Evolution of HBV polymerase gene as a result of adefovir dipivoxil treatment in liver transplant patients with lamivudine resistance / 解放军医学杂志

ABSTRACT

Objective To explore the evolution of HBV polymerase gene as a result of adefovir dipivoxil treatment in liver transplant patients with lamivudine resistance. Methods Eight patients with HBV reinfection which was lamivudine resistance received adefovir therapy (10mg/day). Sequential serum samples were obtained from 2 consecutive patients with adefovir failure, and the polymerase gene of HBV was amplified by PCR and TA cloned, and sequencing and analysis were performed in 10 random clones. Results Neither rtN236T nor A181V/T mutation, which were associated with adefovir (ADV) resistance, was found. The rtL180M mutation associated with lamivudine resistance presented before ADV treatment, and several previously unreported amino acid substitutions were observed in the reverse transcriptase domain. Conclusion Possibly, the rtL180M mutation in the B domain of HBV polymerase reduced the susceptibility to ADV. ADV resistance mutation may occur in other sites besides rtN236T and A181V/T amino acid substitutions or do not happen early after treatment.