、1、3、6、9、12、24 mo时间点的血清.标本经提取HBV DNA,巢氏PCR扩增HBV逆转录酶(reverse transcriptase,RT)区基因,凝胶电泳鉴定后行基因测序及基因型分型.结果:38例患者,100份血清纳入分析,所测血清标本中,基因型B型80例,C型20例,未发现其他如A、D、E、F、G、H、I、J等基因型.11例(28.9%)患者在ETV抗病毒治疗过程中基因型发生了改变,6例从C型变成B型,5例从B型变成C型.14例留有基线血清的患者中,5例患者基因型发生了改变,2例从B型变为C型,3例从C型变为B型,进化树分析显示这些患者在基线与基因型改变时间点的基因序列的遗传距离也发生改变.结论:ETV初治CHB患者HBV基因型可发生改变,但其原因及意义有待于进一步研究.
Objective: To observe the change of hepatitis B virus (HBV) genotypes in patients with entecavir (ETV) newly diagnosed chronic hepatitis B (CHB) .Methods: The third affiliated hospital of Sun Yat-sen University Thirty-eight outpatients with ETV-untreated CHB were enrolled in this study, of whom 14 had baseline serum, and sera from baseline ETV-treated patients at 1, 3, 6, 9, 12 and 24 months were also detected. After HBV DNA was extracted, reverse transcriptase (RT) gene was amplified by nested PCR and sequenced and genotyped by gel electrophoresis.Results: Among the 38 patients, 100 serum samples were included in the analysis, Among the serum samples, genotype B was 80 and genotype C 20, no other genotypes such as A, D, E, F, G, H, I and J were found.11 cases (28.9% Genotypes changed during the course of virus treatment, with 6 cases changing from C to B and 5 from B to C. Of the 14 patients with baseline serum, 5 had a genotype change, 2 Cases changed from type B to type C, and from type C to type B in three cases. Phylogenetic tree analysis showed that these patients had significant differences in gene sequence between baseline and genotype Transmission distance is changed conclusion:. ETV-naïve patients with CHB HBV genotype changes can occur, but its causes and significance needs further study.