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我国慢性乙型肝炎患者 抗病毒治疗的耐药现状

我国慢性乙型肝炎患者 抗病毒治疗的耐药现状. 我国抗乙肝病毒治疗 耐药研究现状. 不同核苷 ( 酸 ) 类似物 在 HBV 聚合酶基因的主要耐药突变位点. 末端蛋白. POL/RT. 间隔区. RNaseH. 1. 845 a.a. 183. 349 (rt1). 692 (rt 344). E. II(F). A. B. C. D. I(G). YMDD. F__V__LLAQ__. L VD 耐药 rtA181T/V rtM204V/I /S

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我国慢性乙型肝炎患者 抗病毒治疗的耐药现状

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  1. 我国慢性乙型肝炎患者 抗病毒治疗的耐药现状

  2. 我国抗乙肝病毒治疗 耐药研究现状

  3. 不同核苷(酸)类似物在HBV聚合酶基因的主要耐药突变位点不同核苷(酸)类似物在HBV聚合酶基因的主要耐药突变位点 末端蛋白 POL/RT 间隔区 RNaseH 1 845 a.a. 183 349 (rt1) 692 (rt 344) E II(F) A B C D I(G) YMDD F__V__LLAQ__ LVD耐药 rtA181T/V rtM204V/I /S ADV 耐药rtA181T/V rtN236T ETV 耐药* rtS184G/AI/L/F/GrtS202G/ rtM250I/V/L LdT 耐药rtM204I TDF耐药 rtA194T * 和LVD-R突变同时

  4. 核苷类药物在初治患者中的耐药发生率 基因型 LVD耐药2 100 HBeAg(+) 患者 80 67 60 57 发生率(%) 40 40 17 20 ND 0 N= 58 58 58 58 (年) 1 2 3 4 5 100 100 基因型ADV耐药3 因基因型LdT耐药导致病毒突破4,5 80 80 HBeAg(-)患者 60 60 HBeAg(+) HBeAg(-) 累计发生率 (%) Cumulative incidence (%) 40 40 29 22 18 20 11 20 9 3 4 3 0 ND ND ND 0 0 N= 183 134 NA NA 60 N= 458 222 458 222 (年) (年) 1 2 3 4 5 1 2 3 4 5 现有数据 – 非头对头研究 基因型 ETV耐药1 100 HBeAg(+) 和 (-)患者 80 60 累计发生率 (%) 40 20 0.2% 0.5% 1.2% 1.2% 1.2% 0 N= 663 278 149 120 108 (年) 1 2 3 4 5 TDF：没有治疗超过48周基因型耐药的数据6 1. Tenney D, et al. APASL March 23–26 2008; Seoul, Korea Oral PL02. 2. Chang TT, et al. J Gastroenterol Hepatol 2004;19:1276-82; 3. Hadziyannis S, et al. Gastroenterology 2006;131:1743-51; 4. Adapted from Standring DN, et al. EASL April 2006 26–30; Vienna, Austria. Poster 514 (J Hepatology. 2006;44(suppl 2):S191). 5. Adapted from Lai C L, et al. AASLD, October 27–31, 2006, Boston, USA. Abstract 91 (Hepatology 2006; 44(4 suppl 1):222A). 6. Adapted from Snow-Lampart A, et al. Hepatitis B and C virus resistance to antiviral therapies 2008, Paris, France. Poster 5.

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