Molecular Epidemiology Of Hepatitis B Virus Genotyping And Drug Resistance Mutation In Ningxia

Objective: To study the changes in HBV-DNA load,serological markers,and liver function-related indicators in patients with chronic hepatitis B in Ningxia.To identify the dominant genotypes of patients with chronic hepatitis B in Ningxia,and to analyze whether there is a correlation between genotypes and resistance mutations.To understand the prevalence of drug resistance mutation patterns in patients with chronic hepatitis B in Ningxia,and to provide theoretical basis for personalized medicine.Methods: This study randomly selected 226 patients with CHB samples,and the clinical data of each specimen were complete.Fluorescence quantitative PCR was used to detect the HBV-DNA load of the samples using chemiluminescent microparticle immunoassay.The drug resistance mutations were detected by direct sequencing and the genotypes were analyzed.The above data were statistically analyzed in combination with the collected clinical case data.Results:1.With the gradual increase of HBV-DNA levels,the content of HBe Ag also increased significantly,but the level of HBs Ag gradually decreased.HBV-DNA levels were positively correlated with HBe Ag and HBe Ab levels(Pearson correlation coefficients were 0.514,0.460;P<0.001),negatively correlated with HBs Ag levels,and were highly correlated(Pearson correlation coefficient was-0.351,P< 0.001).The levels of HBV-DNA and HBe Ab in the HBe Ag-positive group were higher than those in the HBe Ag-negative group(P<0.001),and the ALT levels in the male group were significantly higher than those in the female group(p<0.05),and there was no difference in the indicators among different ethnic groups.There were significant differences in HBV-DNA load,HBs Ab,HBe Ag,and HBe Ab levels between different age groups(p<0.05;p<0.05;p<0.001;p<0.001).The older the HBV-DNA load,the smaller the HBs Ab and HBe Ag levels.2.Of the 226 samples,22 cases accounted for 9.74% of genotype B,168 cases of C genotype accounted for 74.34%,D genotypes accounted for 7.96% cases in 18 cases,and 6.96% in 18 cases.ALT levels in patients with C genotype were significantly higher than those in non-C(p=0.017<0.05)3.Of the 226 samples,41 were resistant mutations.The mutation rate was 18.1%.Among them,the single point mutation rt M204I/V was dominant with a mutation rate of 30.5%.Multisite variation was detected in 13 cases.Two of them were resistant to lamivudine,telbivudine and entecavir.There was a significant difference in the mutation rates of the B genotype and the C genotype between rt184 and rt204(P=0.018*,P=0.022*).The highest mutation rate of the C-type rt204 locus was 44.4%.Conclusion: 1.In Ningxia area,we should pay attention to actively taking preventive control measures in the early stage to block the spread of hepatitis B virus.The consistency of HBV-DNA load and HBe Ag is good,and it can be used as a reliable auxiliary item for judging virus replication in clinical diagnosis and treatment.2.Among the CHB patients in Ningxia,the C genotypes with high degree of liver inflammation have absolute advantages,mainly mutated patterns of rt M204,and are more susceptible to lamivudine resistance than other genotypes.The proportion of D genotypes was significantly higher than before.3.The pattern of drug resistance mutation rate in Ningxia is still mainly based on lamivudine.Due to the presence of common drug resistance sites,the effect of lamivudine resistance should be considered when entecavir is used to avoid multiple drug resistance.