昆明地区 1 452 例低病毒载量慢乙肝患者耐药突变相关位点的分析.

Objective　To analyze and study the genotyping and drug resistance mutation sites of hepatitis B patients with low viral load in Kunming，so as to determine the difficulty of clinical antiviral treatment for low viral load hepatitis B patients and formulate individualized antiviral precision medicine programs. Methods　A total of 1 452 chronic hepatitis B patients with low viral load （HBV DNA < 2.0×10³ IU/mL） were selected for hepatitis B typing and drug resistance gene loci detection. Results　The proportion of HBeAg-negative patients in the low-load hepatitis B population in Kunming was higher （59.5%），and the proportion of male patients （70.6%） was higher than that of female patients. The age distribution was mainly 30-60 years old （72.7%）. Genotyping The C genotype accounted for the highest proportion （61.8%）. Among the 1 452 low-load hepatitis B patients in Kunming area，a total of 37 patients were detected with drug-resistant mutation sites. The drug resistance rates of lamivudine and emtricitabine were consistent （ 1.6%），and the drug resistance rate of telbivudine was the same 1.2%，adefovir resistance rate was 0.9%，entecavir resistance rate was 0.2%，and tenofovir resistance mutation sites were not detected. In addition to drug resistance mutation sites，112 other mutation sites were also detected，among which S256G， S213T， N/H238T/D， Q215H had the highest detection rate， and the mutation site with the lowest detection rate was A194T. Conclusion　The hepatitis B genotype in Kunming is mainly C type，which indicates that the distribution of HBV genotype in this area has independent characteristics. The resistance rate of entecavir in patients with hepatitis B with low viral load in Kunming area was the lowest，and TDF resistance was not found，but their sensitivity to tenofovir dipivoxil decreased. There is still some controversy whether the detected other mutation sites are related to drug resistance，but the detection rate also has a certain proportion. [ABSTRACT FROM AUTHOR]