Open AccessDetection of Mutations Resistant to Lamivudine or Adefovir in HBV and Its Management
Author(s) -
De-xing Jia,
Feng Jin,
Ping Li,
Xiu-ying Lun,
Xiaofei Yu
Publication year - 2013
Publication title -
infection international/infection international (electronic edition)
Language(s) - English
Resource type - Journals
eISSN - 2544-0349
pISSN - 2095-2244
DOI - 10.1515/ii-2017-0063
Subject(s) - adefovir , lamivudine , entecavir , virology , hepatitis b virus , drug resistance , chronic hepatitis , hepatitis b , mutation , medicine , resistance mutation , biology , reverse transcriptase , virus , genetics , polymerase chain reaction , gene
Objective Nucleos(t)ide analogues (NAs) naïve chronic hepatitis B(CHB) patients were given rescue combination therapy after drug resistance to lamivudine or adefovir. Evolution of HBV mutation patterns and its impact on antiviral effects were studied. Methods Total of 142 naïve CHB patients treated with lamivudine were randomly divided into two groups when lamivudine resistance occurred. One group was added with adefovir, the other was switched to entecavir and adefovir. Seventy-two naïve CHB patients treated with adefovir were randomly divided into two groups when adefovir resistance occurred. One group was added with lamivudine, the other was added with entecavir. HBV polymerase reverse transcriptase mutations associated with resistance were analyed before and after 48 weeks of rescue therapy, respectively. Results The mutation patterns of M204V/I, M204V+L180M were predominantly found in CHB patients after lamivudine resistance. Meanwhile, the entecavir resistance mutation patterns were also detected. Therefore, patients with lamivudine resistance could develop more diverse drug resistance mutations if they were switched to entecavir and adefovir. The mutation patterns of rtA181 were predominantly found in CHB patients after adefovir resistance and rescure therapy with add-on entecavir was more effective than with add-on lamivudine Conclusions Resistance mutation analysis chould help to choose NAs, reduce resistance and ehance antiviral effects.