PC/BCP突变对HBeAg阳性慢性乙型肝炎患者血清转化和复发的影响,这些患者接受了核酸类类似物治疗
Shulin Xia1, Xiaomin He1, Jianhe Gan2
1Department of Infectious Diseases, The Taixing People's Hospital, Taixing City, Taizhou, Jiangsu, 225400, People's Republic of China.
Infection and drug resistance
|November 21, 2025
概括
在乙型肝炎病毒 (HBV) 中的前核/基核促成因子 (PC/BCP) 突变显著降低了血清转化率,并增加了使用核类相应物 (NA) 治疗的慢性乙型肝炎 (CHB) 患者的复发率. 建议对个性化NA疗法进行这些突变的常规测试.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 病毒学 病毒学
- 分子生物学分子生物学
背景情况:
- 在乙型肝炎病毒 (HBV) 中的前核/基底核促进子 (PC/BCP) 突变是免疫逃避和抗病毒耐药性的关键.
- 这些突变在HBeAg阳性慢性乙型肝炎 (CHB) 患者中很常见,往往导致对核胺类类似物 (NA) 的反应不佳,治疗后复发率高.
研究的目的:
- 研究PC/BCP突变对NA治疗后HBV血清转化和复发率的影响.
- 分析突变数和特定的PC/BCP突变 (A1762T,G1764A,G1896A) 与临床结果之间的关联.
- 评估PC/BCP突变在耐药性机制中的作用.
主要方法:
- 分析了48名HBeAg阳性CHB患者,他们在2016-2019年期间接受了NA治疗.
- 根据PC/BCP突变状态 (突变与非突变) 将患者划分为组.
- 在NA治疗144周后的血清转化率和在停药48周后的复发率的评估,与基线病毒载量,ALT和突变状态相关.
主要成果:
- 与非突变组 (81.8%) 相比,突变组的血清转化率明显较低 (37.8%).
- 随着突变数量的增加,血清转化率下降,三重突变显示的最低率.
- 突变组具有100%的复发率与HBeAg重新激活,与0%的非突变组相比.
结论:
- PC/BCP突变是HBeAg阳性CHB患者NA反应不良和复发率高的独立预测因素.
- 患有PC/BCP突变的患者的管理应将其视为类似于"隐藏的HBeAg阴性CHB",以防止过早停止治疗.
- 常规PC/BCP突变检测对于指导个性化NA治疗持续时间和优化CHB患者的结果至关重要.
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