153例慢性HBV感染者核苷和核苷酸类药物的耐药变异位点分析

ObjectiveTo amplify and determine the hepatitis B virus (HBV) reverse transcriptase (RT) sequences of 153 Chinese patients with chronic HBV infection and investigate the drug resistance mutations related to nucleos(t)ide analogues, and to analyze if there are drug resistance mutations which might lead to tenofovir resistance. MethodsA total of 153 patients with chronic HBV infection were divided into two groups: 78 HBV carriers who had never used nucleos(t)ide analogues (NAs) and 75 patients with chronic hepatitis B who had been treated with NAs. Their serum samples were used for HBV DNA extraction and RT gene amplification by PCR, and the RT sequences were analyzed to identify the known drug resistance mutations related to NAs and detect the drug resistance mutations related to tenofovir. The obtained data were statistically analyzed using SPSS 19.0; the Student’s t test was used for normally distributed data, and the Wilcoxon’s rank sum test for non-normally distributed data. ResultsDrug resistance mutations related to NAs were detected in 7 cases (8.97%) of the untreated group, but there was no drug resistance mutation related to tenofovir. Drug resistance mutations were detected in 16 cases (2133%) of the treated group, with rtA181T+rtN236T mutations in one case, which might be related to tenofovir resistance. ConclusionThe drug resistance mutation detection rate in untreated group was 8.97%. The drug resistance mutation detection rate was not significantly correlated with HBV genotype and patient’s sex and age in either group. The rtA181T+rtN236T mutations were detected in only one case of the treated group, which indicates a very low rate of pre-existence of tenofovir-related drug resistance mutations in Chinese patients with chronic HBV infection.