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近年来,拉米夫定(3TC)已成为临床上抗乙型肝炎病毒(HBV)最常用的药物之一,大量的报道显示长期应用3TC可诱发HBV P区变异,其主要表现形式为酪氨酸-蛋氨酸-天冬氨酸-天冬氨酸基序(YMDD),从而形成3TC耐药株,这将使患者对3TC产生耐药,甚至导致病情恶化。因此,HBV P区YMDD变异日益受到关注。现根据近年来对HBV YMDD变异的研究报道,对HBV YMDD的发生机制、出现的可能相关因素以及变异的影响和对策等方面对HBV YMDD变异研究予以综述。
In recent years, lamivudine (3TC) has become one of the most commonly used anti-hepatitis B virus (HBV) drugs clinically, a large number of reports show that long-term use of 3TC can induce HBV P region variation, the main manifestations of tyramine Acid-aspartic acid-aspartic acid-aspartic acid motif (YMDD), resulting in a 3TC-resistant strain that will render the patient resistant to 3TC and may even lead to a worsened condition. Therefore, HBV P region YMDD mutation has drawn increasing attention. Now based on the study of HBV YMDD mutation reported in recent years, the mechanism of HBV YMDD, the possible related factors and the impact of variation and countermeasures and other aspects of HBV YMDD mutation are reviewed.