CAJ | 학술논문

尽管经过几十年的预防和控制,我国仍是HBV感染率较高的国家之一.创新HBV耐药突变和基因分型实验诊断平台、提升CHB患者管理水平已势在必行,具体应包括三个方面:一是要根据实验室的实际情况,合理选择耐药突变检测平台；二是要创建简便实用的基因分型平台,实时监测HBV基因型；三是要结合临床,探究不同药物治疗中基因型耐药-表型耐药-临床耐药的相互关系,确定导致表型耐药的突变株的比例或阈值,明确HBV基因组的多态性(即基因型)对临床预后的影响,为CHB个体化诊疗和预后判断奠定基础.
진관경과궤십년적예방화공제,아국잉시HBV감염솔교고적국가지일.창신HBV내약돌변화기인분형실험진단평태、제승CHB환자관리수평이세재필행,구체응포괄삼개방면:일시요근거실험실적실제정황,합리선택내약돌변검측평태；이시요창건간편실용적기인분형평태,실시감측HBV기인형；삼시요결합림상,탐구불동약물치료중기인형내약-표형내약-림상내약적상호관계,학정도치표형내약적돌변주적비례혹역치,명학HBV기인조적다태성(즉기인형)대림상예후적영향,위CHB개체화진료화예후판단전정기출.
Despite decades of the prevention and control.China is still one of the countries with high prevalence of hepatitis B virus (HBV).It is imperative for us to innovate.Lab diagnostic platforms for drug-resistant mutation and HBV genotyping to enhance the management level in patients with CHB.Specifically,the following three strategies should be included:firstly,choose an appropriate platform for drug-resistant mutation detection according to the actual situation in laboratory.Secondly,establish a practical and simple genotyping platform for real-time monitoring of HBV genotypes.Thirdly,combined with clinical,explore the correlation among genotypic resistance,phenotypic resistance and clinical resistance when different medications are adopted,confirm the percentage or threshold of resistant strains causing clinical resistance,and ascertain the influence of HBV genome polymorphism (genotype) on clinical prognosis.These strategies above mentioned will lay a foundation for CHB personalized treatment and prognosis.