CAJ | 학술논문

[目的]探讨乙型肝炎病毒（HBV）Bcp/pc 区变异位点与拉米夫定抗病毒治疗后 HBV DNA 反弹的关系。[方法]检测41例拉米夫定治疗（100 mg/d）1年以上，达到病毒学应答半年以上，再出现 HBV DNA 反弹的乙型肝炎患者（反弹组），以及36例拉米夫定治疗 HBV DNA 持续阴性患者（对照组）的 Bcp/pc 区突变位点。[结果]反弹组治疗后 BCP T1762/A1764双突变检出率（75．6％）高于治疗前检出率（48．8％，P ＝0．023），同时也高于对照组检出率（39．0％，P ＝0．010）。反弹组41例中 YMDD 变异检出率为63．4％（26/41）。经多因素回归分析发现，YMDD 变异（OR＝55．323，P ＜0．001）、BCPT1762/A1764双突变（OR＝10．851，P ＝0．013）是 HBV DNA 反弹的独立预测因素，而前 C 区 A1896突变与 HBV DNA 反弹无明显关联。[结论]BCPA1762T/G1764A双突变可能与拉米夫定治疗后 HBV DNA 反弹有关。
[목적]탐토을형간염병독（HBV）Bcp/pc 구변이위점여랍미부정항병독치료후 HBV DNA 반탄적관계。[방법]검측41례랍미부정치료（100 mg/d）1년이상，체도병독학응답반년이상，재출현 HBV DNA 반탄적을형간염환자（반탄조），이급36례랍미부정치료 HBV DNA 지속음성환자（대조조）적 Bcp/pc 구돌변위점。[결과]반탄조치료후 BCP T1762/A1764쌍돌변검출솔（75．6％）고우치료전검출솔（48．8％，P ＝0．023），동시야고우대조조검출솔（39．0％，P ＝0．010）。반탄조41례중 YMDD 변이검출솔위63．4％（26/41）。경다인소회귀분석발현，YMDD 변이（OR＝55．323，P ＜0．001）、BCPT1762/A1764쌍돌변（OR＝10．851，P ＝0．013）시 HBV DNA 반탄적독립예측인소，이전 C 구 A1896돌변여 HBV DNA 반탄무명현관련。[결론]BCPA1762T/G1764A쌍돌변가능여랍미부정치료후 HBV DNA 반탄유관。
[Objective]To explore the relationship between the mutations of hepatitis B virus(HBV)Bcp/pc area and HBVDNA rebound after lamivudine antiviral therapy.[Methods]Mutations of HBV Bcp/pc area of 41 hepatitis B patients with HBVDNA rebound after 100mg/d lamivudine therapy for more than one year and virology response for more than half a year(rebound group)and 36 patients with continuous negative HBVDNA(control group)were detected.[Results]The detection rate of dual mutations of BCP T1762/A1764 in rebound group (75.6%)after treatment was higher than that before treatment(48.8%)(P =0.023),and also higher than that in control group(39.0%)(P =0.010).The detection rate of YMDD mutation in 41 patients of rebound group was 63.4%(26/41).Multivariate regression analysis showed that YMDD mutation(OR= 55.323,P < 0.001)and BCPT1762/A1764 double mutations(OR=10.851,P =0.013)were independent predictive factors of HBVDNA rebound,while A1896 mutation in pre-C area had no obvious correlation with HBVDNA rebound.[Conclusion]BCPA1762T/G1764A double mutants may be associated with HBVDNA rebound after lamivudine treatment.