丙型肝炎病毒(hepatitis C virus,HCV)是单股RNA病毒,在药物压力下极易变异。近年来,随着直接作用的抗病毒药物(direct-acting antiviral agents,DAA)的临床应用和更新换代,丙肝患者的持续病毒应答率(sustained virological response,SVR)大大提高。然而,DAA压力下产生的耐药相关变异株(resistance associated variants,RAV)也不断出现并被选择出来,严重影响DAA治疗效果或致治疗失败及耐药株流行。介绍了DAA相关耐药基因产生的来源与分类,并总结了近年来相关耐药突变的数据。 Hepatitis C virus (HCV) is a single-stranded RNA virus that mutates easily under drug stress. In recent years, the sustained virological response (SVR) of patients with hepatitis C has been greatly increased with the direct application and replacement of direct-acting antiviral agents (DAA). However, the resistance-associated variants (RAVs) produced under DAA stress are also emerging and being selected, which seriously affect the efficacy of DAA or cause failure of treatment and the spread of drug-resistant strains. The sources and classification of DAA related resistance genes were introduced, and the data of related resistance mutations in recent years were summarized.