Influence of LAM or LAM combined with ECV treatment on drug-resistant gene mutations of different HBV genotypes in patients with CHB

ZHAO Shuai; SUN Jing-na; BAI Xue-mei; LI Yan-ming; GENG Yu-lan; LIU Rong-xin

doi:10.3969/j.issn.1002-266X.2015.45.002

Abstract：Objective To observe the drug-resistant gene mutations of different HBV genotypes of patients with chron-ic hepatitis B (CHB) after treatment of lamivudine (LAM) or the combined treatment of entecavir (ECV) and LAM. Methods One hundred CHB patients with 30 cases of genotype B and 70 cases of genotype C were randomly divided into two groups:the combination group and the single-drug group , 50 patients in each group .The combination group was treated with 50 mg LAM and 0.5 mg ECV everyday orally .The single-drug group was treated with 100 mg LAM orally.After a 24-month-treatment, we detected HBV genotype and gene mutations by PCR-RD blot.Results In the combination group , 4 cases (8%) of resistance gene mutations were detected with the types of rtT 184L+L180M+M204V, rtT184L+S202G+L180M+M204I and rtM250L+M204I, and there were 3 cases (mutation rate 9.1%) of genotype C and 1 case (5.9%) of genotype B .In the single-drug group , 25 cases ( 50%) of resistance gene mutations were detected with the types of rtL180M+M204V, rtL180M +M204I and rtM204I, and there were 18 cases (48.6%) of genotype C and 7 cases (53.8%) of genotype B.Significant different was found in the rate of drug-resistant mutation between the two groups (P<0.05).There was no significant difference in the rate of drug resistance mutation of genotypes B and C between the two groups .Conclusions The detection rate of drug-resistant mutation was significantly lower in treatment with LAM combined with ECV than that in treatment with LAM .The treatment with only LAM or LAM combined with ECV had no effect on drug-resistant gene mutations of different HBV genotypes in pationts with CHB .