Analysis HBV Resistant Mutations And Releated Factors About Nucleoside Analogues Treatment For CHB By Lamivudine Failure

Objective：To investigate the treatment of nucleoside analogues in lamivudineprimary non-response of chronic hepatitis B HBVP zone gene mutations and relatedfactors. Methods：A retrospective analysis of193cases of chronic hepatitis B patientshospitalized from January2010to December2011, the First Affiliated Hospital ofXinjiang Medical University.Lamivudine in the treatment of primary non-responsefollow-up to save the treatment program is divided into direct withdrawal group (N=59),continued lamivudine group (N=58) and the dressing group (N=75), the treatment timeis more than3months, with or without the detection HBVP gene mutations affect itsmutation analysis. Results：The follow-up treatment programs in193cases of primaryresponse failure of lamivudine, its HBVP region genes of the total mutation rate was73.6%(142/193), and direct withdrawal group94.9%,(56/59),continued lamivudine group74.1%,(43/58),dressing group47.4%,(36/76), a variety of nucleoside analogues,lamivudine (84.6%,99/117)＞adefovir (60.7%,17/28)＞entecavir (56.2%,9/16)＞lamivudine+adefovir dipivoxil (36.4%,4/11)＞telbivudine (28.6%,6/21).HBV P genemutation is higher,and most of lamivudine rtM204I/V mutations, the mutant mode ofrtL180M+rtM204I+rtM204V is more than others; Logistic binary regression analysisshowed direct withdrawal(P=0.000, OR=15.912), continued lamivudine (P=0.007,OR=4.26) and high load HBVDNA (P=0.000, OR=13.557) are risk factors for HBV Pgene mutations. Conclusion：In the treatment of lamivudine primary non-responsefollow-up treatment programs, HBV P gene mutation is higher,and most of lamivudinertM204I/V mutations, the mutant mode of rtL180M+rtM204I+rtM204V is more thanothers; Logistic binary regression analysis of direct withdrawal, continued lamivudine and high load HBVDNA are risk factors of HBV P gene mutation.