The rate of hepatitis B virus resistance to adefovir dipivoxil (ADV) and the evolution of hepatitis B virus in lamivudine-resistant chronic hepatitis B patients with ADV monotherapy / 中华肝脏病杂志
Chinese Journal of Hepatology
; (12): 4-7, 2007.
Article
in Zh
| WPRIM
| ID: wpr-285493
Responsible library:
WPRO
ABSTRACT
<p><b>OBJECTIVE</b>To study the resistant rate of hepatitis B virus (HBV) to ADV and the dynamic evolution of HBV in lamivudine (Lam)-resistant chronic hepatitis B (CHB) patients.</p><p><b>METHODS</b>Twenty-three Lam-resistant CHB patients were assigned to a 10mg/d ADV monotherapy for 68-116 weeks. The baseline and different time point blood samples after ADV monotherapy were analyzed for ADV-resistant mutations using direct sequencing of PCR products; the evolution of HBV mutations was examined by clonal analysis of serial samples from one patient infected with ADV-associated resistant HBV strains.</p><p><b>RESULTS</b>The cumulative incidence of genotypic ADV resistance at weeks 48 and 96 was 4.3% and 10.5% respectively respectively. The evolution analysis of HBV mutant strains in an ADV-resistant CHB patient showed that the proportion of YMDD mutants gradually decreased with rtA181S mutants increasing over time after ADV monotherapy, and that rtA181S+N236T mutants became the predominant strains during prolonged ADV monotherapy. The addition of Lam to the ongoing ADV treatment had poorer antiviral response in the patient with rtA181S or rtA181S+N236T mutant infection; one clone with multi-drug resistant mutations was selected during Lam and ADV combination therapy.</p><p><b>CONCLUSION</b>Increased risk of adefovir resistance and selection of multi-drug resistant mutations are associated with long-term ADV monotherapy in patients with Lam-resistant chronic hepatitis B.</p>
Full text:
1
Index:
WPRIM
Main subject:
Antiviral Agents
/
Pharmacology
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Virology
/
Adenine
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Hepatitis B virus
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Classification
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Evolution, Molecular
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Lamivudine
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Hepatitis B, Chronic
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Drug Resistance, Viral
Limits:
Adult
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Female
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Humans
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Male
Language:
Zh
Journal:
Chinese Journal of Hepatology
Year:
2007
Type:
Article