【摘要】 目的了解预存耐药检测对核苷(酸)类似物抗病毒治疗的影响。方法 127例慢性乙型肝炎患者,分治疗组与对照组。治疗组患者用药前进行预存耐药检测,对照组不进行测序。疗程96周,停药后随访24周。结果预存耐药检出率为17.19%;治疗后总耐药发生率治疗组低于对照组(P<0.01)。48周、96周HBV DNA阴转率、HBeAg/抗-HBe血清学转换率治疗组均高于对照组(P<0.05)。结论预存耐药与核苷(酸)类似物耐药和治疗应答密切相关;治疗前进行预存耐药检测对指导临床个体化抗病毒治疗和预防耐药的发生有实用价值。更多还原

【Abstract】 Objective To study the clinical benefit of detecting pre-existing resistance to nucleos(t) ide analogue-based anti-viral therapy.Methods One-hundred-and-twenty-seven patients with chronic hepatitis B were enrolled in the study.Sixty-four of the cases were assigned to the experimental group,in which the hepatitis B virus(HBV) DNA was sequenced to detect the known nucleos(t) ide analogue-resistance mutations prior to treatment initiation.The remaining 63 cases were administered treatment without prior sequencing.The nucleos(t) ide analogue treatment course lasted 96 weeks,and all patients were followed-up for 24 weeks after treatment discontinuation.Results The pre-existing resistance detection rate was 17.2%.The total incidence of resistance was lower in the detected group than in the control group(P < 0.01).After treatment for 48 weeks and 96 weeks,the HBV DNA-negative conversion rate and the hepatitis B e antigen(HBeAg)/anti-HBe antibody serological conversion rate were both higher in the detected group than in the control group(P < 0.05).Conclusion s Since pre-existing resistance to nucleos(t) ide analogues is a critical determinant of a patient’s response to treatment,detecting known nucleos(t) ide analogue-resistance mutations by genotyping prior to treatment initiation has practical value to guide individualized antiviral treatment and prevent the complications associated with inappropriate treatment of drug-resistant patients.更多还原