关键词: 乙型肝炎, 乙型肝炎病毒逆转录酶区, 核苷类耐药, 变异

Abstract: Objective To compare the clinical features between patients infected with hepatitis B virus （HBV）presenting A181T/V mutation or A181T/V+N236T mutation in HBV reverse transcriptase region after nucleoside treatment. Methods Fifty-five patients with rtA181T/V mutation and 34 patients with rtA181T/V+rtN236T mutation were enrolled in this study. Their administration of nucleoside analogues was reviewed;Serum ALT, AST,HBV M and HBV DNA were detected;HBV genotypes were determined by DNA sequencing. Results In adefovir treatment group,the A181T/V+N236T mutation was more common than rtA181T/V mutation（57.6% vs. 42.4%,P<0.05）,while the occurrence of rtA181T/V mutation was higher than A181T/V+N236T mutation in patients receiving lamivudine treatment（75.5% vs. 24.5%,P<0.05）;In the total 89 patients in our series,there were 14 cases with genotypes B and 75 cases with genotype C of HBV infection,and there was no significant difference in the distribution of mutations between patients with either of the two genotype infection; There were no statistical differences as respect to age,gender,ALT,AST,HBV DNA, HBsAg titers and HBeAg status between the two groups of patients with different mutations. Conclusions A given nucleoside analogue treatment leads to specific pattern of HBV reverse transcriptase region mutation;However,there is no special clinical significance between different mutations.

Key words: Hepatitis B, Nucleoside analogues, Reverse transcriptase region, Mutation