| Object:To identify the relationship between HBV RT sequencing before treatment of chronic hepatitis B (CHB) patients and the efficacy of one year of telbivudine(LDT) therapy.Methods:Fifty-one nucleoside-naive HBV DNA positive patients with chronic hepatitis B (CHB) were recruited and received LDT treatment for 48 weeks.The rtM204 and rtL 180 mutations were detected at baseline by DNA sequencing. Serum HBV DNA which was quantified by polymerase chain reaction(PCR) and alanine aminotransferase(ALT) were surveyed at 0,12,24,48 weeks of treatment. Patients without HBV RT sequence mutation were divided into group A,Patients with HBV RT sequence mutation were divided into group B,to analysis whether there are differences between different gene sequences and efficacy of LDT treatment.Results:There were seven cases with HBV RT sequence mutation at baseline of LDT,and the mutation sites were rtL 180M and rtM204I.There were no significant differences in basic demography,clinical,and virological characteristics in group A and group B at baseline.In week 12,24,48, more patients in group A achieved undetectable serum HBV DNA levels than group B[47.7%(21/44) versus 0%(0/7),56.9%(25/44) versus 0%(0/7),70.5%(31/44) versus 0%(0/7),p<0.05).Group A had a higher ALT normalization rate than group B in week 24 and 48[65.9%(29/44) versus 28.6%(2/7),p<0.05; 79.6%(35/44) versus 42.9%(3/7),p<0.05]. Virological breakthrough occurred in two cases and biochemical breakthrough occurred in one case in the 48 weeks of treatment,these three cases were found rtM204L existed by re-detected DNA sequencing.Conclusion:The rtM204I and / or rtL180M mutations at baseline in HBV RT sequencing could affect the virological and biochemical response in CHB patients treated with LDT 1 year.Detect HBV RT sequencing at baseline could contribute to select the available drug and satisfying effect when the patients treated with nucleoside analogues. |
PDF Full Text Request