关键词:  肝炎病毒, 乙型;P基因区变异;替比夫定

Abstract:

Objective
Through the study on HBV P gene sequences of RT resistance mutation patterns and drug resistence of telbivudine in treating with the chronic HBV infeceted patients to discuss the main resistance mutation patterns and drug resistence of telbivudine.Methods The recombinant clone sequencing assay was used to detect HBV P gene sequence  in 47 patients who received telbivudine treatment for 1 year,2 years,and 5 years.  Results In the patients received telbivudine treatment for one year,2 cases(4.26%)had common variable sites,P gene region of mutation patterns was rtM204I;for 2 years,10 cases(21.28%) had variable sites,9 cases of mutation model rtM204I, 1 case mutation model rtL180M + rtM204I;for 5 years, 24 cases(51.06%) had common variable sites variation patterns, 16 cases(66.7%) of rtM204I,4 cases(16.7%)of rtL180M + rtM204I. There were also rtL181V + rtM204I,rtM204V,rtM204I + rtN238H, rtL180M + rtM204I + rtD263E each 1 case. Conclusion The main telbivudine resistance mutation models  are rtM204I and rtL180M + rtM204I.The resistance rates of telbivudine treatment for 1,2,5 years are 4.26%,21.28%,and 51.06%,respectively.And the 5-year resistance rate is significantly lower than that of the 4-year resistance rate of lamivudine,but the resistance rate of telbivudine is higher than that of adefovir.

Key words: hepatitis B virus;P gene mutation;telbivudine