Objective:To investigate the diffrences ofcurative effect of nucleoside medicineand interferon on hepatitis B with different genes and mutation. Methods:Four hundreds and thirty-one cases of hepatitis B were underwent the genotyped and gene mutation detection, and then divided into interferongroup (n=216) and nucleosidegroup (n=215)according to the treatment method. After 48 weeks the curative effect and treatment response rate were compared between the two groups.Results:There were 292 cases (67.75%) of HBV-B and 139 (32.25%) cases of HBV-C. There were 13 cases of primary resistance mutation and 63 cases of secondary resistance gene mutation. After 48 weeks of treatment,the normalization rate of ALT and the negative rate of HBV-DNA in nucleoside group were higher than those in interferon group (P<0.01), HBeAg negative rate, HBeAg conversion rate were lower than those in interferon group (P<0.01).HBV-B and HBV-C type patients response rate has no significant difference (P>0.05) in nucleotide group. There was no significant difference among the primary, secondary and non-mutated patients (P<0.01). In the interferon group, the treatment response rate of the HBV-B patients was significantly higher than that of HBV-C patients (P<0.05).There was no significant difference among the primary, secondary and non-mutated patients (all P>0.05). Conclusion:The treatment of Hepatitis B should be based on the patient's genotyping and gene mutation to select drugs rationally. At the same time, the drug resistance genes should be monitored. Whenresistance caused bygene mutation happens, the treatment plan should be adjusted as soon as possible to obtain the best treatment effect. |
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