摘要
治疗慢性乙型肝炎(CHB)的关键是抗病毒,核苷和核苷酸类药物长时间抗病毒治疗过程中易导致病毒基因变异而产生耐药,致使病毒对药物敏感性下降。介绍了4种核苷和核苷酸类药物的耐药位点及耐药率,其中拉米夫定耐药率最高,恩替卡韦最低。新近研究表明,HBV基因分型与核苷和核苷酸类药物耐药有一定的相关性。为预防耐药,应严格掌握抗病毒适应证,选用高效低耐药药物。耐药后,可加用或换用没有交叉耐药的核苷和核苷酸类药物。
Antiviral treatment is the key in the treatment of chronic hepatitis B.The long-term antiviral therapy with nucleos（t）ide ana-logues may lead to the viral gene mutations and drug resistance,and then the sensitivity of virus to the drug is decreased.In this study,the point mutations associated with four nucleos（t）ide analogues and the incidence of mutations were investigated.The rate of drug resistance to lamivudine was highest and that of resistance to entecavir was lowest.Recent research showed that hepatitis B virus （HBV）genotype was as-sociated with drug resistance to nucleos（t）ide analogues.In order to prevent drug resistance,the indications for antiviral therapy should be determined strictly,and then the nucleos（t）ide analogues with high efficacy and low drug resistance can be selected.And if drug resistance develops,it is necessary to add or change to another nucleos（t）ide analogue without cross resistance.
出处
《临床肝胆病杂志》
CAS
2015年第4期611-613,共3页
Journal of Clinical Hepatology
基金
东莞市市级科技计划医疗卫生类科研项目(20131051010223)
关键词
肝炎
乙型
慢性
抗药性
核苷类
核苷酸类
基因型
综述
hepatitis B,chronic
drug resistance
nucleosides
nucleotides
genotype
review
