Lamivudine-resistance mutations can be selected even at very low levels of hepatitis B viraemia

Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
Valentina SvicherCarlo Federico Perno

Abstract

To investigate lamivudine (LAM)-resistance profiles of hepatitis B virus (HBV) at the early stages of virological breakthrough (serum HBV-DNA 12-345IU/ml) or when HBV-DNA is undetectable. Sixty-four HBV-mono-infected patients were enrolled: 25 had virological breakthrough with serum HBV-DNA ranging from 12 to 345IU/ml during first-line LAM-monotherapy; 24 were on LAM-monotherapy, and 15 were on LAM+adefovir dipivoxil (ADV) with undetectable serum HBV-DNA (<12IU/ml). HBV-reverse transcriptase was successfully sequenced in 22 (88.0%) LAM-treated patients with HBV-DNA between 12 and 345IU/ml, and in 12 (30.8%) patients receiving LAM (±ADV) with HBV-DNA<12IU/ml. Drug-resistance mutations were observed in 17 (77.2%) LAM-treated patients with virological breakthrough: 8 M204V, 7 M204I, 1 M204I/V, and 1 A181T. One or ≥2 compensatory mutations were found in 10 (58.8%) and in 4 (23.5%) patients. Drug-resistance mutations were present also in patients with undetectable serum HBV-DNA: M204I was detected in 2 patients receiving LAM-monotherapy, and V84M in 1 patient receiving LAM+ADV. Overall findings support the existence of drug-resistance mutations even at very low levels of viral replication. The persistence of low-level HBV replicatio...Continue Reading

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Citations

Nov 17, 2012·Journal of Medical Virology·Massimo CiccozziMarco Ciotti
Jul 17, 2019·Journal of Cellular Biochemistry·Fatima AmirSyed Naqui Kazim
Jun 3, 2018·BMC Infectious Diseases·Luna ColagrossiUNKNOWN HEPVIR working group of the European Society for translational antiviral research (ESAR)

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