我國(guó)慢性乙型肝炎患者

1、我國(guó)慢性乙型肝炎患者我國(guó)慢性乙型肝炎患者抗病毒治療的耐藥現(xiàn)狀抗病毒治療的耐藥現(xiàn)狀我國(guó)抗乙肝病毒治療我國(guó)抗乙肝病毒治療耐藥研究現(xiàn)狀耐藥研究現(xiàn)狀不同核苷(酸)類似物在HBV聚合酶基因的主要耐藥突變位點(diǎn)LVD 耐藥耐藥 rtA181T/V rtM204V/I /SADV 耐藥耐藥 rtA181T/V rtN236TETV 耐藥耐藥* rtS184G/AI/L/F/G rtS202G/ rtM250I/V/LLdT 耐藥耐藥 rtM204I TDF耐耐藥藥 rtA194T* 和和LVD-R突變同時(shí)突變同時(shí)845 a.a. 末端蛋白末端蛋白間隔區(qū)間隔區(qū)POL/RTRNaseHABCED 1183349

2、(rt1)692 (rt 344)YMDDF_V_LLAQ_I(G)II(F) 核苷類藥物在初治患者中的耐藥發(fā)生率核苷類藥物在初治患者中的耐藥發(fā)生率1. Tenney D, et al. APASL March 2326 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. E

3、ASL April 2006 2630; Vienna, Austria. Poster 514 (J Hepatology. 2006;44(suppl 2):S191). 5. Adapted from Lai C L, et al. AASLD, October 2731, 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 th

4、erapies 2008, Paris, France. Poster 5. 基因型基因型 ETVETV耐藥耐藥1 10 020204040606080801001001 12 23 34 4累計(jì)發(fā)生率累計(jì)發(fā)生率 (%)(%) 0.2%0.2%0.5%0.5%1.2%1.2%5 51.2%1.2%1.2%1.2%663663278278149149120120108108N=N=( (年年) )基因型基因型 LVDLVD耐藥耐藥2 21001000 020204040606080801 12 23 34 45 5發(fā)生率發(fā)生率(%)(%)NDND5858585858585858N=N=( (年年) )基因型基因型ADVADV耐藥耐藥3 30 03 31111181829290 020204040606080801001001 12 23 34 45 5累計(jì)發(fā)生率累計(jì)發(fā)生率 (%) (%) 183183134134NANANANA6060N=N=( (年年) )現(xiàn)有數(shù)據(jù) 非頭對(duì)頭研究0 02020404060608080100100Cumulative incidence (%)Cumulative incidence (%)因基因型因基因型LdTLdT耐藥導(dǎo)致病毒突破耐藥導(dǎo)致病毒突破4,54,54 422223 39 91 12 23 34