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1.
Braz. j. infect. dis ; 19(3): 291-295, May-Jun/2015. tab, graf
Artículo en Inglés | LILACS | ID: lil-751886

RESUMEN

Background: Research has shown that hepatitis B virus (HBV) genotypes are closely linked to the clinical manifestations, treatment, and prognosis of the disease. Objective: To study the association between genotype and drug-resistant HBV mutations in 620 Chinese patients with chronic HBV infection. Methods: HBV DNA levels were determined using real-time quantitative PCR in plasma samples. Microarrays were performed for the simultaneous detection of HBV genotypes (HBV/B, C, and D) and drug-resistance-related hotspot mutations. A portion of the samples analyzed using microarrays was selected randomly and the data were confirmed using direct DNA sequencing. Results: Most samples were genotype C (471/620; 76.0%), followed by genotype B (149/620; 24.0%). Among the 620 patient samples, 17 (2.7%) had nucleotide analogs (NA) resistance-related mutations. Of these, nine and eight patients carried lamivudine (LAM)-/telbivudine (LdT)-resistance mutations (rtL180M, rtM204I/V) and adefovir (ADV)-resistance mutations (rtA181T/V, rtN236T), respectively. No patients had both lamivudine (LAM)- and either ade-fovir (ADV) or entecavir (ETV) resistance mutations. Additionally, out of the 620 patient samples, 64.0% (397/620) were also detected with the precore stop-codon mutation (G1896A) by microarray assay. Conclusion: The results of the current study revealed that the prevalence of nucleotide analogs (NA)-resistance in Chinese hospitalized HBV-positive patients was so low that intensive nucleotide analogs (NA)-resistance testing before nucleotide analog (NA) treatment might not be required. In addition, the present study suggests that chronic HBV patients with genotype C were infected with fitter viruses and had an increased prevalence of nucleotide analogs (NA)-resistance mutations compared to genotype B virus. .


Asunto(s)
Adulto , Femenino , Humanos , Masculino , Antivirales/administración & dosificación , Farmacorresistencia Viral/genética , Virus de la Hepatitis B/genética , Hepatitis B Crónica/virología , Mutación , Pueblo Asiatico , Adenina/administración & dosificación , Adenina/análogos & derivados , ADN Viral/genética , Genotipo , Guanina/administración & dosificación , Guanina/análogos & derivados , Virus de la Hepatitis B/efectos de los fármacos , Hepatitis B Crónica/tratamiento farmacológico , Lamivudine/administración & dosificación , Análisis por Micromatrices , Organofosfonatos/administración & dosificación , Pronóstico , Análisis de Secuencia de ADN , Timidina/administración & dosificación , Timidina/análogos & derivados
2.
Gut and Liver ; : 776-783, 2015.
Artículo en Inglés | WPRIM | ID: wpr-67326

RESUMEN

BACKGROUND/AIMS: The aim of this study was to evaluate the estimated glomerular filtration rate (eGFR) during telbivudine (LdT) versus entecavir (ETV) treatment in chronic hepatitis B (CHB) patients with underlying comorbidities such as diabetes mellitus (DM), hypertension, and cirrhosis. METHODS: From 2010 to 2012, 116 CHB patients treated with LdT and 578 treated with ETV were compared in this real-practice cohort. The mean changes in eGFR (Modification of Diet in Renal Disease [MDRD] formula) from baseline to months 6, 12, and 18 were analyzed using a linear mixed model. RESULTS: In LdT-treated patients, the mean eGFR increased by 7.6% at month 18 compared with the eGFR at baseline (MDRD formula in mL/min/1.73 m2). However, in ETV-treated patients, the mean eGFR decreased by 4.1% at month 18 compared with the eGFR at baseline. In the LdT-treated patients with DM, hypertension, cirrhosis or low eGFR <90 mL/min/1.73 m2, the mean eGFR showed a steady improvement, whereas the mean eGFR was reduced in the same subgroups of ETV-treated patients. CONCLUSIONS: The eGFR gradually increased over time during LdT treatment, especially in patients with mild abnormal eGFR at baseline, and in those with DM, hypertension, and cirrhosis, whereas a reduction in eGFR was seen with ETV treatment.


Asunto(s)
Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Antivirales/administración & dosificación , Complicaciones de la Diabetes , Diabetes Mellitus , Esquema de Medicación , Fibrosis/complicaciones , Tasa de Filtración Glomerular/efectos de los fármacos , Guanina/administración & dosificación , Hepatitis B Crónica/complicaciones , Hipertensión/complicaciones , Modelos Lineales , Timidina/administración & dosificación , Factores de Tiempo , Resultado del Tratamiento
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