Common mutations of hepatitis B virus and their clinical significance
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摘要: HBV基因组特殊的结构及生活周期特点决定了其易于突变。突变改变了病毒的生物学行为和对抗病毒药物的敏感性,影响治疗效果和疾病的进展。前S/S开放读码框(ORF)以点突变为主,可引起免疫逃避,与隐匿性HBV感染有关;前C/C-ORF以G1896A突变常见,与HBe Ag阴性慢性乙型肝炎(CHB)、肝细胞癌(HCC)、慢性重型肝炎(肝衰竭)的发生相关;P-ORF的突变主要发生在逆转录酶区(RT区),与核苷和核苷酸类药物的耐药关系密切;X-ORF突变主要是重叠于该区的核心启动子的A1762T和G1764A的双突变,与HBe Ag阴性CHB、HCC、慢性重型肝炎(肝衰竭)相关。明确这些突变与疾病的关系,可为HBV感染者制订个体化的诊疗方案。Abstract: Hepatitis B virus( HBV) tends to mutate easily due to its special structure and life cycle. Mutation changes the biological behavior of HBV and its sensitivity to antiviral drugs and even affects therapeutic effect and accelerate disease progression. The point mutations are commonly see in the pre- S / S open reading frame( ORF),which may be associated with immune escape and occult HBV infection. The G1896 A mutation is often observed in the pre- C / C- ORF and is associated with the development of HBe Ag- negative chronic hepatitis B( CHB),hepatocellular carcinoma( HCC),and severe chronic hepatitis( liver failure). The mutations in P- ORF mainly occur in the reverse transcriptase( RT) domain and are closely related to the resistance to nucleos( t) ide analogues. The A1762 T and G1764 A mutations occur in the basal core promoter( BCP),which overlaps with X- ORF,and may be associated with HBe Ag- negative CHB,HCC,and severe chronic hepatitis( liver failure). Clarification of the association between these mutations and diseases helps to develop tailor- made diagnostic and therapeutic regimens for patients with HBV infection.
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Key words:
- hepatitis B virus /
- genome /
- mutation /
- drug resistance
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