The Relationship Between Haptitis HBV Genotypes Andresistance Matuants AP:PA Treatment Of Adefovir Dipivoxil(ADV)

Object:To study the relationship between hepatitis B virus (HBV) genotypes and the efficacy of adefovir dipivoxil treatment; Survey nature resistance mutants in rtl81/rt236 and resistance mutants induced by adefovir(ADV) and analyse the relationship between resistance mutants and hepatitis B virus(HBV) genotypes.Methods:1. All the patients were selectwd randomly by HBVDNA≥105IU/ml and ALT≥2×ULN (HBeAg negative≥104IU/ml) and taking antiviral drug to treat CHB the first time; deleted who were infected by other hepatitis virus complic liver cancer, autoimmunity disease, diabetes and renal disfunction or had taken inhibiter or women in the period of gravidity or suckling in the latest half year. the number of patients is 86 and all of them taked ADV10mg/d for 48 weeks.2.The selected patients were collected blood in vein pre or post-treatment,which were preserved in-80℃freezer.3.HBVDNA was refined in the serum, account to the conservative gene order of Pre-S and S,which was amplified by ntPCR. HBVgenotypes were determined by the size of bp on the agarose gel electrophoresis.4. The levels of serum HBVDNA replication was tested by Fluorescent quantitative PCR,ALT levels was teated by full-automatic biochemical analyzer, HBV serologic markers were detected by ELISA.obverse the relationship between the HBV genotypes and the antiviral efficacy of adefovir dipivoxil treatment.5.10 patients with good effect whose HBV DNA could be detected,all the patients in vain and virus breakthrough were selected to dctect HBVgene locus by nt PCR,Obversing whether resistance mutants exists in rt181/rt236 and the relationship between resistance mutants and HBV genotypes.Result:Of the 86 patients, genotypes B HBV were found in 26 (30.23%),C in 54(62.79%) and B+C in 6(6.98%). s, the levels of serum HBVDNA replication,ALT levers,HBV serologic markers had no defference between genotypes B and C(P＞0.05). there was no statistically significant difference in the rate of HBVDNA restricted in effect,HBVDNA undetectability, the normalization of ALT,HBeAg and HBeAg/HBeAb between patients with genotypes B or C HBV after 12 weeks,24 weeks,48 weeks.(P> 0.05) After 48weeks treatment,78 patients were with good effect and 9 in vain and 1 virus breakthrough.All the samples selected were not found resistance mutants in rtA181 V/T/rtN236Tconclusion:Genotypes B of HBV could have the same response to ADV therapy as genotype C,The study did not found nature resistance mutants and adefovir-resistance mutants in rt181/rt236 and the rate of adefovir resistance mutants is 0 after one year.