The Regulation Of HBV Mutational Sites In Natural Mutation And Interferon-induced Mutation And Relationship Between HBV Mutation And Antiviral Medicine

ObjectiveThis study is designed to compare the similarities and differences of HBV-corepromoter（BCP）/precore/core gene mutations between natural mutation and themutation induced by interferon．Furthermore， we analyzed the existence of specificmutations caused by ordinary interferon．In addition，the short-term antiviral efficacyof ordinary interferon and lamivudine in HBV-BCP/pre C/C natural mutation wasalso compared．We observed the short-term antiviral efficacy of pegylated interferonα-2a and lamivudine in common interferon-induced HBV gene mutation．ApproachWe gathered the clinical data of104chronic hepatitis B patients accompaniedwith the gene mutations in the HBV core promoter（BCP）region and the precore/coreregion in Infectious Diseases department of the First Affiliated Hospital of Zhengzhou University．The patients received the interferon treatment were collectedin interferon-induced mutation group(B group，40cases)，whereas the ones in naturalmutation group (A group，60cases) were not treated with interferon treatment． Thenwe analyzed the regularity of gene mutations locus in the two groups，and studied thepresence of the specific mutation sites caused by interferon．In addition the ones ingroup A was divided into ordinary interferon group (group A1，32cases) andlamivudine group (group A2，28cases) according to the selection of the antiviraldrug．Then the ALT and HBV-DNA level were detected in the two groups after6months．We also divided the patients in group B into pegylated interferon group(group B1，16cases) and lamivudine group (group B2，28cases) on the basis of thesecond antiviral medicine．Six months later，we tested the levels of ALT andHBV-DNA and analyzed the short-term response rates．Result1. The mutation rates of pre-C area G1896A loci in group A was73.33%，meanwhile that in group B was68.18%．There wasn’t significant difference betweenthe two group (P>0.05)．BCP area Two loci (A1762T and G1764A locus) mutationrates in the two groups were71.67%and65.90%respectively．And there was nosignificant difference between two groups (P>0.05)．But the C gene (I97L，S87G，L60V) mutation rates in group B was significantly higher than group A (P<0.05)．2. Group A1(32cases of natural variation) and group A2(28cases of naturalvariation) were respectively treated with Ordinary interferon and lamivudine for sixmonths，the recovery rate of ALT were respectively90.63%and93.75%in the twogroups，And there was no significant difference (P>0.05)，And the negative rate ofHBV-DNA in the two groups were respectively96.43%and100%，And there was nosignificant difference (P>0.05)．3. The group B (44cases of interferon induced HBV mutation) were stopped toapplication ordinary interferon，Then group B1（28cases received lamivudinetreatment）and group B2(16cases received lamivudine treatment) were both received the sencond antiviral therapy for6months，they were respectively receive pegylatedinterferon and lamivudine antiviral therapy，The recovery rate of ALT and negativerate of HBV-DNA in group B1were significantly lower than that in B2group，thedifferences were statistically significant (P <0.05)．Conclusion1. The precore region gene G1896A loci and BCP area Two loci (A1762T andG1764A locus) mutation rates are both high in the patients with HBV naturalmutation and interferon induced mutation，and there is no significant differencebetween the two groups，But the hot spot mutations (I97L，S87G，L60V) of C generegion in the interferon induced mutation group is obviously up-regulated than that innatural mutation group，we inferred that hot spot mutations (I97L，S87G，L60V) ofHBV-C gene region may be caused by the long-term treatment by interferon．2. Interferon and lamivudine both have high resently response rates in thepatients with HBV-core promoter（CP）and the precore/core gene mutations．3. The antiviral effect by lamivudine is better than that by pegylated interferon inthe patients with interferon induced HBV-core promoter（CP）and the precore/coregene mutation．...