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目的:探讨乙型肝炎病毒(hepatitis B virus,HBV)序列rt238位点的氨基酸多态性与抗病毒治疗、耐药突变及基因型等的关系。方法:采用P区测序法对76例阿德福韦(adefovir,ADV)基因耐药患者、52例拉米夫定(Lamivudine,LAM)基因耐药患者和50例未经抗病毒治疗的慢乙肝患者的血清病毒进行P区测序。结果:在76例ADV基因耐药患者中,rt238的三种不同类型氨基酸在HBV基因型中的分布差异显著(x2=40.196,P=0.000)。Rt H238主要出现在基因型B患者中,rt N238主要出现在基因型C患者中,而rt T238的HBV序列全部为基因型C。控制HBV基因型,rt238氨基酸类型与rt181、rt236位点突变无明显相关。rt T238只出现在ADV和LAM基因耐药组。Rt238位点的氨基酸在不同治疗组中的分布无统计学意义(P=0.127)。结论:Rt238位点的氨基酸多态性与HBV基因型显著相关,是一个基因型依赖位点,rt T238可能是基因型C相关的潜在耐药突变。
Objective: To investigate the relationship between the amino acid polymorphism at rt238 of hepatitis B virus (HBV) sequence and antiviral therapy, drug resistance mutations and genotypes. Methods: Sixty-two adefovir (ADV) -resistant patients, 52 patients with resistant gene Lamivudine (LAM) and 50 patients without chronic hepatitis B Patient’s Serum Viruses Perform P-Region Sequencing. RESULTS: Among 76 ADV-resistant patients, the distribution of three different amino acids of rt238 in HBV genotypes was significantly different (x2 = 40.196, P = 0.000). Rt H238 mainly in genotype B patients, rt N238 mainly in genotype C patients, and rt T238 HBV sequences are all genotype C. HBV genotype control, rt238 amino acid type and rt181, rt236 site mutation was not significantly correlated. rt T238 appeared only in ADV and LAM gene resistant group. There was no statistically significant distribution of amino acids at the Rt238 locus among the different treatment groups (P = 0.127). Conclusion: Amino acid polymorphism at Rt238 locus is significantly associated with HBV genotype, which is a genotype-dependent site. Rt T238 may be a potential drug-resistant mutation associated with genotype C.