Investigation Analysis On Natural Mutation Of RtM204 And RtN236 In HBV Polymerase Region In Chronic Hepatitis B Patients In Fujian Province

Objectives:1. To investigate the natural frequencies of rtM204 mutation in HBV polymerase in patients with mild hepatitis, moderate hepatitis, serve hepatitis or liver cirrhosis, and cinical significance.2. To investigate the natural frequencies of rtN2236 mutation in HBV polymerase region in patients with mild hepatitis, moderate hepatitis, serve hepatitis or liver cirrhosis, and to observe the correlations between rtN2236T and disease progress.MethodsReal-time fluorescence quantitative PCR was used to assay rtM204 mutation and PCR-RFLP methods was used to detect rtN236 mutation.Results1. There were 5 individuals (2%) with rtM204V/I mutation in 250 patients, including one patient with YIDD, two with YVDD and two with YI/VDD. 56.4%(141/250) of patients were with HBV C genotype, and 43.6%(109/250) patients with genotype B. There is no significant difference in the distribution of the clinic types between rtM204V/I mutation group and the non mutation group(including the chronic light degree﹨chronic mid-range﹨chronic severe degree﹨cirrhosis caused by hepatitis B virus).rtM204V/I mutation was not associated with HBV genotype, patients gender, HBeAg+/-, HBV-DNA loads, ALT, AST or disease severity, but age(45.00±12.96 vs.34.38±11.36, p=0.04).2. Natural incidences of HBV rtN236T mutation was approximate 2.25%(4/178), and this mutation was irrelevant to the distribution of the clinic types(including the chronic light degree﹨chronic mid-range﹨chronic severe degree﹨cirrhosis caused by hepatitis B virus).Conclusions1. Natural mutation of rtM204V/I and rtN236T were both presented in chronic hepatitis B patients without antiviral treatment, but with infrequent incidence in Fujian province. The presentation of natural mutation of rtM204V/I and rtN236T might probably responsible for non-response to nucleotide(analog) antiviral drugs. 2. The major genotypes of HBV in patients without nucleotide(analog) antiviral drugs were genotype C and B, which was coincident with dominant genotype on epidemiology in Fujian province.