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目的评价阿德福韦酯治疗黎族慢性乙型肝炎(CHB)患者疗效与乙型肝炎病毒(HBV)基因型的关系。方法 42例HBeAg阳性、HBVDNA>105copies/ml、ALT>2倍正常值上线的黎族CHB患者,每天口服阿德福韦酯胶囊10mg,治疗48周。在治疗前及治疗后48周,动态观察HBeAg、HBVDNA和ALT的变化。结果 42例患者中,HBVC型是优势基因型(57.14%),其次为B型(38.10%),也有D型(2.38%)和C+D型混合感染(2.38%)的存在。经阿德福韦酯胶囊治疗48周后,B型患者HBeAg阴转率(37.50%)、病毒应答率(56.25%)和血清ALT复常率(62.50%)均高于C型的29.17%、50.00%和54.17%,但两组比较差异无统计学意义(P>0.05)。结论 HBVC型是海南岛黎族HBeAg阳性CHB患者的优势基因型,HBV基因型可能对阿德福韦酯的治疗效果无影响。
Objective To evaluate the efficacy of adefovir dipivoxil in the treatment of chronic hepatitis B (CHB) patients with hepatitis B virus (HBV) genotypes. Methods 42 cases of CHB patients with HBeAg positive, HBVDNA> 105copies / ml, ALT> 2 times normal on-line were given oral adefovir dipivoxil 10mg daily for 48 weeks. Changes of HBeAg, HBVDNA and ALT were observed before treatment and 48 weeks after treatment. Results Among the 42 patients, HBV genotype was the dominant genotype (57.14%), followed by type B (38.10%), with the presence of D (2.38%) and C + D mixed infections (2.38%). After 48 weeks of treatment with adefovir dipivoxil, the HBeAg negative conversion rate (37.50%), viral response rate (56.25%) and serum ALT normalization rate (62.50%) in type B patients were all higher than those in type C 29.17% 50.00% and 54.17% respectively, but there was no significant difference between the two groups (P> 0.05). Conclusion HBVC type is the predominant genotype of HBeAg-positive CHB patients in Li nationality of Hainan Island. HBV genotype may have no effect on the therapeutic effect of adefovir dipivoxil.